IDEAS home Printed from https://ideas.repec.org/p/hhs/bergec/2009_007.html
   My bibliography  Save this paper

Prioritization and patients' rights: Analysing the effect of a reform in the Norwegian Hospital Sector

Author

Listed:

Abstract

The right to equal treatment, irrespective of age, gender, ethnicity, socio-economic status and place of resident, is an important principle for several health care systems. A reform of the Norwegian hospital sector may be used as a relevant experiment for investigating whether centralization of ownership and management structures will lead to more equal prioritization practices over geographical regions. One concern was variation in waiting times across thecountry. The reform was followed up in subsequent years by some other policy initiatives that also aimed at reducing waiting lists. Prioritization practice is measured by a method that takes departure in recommended maximum waiting times from medical guidelines. We merge the information from the guidelines with individual patient data on actual waiting times. This way we can monitor whether each patient in the available register of actual hospital visits has waited shorter or longer than what is considered medically acceptable by the guideline. The results indicate no equalisation between the five new health regions, but we find evidence of more equal prioritization within four of the health regions. Our method of measuring prioritizations allows us to analyse how prioritization practice evolved over time after the reform, thus covering some further initiatives with the same objective. The results indicate that an observed reduction in waiting times after the reform have favoured patients of lower prioritization status, something we interpret as a general worsening of prioritization practices over time.

Suggested Citation

  • Askildsen, Jan Erik & Holmås, Tor Helge & Kaarbøe, Oddvar, 2009. "Prioritization and patients' rights: Analysing the effect of a reform in the Norwegian Hospital Sector," Working Papers in Economics 07/09, University of Bergen, Department of Economics.
  • Handle: RePEc:hhs:bergec:2009_007
    as

    Download full text from publisher

    File URL: http://www.uib.no/filearchive/wp0709_1.pdf
    Download Restriction: no

    Other versions of this item:

    References listed on IDEAS

    as
    1. Siciliani, Luigi & Hurst, Jeremy, 2005. "Tackling excessive waiting times for elective surgery: a comparative analysis of policies in 12 OECD countries," Health Policy, Elsevier, vol. 72(2), pages 201-215, May.
    2. Trond E. Olsen, 1996. "Agency Costs and the Limits of Integration," RAND Journal of Economics, The RAND Corporation, vol. 27(3), pages 479-501, Autumn.
    3. Magnussen, Jon & Hagen, Terje P. & Kaarboe, Oddvar M., 2007. "Centralized or decentralized? A case study of Norwegian hospital reform," Social Science & Medicine, Elsevier, vol. 64(10), pages 2129-2137, May.
    4. Hugh Gravelle & Luigi Siciliani, 2008. "Is waiting-time prioritisation welfare improving?," Health Economics, John Wiley & Sons, Ltd., vol. 17(2), pages 167-184.
    5. Hagen, Terje P. & Kaarboe, Oddvar M., 2006. "The Norwegian hospital reform of 2002: Central government takes over ownership of public hospitals," Health Policy, Elsevier, vol. 76(3), pages 320-333, May.
    6. Sofia Dimakou & David Parkin & Nancy Devlin & John Appleby, 2009. "Identifying the impact of government targets on waiting times in the NHS," Health Care Management Science, Springer, vol. 12(1), pages 1-10, March.
    7. Vrangbæk, Karsten & Østergren, Katarina & Birk, Hans Okkels & Winblad, Ulrika, 2007. "Patient reactions to hospital choice in Norway, Denmark, and Sweden," Health Economics, Policy and Law, Cambridge University Press, vol. 2(02), pages 125-152, April.
    8. Daniels, Norman & Sabin, James E., 2002. "Setting Limits Fairly: Can we learn to share medical resources?," OUP Catalogue, Oxford University Press, number 9780195149364.
    9. Arnesen, Kjell E. & Erikssen, Jan & Stavem, Knut, 2002. "Gender and socioeconomic status as determinants of waiting time for inpatient surgery in a system with implicit queue management," Health Policy, Elsevier, vol. 62(3), pages 329-341, December.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Carlsen, Fredrik & Kaarboe, Oddvar Martin, 2015. "The relationship between educational attainment and waiting time among the elderly in Norway," Health Policy, Elsevier, vol. 119(11), pages 1450-1458.
    2. Carlsen, Fredrik & Kaarboe, Oddvar M., 2010. "Norwegian priority guidelines: Estimating the distributional implications across age, gender and SES," Health Policy, Elsevier, vol. 95(2-3), pages 264-270, May.
    3. Gutacker, Nils & Siciliani, Luigi & Cookson, Richard, 2016. "Waiting time prioritisation: Evidence from England," Social Science & Medicine, Elsevier, vol. 159(C), pages 140-151.
    4. Oddvar Kaarboe & Fredrik Carlsen, 2014. "Waiting Times And Socioeconomic Status. Evidence From Norway," Health Economics, John Wiley & Sons, Ltd., vol. 23(1), pages 93-107, January.
    5. Januleviciute, Jurgita & Askildsen, Jan Erik & Kaarboe, Oddvar & Holmås, Tor Helge & Sutton, Matt, 2013. "The impact of different prioritisation policies on waiting times: Case studies of Norway and Scotland," Social Science & Medicine, Elsevier, vol. 97(C), pages 1-6.
    6. Johar, Meliyanni & Jones, Glenn & Keane, Micheal P. & Savage, Elizabeth & Stavrunova, Olena, 2013. "Discrimination in a universal health system: Explaining socioeconomic waiting time gaps," Journal of Health Economics, Elsevier, vol. 32(1), pages 181-194.
    7. Aakvik, Arild & Holmås, Tor Helge & Kjerstad, Egil, 2015. "Prioritization and the elusive effect on welfare – A Norwegian health care reform revisited," Social Science & Medicine, Elsevier, vol. 128(C), pages 290-300.
    8. Johar, Meliyanni & Jones, Glenn & Keane, Micheal P. & Savage, Elizabeth & Stavrunova, Olena, 2013. "Discrimination in a universal health system: Explaining socioeconomic waiting time gaps," Journal of Health Economics, Elsevier, vol. 32(1), pages 181-194.

    More about this item

    Keywords

    Prioritization; waiting time; hospital reform;

    JEL classification:

    • I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:hhs:bergec:2009_007. See general information about how to correct material in RePEc.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: (Kjell Erik Lommerud). General contact details of provider: http://edirc.repec.org/data/iouibno.html .

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service hosted by the Research Division of the Federal Reserve Bank of St. Louis . RePEc uses bibliographic data supplied by the respective publishers.