IDEAS home Printed from https://ideas.repec.org/p/nuf/econwp/1504.html
   My bibliography  Save this paper

The Effects of Immigration on NHS Waiting Times

Author

Listed:
  • Osea Giuntella

    (University of Oxford, IZA)

  • Catia Nicodemo

    (University of Oxford, CHSEO, IZA)

  • Carlos Vargas Silva

    (University of Oxford, COMPAS)

Abstract

This paper analyzes the effects of immigration on access to health care in England. Linking administrative records from the Hospital Episode Statistics (2003-2012) with immigration data drawn from the UK Labor Force Survey, we analyze how immigrant inflows affected waiting times in the National Health Service. We find that immigration reduced waiting times for outpatient referrals and did not have significant effects on waiting times in Accident and Emergency (A&E) and elective care. However, there is evidence that immigration increased waiting times for outpatient referrals in more deprived areas outside London. These effects are concentrated in the years immediately following the 2004 EU enlargement and vanish in the medium-run (e.g., 3 to 4 years). Our findings suggest that these regional disparities are explained by both differences in the health status of immigrants moving into different local authorities and in natives’ internal mobility across local authorities.

Suggested Citation

  • Osea Giuntella & Catia Nicodemo & Carlos Vargas Silva, 2015. "The Effects of Immigration on NHS Waiting Times," Economics Papers 2015-W04, Economics Group, Nuffield College, University of Oxford.
  • Handle: RePEc:nuf:econwp:1504
    as

    Download full text from publisher

    File URL: http://www.nuffield.ox.ac.uk/economics/papers/2015/giunt_nic_silva2015.pdf
    Download Restriction: no
    ---><---

    Other versions of this item:

    References listed on IDEAS

    as
    1. Nils Gutacker & Luigi Siciliani & Giuseppe Moscelli & Hugh Gravelle, 2015. "Do patients choose hospitals that improve their health?," Working Papers 111cherp, Centre for Health Economics, University of York.
    2. Timothy J. Hatton & Massimiliano Tani, 2005. "Immigration and Inter-Regional Mobility in the UK, 1982-2000," Economic Journal, Royal Economic Society, vol. 115(507), pages 342-358, November.
    3. Giuntella, Osea, 2013. "Why Does the Health of Immigrants Deteriorate? Evidence from Birth Records," IZA Discussion Papers 7588, Institute of Labor Economics (IZA).
    4. Christian Dustmann & Tommaso Frattini & Caroline Halls, 2010. "Assessing the Fiscal Costs and Benefits of A8 Migration to the UK," Fiscal Studies, Institute for Fiscal Studies, vol. 31(1), pages 1-41, March.
    5. Martin Gaynor & Carol Propper & Stephan Seiler, 2012. "Free to Choose? Reform and Demand Response in the English National Health Service," CEP Discussion Papers dp1179, Centre for Economic Performance, LSE.
    6. Mette Foged & Giovanni Peri, 2016. "Immigrants' Effect on Native Workers: New Analysis on Longitudinal Data," American Economic Journal: Applied Economics, American Economic Association, vol. 8(2), pages 1-34, April.
    7. Norman, Paul & Boyle, Paul & Rees, Philip, 2005. "Selective migration, health and deprivation: a longitudinal analysis," Social Science & Medicine, Elsevier, vol. 60(12), pages 2755-2771, June.
    8. Gaynor, Martin & Laudicella, Mauro & Propper, Carol, 2012. "Can governments do it better? Merger mania and hospital outcomes in the English NHS," Journal of Health Economics, Elsevier, vol. 31(3), pages 528-543.
    9. Borjas, George J & Freeman, Richard B & Katz, Lawrence, 1996. "Searching for the Effect of Immigration on the Labor Market," American Economic Review, American Economic Association, vol. 86(2), pages 246-251, May.
    10. Pia M. Orrenius & Madeline Zavodny, 2015. "Does Immigration Affect Whether US Natives Major in Science and Engineering?," Journal of Labor Economics, University of Chicago Press, vol. 33(S1), pages 79-108.
    11. Propper Carol & Sutton Matt & Whitnall Carolyn & Windmeijer Frank, 2008. "Did 'Targets and Terror' Reduce Waiting Times in England for Hospital Care?," The B.E. Journal of Economic Analysis & Policy, De Gruyter, vol. 8(2), pages 1-27, January.
    12. Carol Propper, 1995. "The Disutility of Time Spent on the United Kingdom's National Health Service Waiting Lists," Journal of Human Resources, University of Wisconsin Press, vol. 30(4), pages 677-700.
    13. Walter Beckert & Mette Christensen & Kate Collyer, 2012. "Choice of NHS‐funded Hospital Services in England," Economic Journal, Royal Economic Society, vol. 122(560), pages 400-417, May.
    14. Jonathan Wadsworth, 2013. "Mustn't Grumble: Immigration, Health and Health Service Use in the UK and Germany," Fiscal Studies, Institute for Fiscal Studies, vol. 34(1), pages 55-82, March.
    15. Laudicella, Mauro & Siciliani, Luigi & Cookson, Richard, 2012. "Waiting times and socioeconomic status: Evidence from England," Social Science & Medicine, Elsevier, vol. 74(9), pages 1331-1341.
    16. Joseph G. Altonji & David Card, 1991. "The Effects of Immigration on the Labor Market Outcomes of Less-skilled Natives," NBER Chapters, in: Immigration, Trade, and the Labor Market, pages 201-234, National Bureau of Economic Research, Inc.
    17. Laura Jaitman & Stephen Machin, 2013. "Crime and immigration: new evidence from England and Wales," IZA Journal of Migration and Development, Springer;Forschungsinstitut zur Zukunft der Arbeit GmbH (IZA), vol. 2(1), pages 1-23, December.
    18. Giuntella, Osea & Mazzonna, Fabrizio, 2015. "Do immigrants improve the health of natives?," Journal of Health Economics, Elsevier, vol. 43(C), pages 140-153.
    19. Castelli, Adriana & Dawson, Diane & Gravelle, Hugh & Jacobs, Rowena & Kind, Paul & Loveridge, Pete & Martin, Stephen & O'Mahony, Mary & Stevens, Philip Andrew & Stokes, Lucy & Street, Andrew & Weale, , 2007. "A New Approach to Measuring Health System Output and Productivity," National Institute Economic Review, Cambridge University Press, vol. 200, pages 105-117, April.
    20. Christopher J. Ruhm, 2000. "Are Recessions Good for Your Health?," The Quarterly Journal of Economics, Oxford University Press, vol. 115(2), pages 617-650.
    21. George J. Borjas, 2006. "Native Internal Migration and the Labor Market Impact of Immigration," Journal of Human Resources, University of Wisconsin Press, vol. 41(2).
    22. Christian Dustmann & Tommaso Frattini & Ian P. Preston, 2013. "The Effect of Immigration along the Distribution of Wages," Review of Economic Studies, Oxford University Press, vol. 80(1), pages 145-173.
    23. Paolo Lucchino & Dr Chiara Rosazza Bondibene & Jonathan Portes, 2012. "Examining the relationship between immigration and unemployment using National Insurance Number registration data," National Institute of Economic and Social Research (NIESR) Discussion Papers 386, National Institute of Economic and Social Research.
    24. Abdurrahman Aydemir & George J. Borjas, 2011. "Attenuation Bias in Measuring the Wage Impact of Immigration," Journal of Labor Economics, University of Chicago Press, vol. 29(1), pages 69-113, January.
    25. Sitzia, John & Wood, Neil, 1997. "Patient satisfaction: A review of issues and concepts," Social Science & Medicine, Elsevier, vol. 45(12), pages 1829-1843, December.
    26. Cullis, John G. & Jones, Philip R. & Propper, Carol, 2000. "Waiting lists and medical treatment: Analysis and policies," Handbook of Health Economics, in: A. J. Culyer & J. P. Newhouse (ed.), Handbook of Health Economics, edition 1, volume 1, chapter 23, pages 1201-1249, Elsevier.
    27. Martin, Stephen & Rice, Nigel & Jacobs, Rowena & Smith, Peter, 2007. "The market for elective surgery: Joint estimation of supply and demand," Journal of Health Economics, Elsevier, vol. 26(2), pages 263-285, March.
    28. Card, David, 2001. "Immigrant Inflows, Native Outflows, and the Local Labor Market Impacts of Higher Immigration," Journal of Labor Economics, University of Chicago Press, vol. 19(1), pages 22-64, January.
    29. Paolo Lucchino & Dr Chiara Rosazza Bondibene & Jonathan Portes, 2012. "Examining the relationship between immigration and unemployment using National Insurance Number registration data," National Institute of Economic and Social Research (NIESR) Discussion Papers 386, National Institute of Economic and Social Research.
    30. Steven Kennedy & James Ted McDonald & Nicholas Biddle, 2006. "The Healthy Immigrant Effect and Immigrant Selection: Evidence from Four Countries," Social and Economic Dimensions of an Aging Population Research Papers 164, McMaster University.
    31. Carol Propper & Simon Burgess & Denise Gossage, 2008. "Competition and Quality: Evidence from the NHS Internal Market 1991–9," Economic Journal, Royal Economic Society, vol. 118(525), pages 138-170, January.
    32. Hugh Gravelle & Peter C. Smith & Ana Xavier, "undated". "Waiting Times and Waiting Lists: A Model of the Market for Elective Surgery," Discussion Papers 00/27, Department of Economics, University of York.
    33. Christian Dustmann & Tommaso Frattini, 2014. "The Fiscal Effects of Immigration to the UK," Economic Journal, Royal Economic Society, vol. 124(580), pages 593-643, November.
    34. Brian Bell & Francesco Fasani & Stephen Machin, 2013. "Crime and Immigration: Evidence from Large Immigrant Waves," The Review of Economics and Statistics, MIT Press, vol. 95(4), pages 1278-1290, October.
    35. Frank Windmeijer & Hugh Gravelle & Pierre Hoonhout, 2005. "Waiting lists, waiting times and admissions: an empirical analysis at hospital and general practice level," Health Economics, John Wiley & Sons, Ltd., vol. 14(9), pages 971-985, September.
    36. repec:ecj:econjl:v:122:y:2012:i::p:400-417 is not listed on IDEAS
    37. Barry R. Chiswick & Yew Liang Lee & Paul W. Miller, 2008. "Immigrant Selection Systems And Immigrant Health," Contemporary Economic Policy, Western Economic Association International, vol. 26(4), pages 555-578, October.
    38. George J. Borjas, 2003. "The Labor Demand Curve is Downward Sloping: Reexamining the Impact of Immigration on the Labor Market," The Quarterly Journal of Economics, Oxford University Press, vol. 118(4), pages 1335-1374.
    39. Luigi Siciliani & Tor Iversen, 2012. "Waiting Times and Waiting Lists," Chapters, in: Andrew M. Jones (ed.), The Elgar Companion to Health Economics, Second Edition, chapter 24, Edward Elgar Publishing.
    40. Lindsay, Cotton M & Feigenbaum, Bernard, 1984. "Rationing by Waiting Lists," American Economic Review, American Economic Association, vol. 74(3), pages 404-417, June.
    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. Fetzer, Thiemo & Kyburz, Stephan, 2018. "Cohesive Institutions and Political Violence," The Warwick Economics Research Paper Series (TWERPS) 1166, University of Warwick, Department of Economics.
    2. Menghua Li & Yun Zhou & Xinjie Shi, 2021. "Who Will Care for Middle Aged and Elderly Parents in Rural China?," China & World Economy, Institute of World Economics and Politics, Chinese Academy of Social Sciences, vol. 29(2), pages 123-150, March.
    3. Osea Giuntella & Fabrizio Mazzonna & Catia Nicodemo & Carlos Vargas-Silva, 2019. "Immigration and the reallocation of work health risks," Journal of Population Economics, Springer;European Society for Population Economics, vol. 32(3), pages 1009-1042, July.
    4. Sascha O. Becker & Thiemo Fetzer, 2018. "Has Eastern European Migration Impacted UK-born Workers?," CAGE Online Working Paper Series 376, Competitive Advantage in the Global Economy (CAGE).
    5. Nicodemo, Catia & Raya, Josep M., 2018. "Does Juan Carlos or Nelson Obtain a Larger Price Cut in the Spanish Housing Market?," IZA Discussion Papers 11811, Institute of Labor Economics (IZA).
    6. Bruna Morais Guidetti & Paula Carvalho Pereda, Edson Roberto Severnini, 2021. "Health Shocks under Hospital Capacity Constraints: Evidence from Air Pollution in São Paulo, Brazil," Working Papers, Department of Economics 2021_05, University of São Paulo (FEA-USP).
    7. Lonsky, Jakub, 2020. "Does Immigration Decrease Far-Right Popularity? Evidence from Finnish Municipalities," GLO Discussion Paper Series 540, Global Labor Organization (GLO).
    8. Papageorgiou, Athanasios, 2018. "The Effect of Immigration on the Well-Being of Native Populations: Evidence from the United Kingdom," MPRA Paper 93045, University Library of Munich, Germany.
    9. Guidetti, Bruna & Pereda, Paula & Severnini, Edson R., 2020. "Health Shocks under Hospital Capacity Constraint: Evidence from Air Pollution in Sao Paulo, Brazil," IZA Discussion Papers 13211, Institute of Labor Economics (IZA).
    10. Bettin, Giulia & Sacchi, Agnese, 2020. "Health spending in Italy: The impact of immigrants," European Journal of Political Economy, Elsevier, vol. 65(C).
    11. Jakub Lonsky, 0. "Does immigration decrease far-right popularity? Evidence from Finnish municipalities," Journal of Population Economics, Springer;European Society for Population Economics, vol. 0, pages 1-43.
    12. repec:cep:spccrr:spdorp03 is not listed on IDEAS
    13. Rezwanul Hasan Rana & Khorshed Alam & Jeff Gow, 2020. "The Impact of Immigration on Public and Out-of-Pocket Health Expenditure in OECD Countries," Journal of International Migration and Integration, Springer, vol. 21(2), pages 485-508, June.
    14. Jakub Lonsky, 2021. "Does immigration decrease far-right popularity? Evidence from Finnish municipalities," Journal of Population Economics, Springer;European Society for Population Economics, vol. 34(1), pages 97-139, January.
    15. Stewart, Kitty & Cooper, Kerris & Shutes, Isabel, 2020. "What will ‘taking back control’ mean for social policy in the UK? Brexit, public services and social rights," LSE Research Online Documents on Economics 105183, London School of Economics and Political Science, LSE Library.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Osea Giuntella & Fabrizio Mazzonna & Catia Nicodemo & Carlos Vargas-Silva, 2019. "Immigration and the reallocation of work health risks," Journal of Population Economics, Springer;European Society for Population Economics, vol. 32(3), pages 1009-1042, July.
    2. Bond, Timothy N. & Giuntella, Osea & Lonsky, Jakub, 2020. "Immigration and Work Schedules: Theory and Evidence," IZA Discussion Papers 13236, Institute of Labor Economics (IZA).
    3. Aydemir, Abdurrahman B. & Kırdar, Murat G., 2017. "Quasi-experimental impact estimates of immigrant labor supply shocks: The role of treatment and comparison group matching and relative skill composition," European Economic Review, Elsevier, vol. 98(C), pages 282-315.
    4. Papageorgiou, Athanasios, 2018. "The Effect of Immigration on the Well-Being of Native Populations: Evidence from the United Kingdom," MPRA Paper 93045, University Library of Munich, Germany.
    5. Bettin, Giulia & Sacchi, Agnese, 2020. "Health spending in Italy: The impact of immigrants," European Journal of Political Economy, Elsevier, vol. 65(C).
    6. Jaeger, David A & Ruist, Joakim & Stuhler, Jan, 2018. "Shift-Share Instruments and the Impact of Immigration," CEPR Discussion Papers 12701, C.E.P.R. Discussion Papers.
    7. Giuntella, Osea & Mazzonna, Fabrizio, 2015. "Do immigrants improve the health of natives?," Journal of Health Economics, Elsevier, vol. 43(C), pages 140-153.
    8. Fetzer, Thiemo & Kyburz, Stephan, 2018. "Cohesive Institutions and Political Violence," The Warwick Economics Research Paper Series (TWERPS) 1166, University of Warwick, Department of Economics.
    9. Sascha O. Becker & Thiemo Fetzer, 2018. "Has Eastern European Migration Impacted UK-born Workers?," CAGE Online Working Paper Series 376, Competitive Advantage in the Global Economy (CAGE).
    10. Edo, Anthony & Rapoport, Hillel, 2019. "Minimum wages and the labor market effects of immigration," Labour Economics, Elsevier, vol. 61(C).
    11. Borjas, George J. & Edo, Anthony, 2021. "Gender, Selection into Employment, and the Wage Impact of Immigration," IZA Discussion Papers 14261, Institute of Labor Economics (IZA).
    12. Simonetta Longhi & Peter Nijkamp & Jacques Poot, 2009. "Regional Economic Impacts of Immigration: A Review," Tinbergen Institute Discussion Papers 09-047/3, Tinbergen Institute, revised 23 Jul 2009.
    13. Gutacker, Nils & Siciliani, Luigi & Cookson, Richard, 2016. "Waiting time prioritisation: Evidence from England," Social Science & Medicine, Elsevier, vol. 159(C), pages 140-151.
    14. Ottaviano, Gianmarco I.P. & Peri, Giovanni & Wright, Greg C., 2018. "Immigration, trade and productivity in services: Evidence from U.K. firms," Journal of International Economics, Elsevier, vol. 112(C), pages 88-108.
    15. Rosa Sanchis-Guarner, 2017. "Decomposing the impact of immigration on house prices," Working Papers 2017/14, Institut d'Economia de Barcelona (IEB).
    16. Gray, Rowena & Montresor, Giulia & Wright, Greg C., 2020. "Processing immigration shocks: Firm responses on the innovation margin," Journal of International Economics, Elsevier, vol. 126(C).
    17. Ortega, Javier & Verdugo, Gregory, 2016. "Moving Up or Down? Immigration and the Selection of Natives across Occupations and Locations," IZA Discussion Papers 10303, Institute of Labor Economics (IZA).
    18. Peter Howley & Muhammad Waqas & Mirko Moro & Liam Delaney & Tony Heron, 2020. "It’s Not All about the Economy Stupid! Immigration and Subjective Well-Being in England," Work, Employment & Society, British Sociological Association, vol. 34(5), pages 919-936, October.
    19. Lonsky, Jakub, 2020. "Does Immigration Decrease Far-Right Popularity? Evidence from Finnish Municipalities," GLO Discussion Paper Series 540, Global Labor Organization (GLO).
    20. Ortega, J. & Verdugo, G., 2015. "The Impact of Immigration on the Local Labor Market Outcomes of Blue Collar Workers: Panel Data Evidence," Working Papers 15/07, Department of Economics, City University London.

    More about this item

    Keywords

    Immigration; waiting times; access to health care; welfare;
    All these keywords.

    JEL classification:

    • I10 - Health, Education, and Welfare - - Health - - - General
    • J61 - Labor and Demographic Economics - - Mobility, Unemployment, Vacancies, and Immigrant Workers - - - Geographic Labor Mobility; Immigrant Workers

    NEP fields

    This paper has been announced in the following NEP Reports:

    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:nuf:econwp:1504. 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: . General contact details of provider: https://www.nuffield.ox.ac.uk/economics/ .

    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 bibliographic 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.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Maxine Collett (email available below). General contact details of provider: https://www.nuffield.ox.ac.uk/economics/ .

    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.