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Measuring and Comparing Health Care Waiting Times in OECD Countries


  • Luigi Siciliani

    (University of York)

  • Valerie Moran

    (University of York)

  • Michael Borowitz

    (Gobal Fund)


Waiting times for elective (non-emergency) treatments are a key health policy concern in several OECD countries. This study describes common measures on waiting times across OECD countries from administrative data. It focuses on common elective procedures, like hip and knee replacement, and cataract surgery, where waiting times are notoriously long. It provides comparative data on waiting times across twelve OECD countries and presents trends in waiting times in the last decade. Waiting times appear to be low in the Netherlands and Denmark. In the last decade the United Kingdom (in particular England), Finland and the Netherlands have witnessed large reductions in waiting times which can be attributed to a range of policy initiatives, including higher spending, waiting-times target schemes, and incentive mechanisms which reward higher levels of activity. The negative trend in these countries has however halted in recent years and in some cases reverted. The analysis also emphasizes systematic differences across different waiting-time measures, in particular between the distribution of waiting times of patients treated versus the one of patients on the list. For example, the mean waiting time of patients on the list is generally higher than the mean waiting time of patients treated though we can find examples of the opposite. Mean waiting times are systematically higher than median waiting times and the difference can be quantitatively large. Les délais d'attente pour les traitements électifs (non urgents) constituent un problème majeur de la politique de santé dans plusieurs pays de l'OCDE. Cette étude fondée sur des données administratives décrit les mesures courantes pour réduire les temps d'attente dans les pays de l'OCDE. Elle se concentre sur les interventions non urgentes pratiquées dans les pays, comme le remplacement de la hanche et du genou ainsi que la chirurgie de la cataracte, pour lesquels les délais d'attente sont connus pour être longs. Elle fournit des données comparatives sur les délais d’attente dans douze pays de l'OCDE et montre comment ils ont évolué ces dix dernières années. Ainsi, ils paraissent être courts aux Pays-Bas et au Danemark. Ces dix dernières années, le Royaume-Uni (en particulier l’Angleterre), la Finlande et les Pays-Bas ont vu leurs délais d’attente se réduire considérablement, ceci pouvant être attribué à une série d'initiatives stratégiques, comme une hausse des dépenses, la mise en place de systèmes d’objectif des délais d’attente et des mécanismes d'incitation récompensant des niveaux d'activité plus élevés. La réduction des délais d’attente dans ces pays s’est toutefois interrompue depuis quelques années et, dans certains cas, ils sont même revenus à la hausse. L'analyse souligne également des différences systématiques entre les différentes mesures relatives aux délais d'attente, en particulier entre la répartition des délais d’attente des patients traités et celle des personnes inscrites sur des listes d'attente. Par exemple, le délai d’attente moyen des patients sur une liste est généralement plus élevé que celui des patients traités, bien qu’il existe des contreexemples. Les délais d’attente moyens sont systématiquement plus élevés que les délais d’attente médians et la différence peut être quantitativement importante.

Suggested Citation

  • Luigi Siciliani & Valerie Moran & Michael Borowitz, 2013. "Measuring and Comparing Health Care Waiting Times in OECD Countries," OECD Health Working Papers 67, OECD Publishing.
  • Handle: RePEc:oec:elsaad:67-en

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    References listed on IDEAS

    1. Erik Schut & Stéphane Sorbe & Jens Høj, 2013. "Health Care Reform and Long-Term Care in the Netherlands," OECD Economics Department Working Papers 1010, OECD Publishing.
    2. 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.
    3. Wright,H. R. C., 2013. "Free Trade and Protection in the Netherlands 1816–30," Cambridge Books, Cambridge University Press, number 9781107621800, March.
    4. Viberg, Nina & Forsberg, Birger C. & Borowitz, Michael & Molin, Roger, 2013. "International comparisons of waiting times in health care – Limitations and prospects," Health Policy, Elsevier, vol. 112(1), pages 53-61.
    5. Dixon, Huw & Siciliani, Luigi, 2009. "Waiting-time targets in the healthcare sector: How long are we waiting?," Journal of Health Economics, Elsevier, vol. 28(6), pages 1081-1098, December.
    6. 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.
    7. Schut, Frederik T. & Varkevisser, Marco, 2013. "Tackling hospital waiting times: The impact of past and current policies in the Netherlands," Health Policy, Elsevier, vol. 113(1), pages 127-133.
    8. Propper, Carol & Sutton, Matt & Whitnall, Carolyn & Windmeijer, Frank, 2010. "Incentives and targets in hospital care: Evidence from a natural experiment," Journal of Public Economics, Elsevier, vol. 94(3-4), pages 318-335, April.
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    Cited by:

    1. Johansson, Kjell Arne & Nygaard, Elizabeth & Herlofsen, Berit & Lindemark, Frode, 2017. "Implementation of the 2013 amended Patients’ Rights Act in Norway: Clinical priority guidelines and access to specialised health care," Health Policy, Elsevier, vol. 121(4), pages 346-353.
    2. repec:eee:hepoli:v:121:y:2017:i:9:p:963-970 is not listed on IDEAS
    3. Dyrstad, Karin & Halvorsen, Thomas & Hem, Karl-Gerhard & Rohde, Tarald, 2016. "Sick of waiting: Does waiting for elective treatment cause sickness absence?," Health Policy, Elsevier, vol. 120(12), pages 1383-1388.
    4. Gutacker, Nils & Siciliani, Luigi & Cookson, Richard, 2016. "Waiting time prioritisation: Evidence from England," Social Science & Medicine, Elsevier, vol. 159(C), pages 140-151.
    5. Gutacker, Nils & Siciliani, Luigi & Moscelli, Giuseppe & Gravelle, Hugh, 2016. "Choice of hospital: Which type of quality matters?," Journal of Health Economics, Elsevier, vol. 50(C), pages 230-246.
    6. Fukushima, Kazuya & Mizuoka, Sou & Yamamoto, Shunsuke & Iizuka, Toshiaki, 2016. "Patient cost sharing and medical expenditures for the Elderly," Journal of Health Economics, Elsevier, vol. 45(C), pages 115-130.
    7. Gravelle, Hugh & Schroyen, Fred, 2016. "Optimal hospital payment rules under rationing by random waiting," Discussion Paper Series in Economics 8/2016, Norwegian School of Economics, Department of Economics.
    8. Sutherland, Jason Murray & Crump, R. Trafford & Chan, Angie & Liu, Guiping & Yue, Elizabeth & Bair, Matthew, 2016. "Health of patients on the waiting list: Opportunity to improve health in Canada?," Health Policy, Elsevier, vol. 120(7), pages 749-757.
    9. Lautier, Marc, 2014. "International trade of health services: Global trends and local impact," Health Policy, Elsevier, vol. 118(1), pages 105-113.
    10. Heinrich, Nils & Wübker, Ansgar & Wuckel, Christiane, 2017. "Waiting times for outpatient treatment in Germany: New experimental evidence from primary data," Ruhr Economic Papers 683, RWI - Leibniz-Institut für Wirtschaftsforschung, Ruhr-University Bochum, TU Dortmund University, University of Duisburg-Essen.
    11. Kowalska, Iwona & Sagan, Anna & Mokrzycka, Anna & Zabdyr-Jamróz, Michał, 2015. "The first attempt to create a national strategy for reducing waiting times in Poland: Will it succeed?," Health Policy, Elsevier, vol. 119(3), pages 258-263.

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    JEL classification:

    • I10 - Health, Education, and Welfare - - Health - - - General
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health

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