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Measuring and Comparing Health Care Waiting Times in OECD Countries

Listed author(s):
  • 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.

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Paper provided by OECD Publishing in its series OECD Health Working Papers with number 67.

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Date of creation: 18 Nov 2013
Handle: RePEc:oec:elsaad:67-en
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  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, December.
  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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