Explaining the gender gap in waiting times for scheduled surgery in the Portuguese National Health Service

This study examines waiting times for all patients submitted to surgical treatment in the Portuguese National Health Service (NHS), from 2011 to 2015 (amounting to more than 2.6 million observations) and it tries to evaluate whether there is gender discrimination in access to scheduled surgery. We show that men have 10% shorter waiting times than women. We then estimate a regression model on waiting times that controls for multiple sources of observed and unobserved heterogeneity. Some of these controls are high-dimensional fixed effects. The results still indicate an unexplained differential where men have 3.1% shorter waiting times than women. To understand the contribution of the controls to the explained gender gap we use Gelbach’s decomposition. The results indicate that the patient’s initial priority is the variable that contributes most to the explained gap (-5.8 log points), followed by hospital specific fixed-effects (-1.7 log points). In addition to noticing the resource allocation is not efficiently provided, decision-makers should pay more attention to a pattern that seems to disadvantage women. Overall, we consider that our approach provides a more informative assessment of the sources of the gender gap than previous literature.