Waiting Times and Socioeconomic Status: Evidence from England

Waiting times for elective surgery, like hip replacement, are often referred to as an equitable rationing mechanism in publicly-funded healthcare systems because access to care is not based on socioeconomic status. This study uses patient level administrative data from the Hospital Episode Statistics database in England to investigate whether patients with higher socioeconomic status (as measured by small area level income and education deprivation) wait less than other patients. The analysis focuses on the time waited for an elective hip replacement in 2001. Overall, it provides evidence of inequity in waiting times favouring more educated individuals and, to a lesser extent, richer individuals. The results from log-linear regression models and duration analysis bring evidence that inequalities occur within hospitals and over large part of the waiting time distribution. The inequality experienced by the lowest income group increases after controlling for hospital heterogeneity.