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Waiting Times and Waiting Lists: A Model of the Market for Elective Surgery


  • Hugh Gravelle
  • Peter C. Smith
  • Ana Xavier


We present a simple dynamic model of the demand and supply for elective surgery in the NHS and test it using a panel of quartely data for 123 English health authorities from the second quarter of 1987 to the first quarter of 1993. We find that supply is increasing in measures of the previous period's waiting time and that demand is decreasing in the previous period waiting time. The results imply that health care systems which are rationed by waiting do respond to indicators of waiting times and waiting lists. More generally, the paper adds to the small but consistent body of research which demonstrates that health care systems respond to the publication of high profile performance data.

Suggested Citation

  • 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.
  • Handle: RePEc:yor:yorken:00/27

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    References listed on IDEAS

    1. Roy Carr-Hill & Geoffrey Hardman & Stephen Martin & Stuart Peacock & Trevor Sheldon & Peter Smith, 1994. "A formula for distributing NHS revenues based on small area use of hospital beds," Working Papers 022cheop, Centre for Health Economics, University of York.
    2. Besley, Timothy & Hall, John & Preston, Ian, 1999. "The demand for private health insurance: do waiting lists matter?," Journal of Public Economics, Elsevier, vol. 72(2), pages 155-181, May.
    3. Lindsay, Cotton M & Feigenbaum, Bernard, 1984. "Rationing by Waiting Lists," American Economic Review, American Economic Association, vol. 74(3), pages 404-417, June.
    4. Martin, Stephen & Smith, Peter C., 1999. "Rationing by waiting lists: an empirical investigation," Journal of Public Economics, Elsevier, vol. 71(1), pages 141-164, January.
    5. Croxson, B. & Propper, C. & Perkins, A., 2001. "Do doctors respond to financial incentives? UK family doctors and the GP fundholder scheme," Journal of Public Economics, Elsevier, vol. 79(2), pages 375-398, February.
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    Cited by:

    1. Rodríguez-Álvarez, Ana & Rosete-Rivero, Mayte, 2017. "Spanish public hospital waiting lists: A theoretical and empirical approach," Economics - The Open-Access, Open-Assessment E-Journal, Kiel Institute for the World Economy (IfW), vol. 11, pages 1-21.
    2. Antonia Morga & Ana Xavier, "undated". "Hospital specialists' private practice and its impact on the number of NHS patients treated and on the delay for elective surgery," Discussion Papers 01/01, Department of Economics, University of York.
    3. Hugh Gravelle & Matthew Sutton & Stephen Morris & Frank Windmeijer & Alastair Leyland & Chris Dibben & Mike Muirhead, 2003. "Modelling supply and demand influences on the use of health care: implications for deriving a needs-based capitation formula," Health Economics, John Wiley & Sons, Ltd., vol. 12(12), pages 985-1004.
    4. Giuntella, Osea & Nicodemo, Catia & Vargas-Silva, Carlos, 2015. "The Effects of Immigration on NHS Waiting Times," IZA Discussion Papers 9351, Institute for the Study of Labor (IZA).
    5. Joan Costa & Jaume Garcia, 2001. "Demand for private health insurance: Is there a quality gap?," Working Papers, Research Center on Health and Economics 531, Department of Economics and Business, Universitat Pompeu Fabra.
    6. Joan Costa & Jaume Garcia, 2003. "Demand for private health insurance: how important is the quality gap?," Health Economics, John Wiley & Sons, Ltd., vol. 12(7), pages 587-599.
    7. Simona GRASSI, 2006. "On the characteristics of a mixed system of provision of a private good. An application to health care," Departmental Working Papers 2006-14, Department of Economics, Management and Quantitative Methods at Università degli Studi di Milano.
    8. Mark Dusheiko & Hugh Gravelle & Rowena Jacobs & Peter C Smith, "undated". "The Effect of Budgets on Doctor Behaviour: Evidence From A Natural Experiment," Discussion Papers 03/04, Department of Economics, University of York.
    9. Merehau Cindy Mervin & Sukhan Jackson, 2009. "How can we improve waiting time for elective surgery in Australian public hospitals?," Discussion Papers Series 387, School of Economics, University of Queensland, Australia.
    10. Mark Dusheiko & Hugh Gravelle & Rowena Jacobs, 2004. "The effect of practice budgets on patient waiting times: allowing for selection bias," Health Economics, John Wiley & Sons, Ltd., vol. 13(10), pages 941-958.

    More about this item


    Waiting times; Rationing; Elective surgery.;

    JEL classification:

    • I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets
    • H51 - Public Economics - - National Government Expenditures and Related Policies - - - Government Expenditures and Health

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