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Waiting Time Targets in Healthcare Markets: How Long Are We Waiting?

Listed author(s):
  • Huw Dixon
  • Luigi Siciliani

Waiting-time targets are frequently used by policy makers in the healthcare sector to monitor providers' performance. Such targets are based on the distribution of the patients on the list. We compare and link such distribution with the distribution of waiting time of the patients treated, as opposed to on the list, which is arguably a better measure of welfare or total disutility from waiting (although it can only be calculated retrospectively). We show that the latter can be estimated from the former, and viceversa. We also show that, depending the hazard function, one distribution may be more or less favourable than the other. However, empirically we .nd that the proportion of patients waiting on the list more than x months is a downward estimate of the proportion of patients treated waiting more than x months, therefore biasing downwards the total disutility from waiting.

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Paper provided by Department of Economics, University of York in its series Discussion Papers with number 09/05.

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Date of creation: Mar 2009
Handle: RePEc:yor:yorken:09/05
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Department of Economics and Related Studies, University of York, York, YO10 5DD, United Kingdom

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Web page: https://www.york.ac.uk/economics/
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  1. 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.
  2. Sicilani Luigi & Jeremy Hurst, 2005. "Explaining Waiting-time Variations for Elective Surgery Across OECD Countries," OECD Economic Studies, OECD Publishing, vol. 2004(1), pages 95-123.
  3. Engin Kara & Huw Dixon, 2005. "Persistence and Nominal Inertia in a Generalized Taylor Economy: How Longer Contracts Dominate Shorter Contracts," Computing in Economics and Finance 2005 87, Society for Computational Economics.
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  6. Carol Propper & Matt Sutton & Carolyn Whitnall & Frank Windmeijer, 2007. "Did 'Targets and Terror' Reduce Waiting times in England for Hospital Care?," The Centre for Market and Public Organisation 07/179, Department of Economics, University of Bristol, UK.
  7. Luigi Siciliani & Steve Martin, 2007. "An empirical analysis of the impact of choice on waiting times," Health Economics, John Wiley & Sons, Ltd., vol. 16(8), pages 763-779.
  8. Martin, Stephen & Rice, Nigel & Jacobs, Rowena & Smith, Peter, 2007. "The market for elective surgery: Joint estimation of supply and demand," Journal of Health Economics, Elsevier, vol. 26(2), pages 263-285, March.
  9. Kurt R. Brekke & Luigi Siciliani & Odd Rune Straume, 2007. "Competition and Waiting Times in Hospital Markets," NIPE Working Papers 9/2007, NIPE - Universidade do Minho.
  10. Bishai, David M. & Lang, Hui Chu, 2000. "The willingness to pay for wait reduction: the disutility of queues for cataract surgery in Canada, Denmark, and Spain," Journal of Health Economics, Elsevier, vol. 19(2), pages 219-230, March.
  11. Hugh Gravelle & Luigi Siciliani, 2007. "Third degree waiting time discrimination: optimal allocation of a public sector health care treatment under rationing by waiting," Discussion Papers 07/22, Department of Economics, University of York.
  12. Pedro Pita Barros & Pau Olivella, 2005. "Waiting Lists and Patient Selection," Journal of Economics & Management Strategy, Wiley Blackwell, vol. 14(3), pages 623-646, 09.
  13. Siciliani Luigi, 2007. "Optimal Contracts for Health Services in the Presence of Waiting Times and Asymmetric Information," The B.E. Journal of Economic Analysis & Policy, De Gruyter, vol. 7(1), pages 1-27, August.
  14. Iversen, Tor, 1993. "A theory of hospital waiting lists," Journal of Health Economics, Elsevier, vol. 12(1), pages 55-71, April.
  15. Croxson, Bronwyn & Propper, Carol & Shearer, Arran, 2000. "Waiting Times for Hospital Admissions: the Impact of GP Fundholding," CEPR Discussion Papers 2489, C.E.P.R. Discussion Papers.
  16. Luigi Siciliani, 2008. "A note on the dynamic interaction between waiting times and waiting lists," Health Economics, John Wiley & Sons, Ltd., vol. 17(5), pages 639-647.
  17. Luigi Siciliani, 2005. "Does more choice reduce waiting times?," Health Economics, John Wiley & Sons, Ltd., vol. 14(1), pages 17-23.
  18. Carol Propper, 1995. "The Disutility of Time Spent on the United Kingdom's National Health Service Waiting Lists," Journal of Human Resources, University of Wisconsin Press, vol. 30(4), pages 677-700.
  19. Propper, Carol, 1990. "Contingent Valuation of Time Spent on NHS Waiting Lists," Economic Journal, Royal Economic Society, vol. 100(400), pages 193-199, Supplemen.
  20. Johannesson, Magnus & Johansson, Per-Olov & Söderqvist, Tore, 1997. "Time Spent on Waiting Lists for Medical Care: An Insurance Approach," SSE/EFI Working Paper Series in Economics and Finance 192, Stockholm School of Economics.
  21. Gravelle, Hugh & Siciliani, Luigi, 2008. "Optimal quality, waits and charges in health insurance," Journal of Health Economics, Elsevier, vol. 27(3), pages 663-674, May.
  22. Hugh Gravelle & Peter Smith & Ana Xavier, 2003. "Performance signals in the public sector: the case of health care," Oxford Economic Papers, Oxford University Press, vol. 55(1), pages 81-103, January.
  23. Hugh Gravelle & Luigi Siciliani, 2006. "Is Waiting-time Prioritisation Welfare Improving?," Discussion Papers 06/13, Department of Economics, University of York.
  24. Hoel, Michael & Saether, Erik Magnus, 2003. "Public health care with waiting time: the role of supplementary private health care," Journal of Health Economics, Elsevier, vol. 22(4), pages 599-616, July.
  25. Smith, Peter C. & van Ackere, Ann, 2002. "A note on the integration of system dynamics and economic models," Journal of Economic Dynamics and Control, Elsevier, vol. 26(1), pages 1-10, January.
  26. Lindsay, Cotton M & Feigenbaum, Bernard, 1984. "Rationing by Waiting Lists," American Economic Review, American Economic Association, vol. 74(3), pages 404-417, June.
  27. Lancaster,Tony, 1992. "The Econometric Analysis of Transition Data," Cambridge Books, Cambridge University Press, number 9780521437899, December.
  28. Gravelle, Hugh & Dusheiko, Mark & Sutton, Matthew, 2002. "The demand for elective surgery in a public system: time and money prices in the UK National Health Service," Journal of Health Economics, Elsevier, vol. 21(3), pages 423-449, May.
  29. Olivella, Pau, 2003. "Shifting public-health-sector waiting lists to the private sector," European Journal of Political Economy, Elsevier, vol. 19(1), pages 103-132, March.
  30. Stephen Martin & Peter C. Smith, 2003. "Using panel methods to model waiting times for National Health Service surgery," Journal of the Royal Statistical Society Series A, Royal Statistical Society, vol. 166(3), pages 369-387.
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