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Waiting times for outpatient treatment in Germany: New experimental evidence from primary data

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  • Heinrich, Nils
  • Wübker, Ansgar
  • Wuckel, Christiane

Abstract

Long waiting lines are a common feature and a major concern in many public health care delivery systems. The waiting lines are often characterized as inefficient, because they are a burden to patients without generating any gains for providers. There is an ongoing debate in Germany regarding the preferential treatment given to private health insurance (PHI) holders while statutory health insurance (SHI) holders face continuously increasing waiting times. In order to tackle this problem in the outpatient sector, in 2015 Germany introduced a reform that was aimed at providing SHI holders with appointments within an acceptable time frame. We exploited longitudinal experimental data to examine waiting times for six elective outpatient treatments in Germany and assessed the reform's impact on this issue. We found a sizeable difference in waiting times favoring private patients. For SHI holders, waiting times remained stable over time (27.5 days in 2014; 30.7 days in 2016; ? 3.2 days, p-value = 0.889), while PHI holders experienced a significant improvement (13.5 days in 2014; 7.8 days in 2016; ? 5.7 days, p-value = 0.002). The results indicate that there is an unequal access to elective outpatient treatment depending on the patient's insurance status. Our conclusion is that, the reform did not repair the existing inequalities. The gap has rather widened.

Suggested Citation

  • Heinrich, Nils & Wübker, Ansgar & Wuckel, Christiane, 2017. "Waiting times for outpatient treatment in Germany: New experimental evidence from primary data," Ruhr Economic Papers 683, RWI - Leibniz-Institut für Wirtschaftsforschung, Ruhr-University Bochum, TU Dortmund University, University of Duisburg-Essen.
  • Handle: RePEc:zbw:rwirep:683
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    File URL: https://www.econstor.eu/bitstream/10419/156758/1/884041980.pdf
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    References listed on IDEAS

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    1. Siciliani, Luigi & Moran, Valerie & Borowitz, Michael, 2014. "Measuring and comparing health care waiting times in OECD countries," Health Policy, Elsevier, vol. 118(3), pages 292-303.
    2. 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.
    3. Kathrin Roll & Tom Stargardt & Jonas Schreyögg, 2012. "Effect of Type of Insurance and Income on Waiting Time for Outpatient Care," The Geneva Papers on Risk and Insurance - Issues and Practice, Palgrave Macmillan;The Geneva Association, vol. 37(4), pages 609-632, October.
    4. Christoph Schwierz & Achim Wübker & Ansgar Wübker & Björn Kuchinke, 2011. "Discrimination in waiting times by insurance type and financial soundness of German acute care hospitals," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 12(5), pages 405-416, October.
    5. Lindsay, Cotton M & Feigenbaum, Bernard, 1984. "Rationing by Waiting Lists," American Economic Review, American Economic Association, vol. 74(3), pages 404-417, June.
    6. Luigi Siciliani & Rossella Verzulli, 2009. "Waiting times and socioeconomic status among elderly Europeans: evidence from SHARE," Health Economics, John Wiley & Sons, Ltd., vol. 18(11), pages 1295-1306.
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    More about this item

    Keywords

    Waiting times; outpatient care; Germany; public health insurance; private health insurance;

    JEL classification:

    • I10 - Health, Education, and Welfare - - Health - - - General
    • I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health

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