title: The effects of expanding patient choice of provider on waiting times: evidence from a policy experiment.
abstract: Long waiting times for inpatient treatment in the UK National Health Service have been a source of popular and political concern, and therefore a target for policy initiatives. In the London Patient Choice Project, patients at risk of breaching inpatient waiting time targets were offered the choice of an alternative hospital with a guaranteed shorter wait. This paper develops a simple theoretical model of the effect of greater patient choice on waiting times. It then uses a difference in difference econometric methodology to estimate the impact of the London choice project on ophthalmology waiting times. In line with the model predictions, the project led to shorter average waiting times in the London region and a convergence in waiting times amongst London hospitals.
authors.affiliation: Centre for Health Economics, University of York, York, UK.
authors.forename: Diane
authors.initials: D
authors.lastname: Dawson
authors.forename: Hugh
authors.initials: H
authors.lastname: Gravelle
authors.forename: Rowena
authors.initials: R
authors.lastname: Jacobs
authors.forename: Stephen
authors.initials: S
authors.lastname: Martin
authors.forename: Peter C
authors.initials: PC
authors.lastname: Smith
mesh_terms: D002755:Choice Behavior; D017558:Elective Surgical Procedures / Q000191:economics / Q000706:statistics & numerical data*; D020793:Gatekeeping; D006291:Health Policy; D006301:Health Services Needs and Demand / Q000706:statistics & numerical data; D006302:Health Services Research; D006779:Hospitals, Public / Q000191:economics / Q000592:standards* / Q000706:statistics & numerical data; D006801:Humans; D008131:London; D017059:Models, Econometric; D013508:Ophthalmologic Surgical Procedures / Q000191:economics / Q000706:statistics & numerical data; D028701:Patient Rights / Q000592:standards*; D017060:Patient Satisfaction / Q000191:economics / Q000706:statistics & numerical data*; D010865:Pilot Projects; D019984:Quality Indicators, Health Care; D013222:State Medicine / Q000191:economics / Q000592:standards*; D013997:Time Factors; D006113:United Kingdom; D014850:Waiting Lists