Do waiting times affect health outcomes? Evidence from coronary bypass.
Long waiting times for non-emergency services are a feature of several publicly-funded health systems. A key policy concern is that long waiting times may worsen health outcomes: when patients receive treatment, their health condition may have deteriorated and health gains reduced. This study investigates whether patients in need of coronary bypass with longer waiting times are associated with poorer health outcomes in the English National Health Service over 2000-2010. Exploiting information from the Hospital Episode Statistics (HES), we measure health outcomes with in-hospital mortality and 28-day emergency readmission following discharge. Our results, obtained combining hospital fixed effects and instrumental variable methods, find no evidence of waiting times being associated with higher in-hospital mortality and weak association between waiting times and emergency readmission following a surgery. The results inform the debate on the relative merits of different types of rationing in healthcare systems. They are to some extent supportive of waiting times as an acceptable rationing mechanism, although further research is required to explore whether long waiting times affect other aspects of individuals' life.
Centre for Health Economics, University of York, York, YO10 5DD, United Kingdom.
Giuseppe
G
Moscelli
Centre for Health Economics, University of York, York, YO10 5DD, United Kingdom; Department of Economics and Related Studies, University of York, York, YO10 5DD, United Kingdom.
Luigi
L
Siciliani
Department of Economics and Related Studies, University of York, York, YO10 5DD, United Kingdom. Electronic address: vt563@york.ac.uk.
Valentina
V
Tonei
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001026:Coronary Artery Bypass / Q000401:mortality / Q000706:statistics & numerical data*; D005260:Female; D006297:Health Services Accessibility / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D010343:Patient Admission / Q000706:statistics & numerical data; D063868:Patient Outcome Assessment; D013222:State Medicine / Q000458:organization & administration / Q000706:statistics & numerical data; D013997:Time Factors; D014850:Waiting Lists / Q000401:mortality*
Coronary bypass; England; Health outcomes; Hospitals; Waiting times