The asymmetric effects of waiting time targets in health care

Dimakou, Sofia and Dimakou, Ourania and Basso, Henrique S. (2015) The asymmetric effects of waiting time targets in health care. Working Paper. Birkbeck, University of London, London, UK.

Abstract

Waiting time targets have been a key policy intervention in many OECD countries, aimed at reducing persistent waiting times for healthcare. What is the impact of targets on the distribution of patients' waiting time? Do they affect healthcare outcomes? We address the first question by developing a theoretical model of healthcare provision and empirically assessing the entire distribution of patients' durations at the hospital level. Our model and empirical evidence identify two distinct admission patterns. Hospitals respond by either treating all patients faster or by `substituting' among short and long waiters, indicating an asymmetric effect across patients. In order to address the impact of targets on healthcare outcomes (mortality, prolonged healthcare, delayed discharge at the patient level) we explore the identified heterogeneity of responses across hospitals. We find supportive evidence of a systematic difference in outcomes of patients treated in hospitals that exhibit asymmetric responses to targets.

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