Waiting Time Policies in the Health Sector: What Works?

On 16th September Professor Luigi Siciliani led an OHE lunchtime seminar on waiting time policies in the health sector. The slides are now available.

On 16th September Professor Luigi Siciliani of the University of York led an OHE lunchtime seminar on waiting time policies in the health sector.

Professor Siciliani gave a summary of health sector waiting time policies across 13 OECD countries. He highlighted that the most common policy seems to be a form of maximum waiting time guarantee. 

Increasingly, such guarantees are backed with targets for providers and sanctions for non-compliance (for example England and Finland). The guarantees often go hand-in-hand with choice, competition and an increase in supply (for example Denmark, Portugal and the Netherlands). 

Demand-side policies attempt to define more rigorous clinical thresholds. However, they have proved difficult to implement. A promising policy is to link waiting time guarantees to different categories of clinical need, a form of prioritisation. 

Professor Siciliani also presented comparative evidence of waiting times across OECD countries over the last decade. Waiting times for elective procedures in the UK declined between 2001 and 2008, but have been stable in recent years. 

In some countries, for example the Netherlands, dramatic reductions in waiting times have been seen, but these appear to have come at a cost, as health care expenditure has also increased rapidly. 

Finally, Prof Siciliani discussed inequalities in waiting times by socioeconomic status. Several studies show that patients with lower socioeconomic status wait longer for some procedures in several countries. These results could have important implications for waiting list prioritisation. 

For more information see:

Siciliani, Borowitz and Moran (eds.), 2013. Waiting time policies in the health sector: what works? OECD Health Policy Studies, OECD publishing.

Siciliani, Moran and Borowitz, 2014. Measuring and comparing health care waiting times in OECD countries, Health Policy, 118(3), pp.292-303.

Moscelli, Siciliani, Gutacker and Cookson, 2015. Socioeconomic inequality of access to healthcare: Does patients’ choice explain the gradient? Evidence from the English NHS, CHE working paper, 112.

Find details of upcoming OHE seminars here.