Do English NHS waiting time targets distort treatment priorities in orthopaedic surgery?

Appleby, John; Boyle, Seán; Devlin, Nancy; Harley, Mike; Harrison, Anthony; Thorlby, Ruth

doi:10.1258/1355819054339022

Cited by 36 publications

(29 citation statements)

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“…Some countries have explicit waiting-time prioritisation for certain types of treatments (Appleby et al, 2005;Gravelle and Siciliani, 2008a;Scottish Executive 2003;Siciliani and Hurst, 2005). Examples include Australia, Canada, Denmark, England, Italy, New Zealand, Norway, Scotland, and Spain.…”

Section: Introductionmentioning

confidence: 99%

Monitoring prioritisation in the public health-care sector by use of medical guidelines. The case of Norway

2010

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This paper presents a new way to monitor priority settings in public health-care systems. We take departure in medical guidelines prescribing acceptable waiting times for different medical descriptions. Allocating ICD10 codes to the medical descriptions, we are able to compare actual waiting times to the recommended maximum waiting times. This way we use the medical guidelines as a tool for monitoring prioritisation in the health sector. In an application, using data from the Norwegian Patient Register, we test statistically for compliance with the guidelines. The results indicate that patients suffering from the most severe conditions are receiving too low priority in the Norwegian health-care sector relative to patients of lower priority.

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Section: Introductionmentioning

confidence: 99%

Monitoring prioritisation in the public health-care sector by use of medical guidelines. The case of Norway

2010

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“…Other countries have developed systems where patients receive points, and patients with higher scores should have shorter waiting times (New Zealand and Canada). In England, an elective surgery waiting-time target was introduced in 2000 [3]. The target has been progressively reduced from 18 months in March 2000 to the current 18 weeks target.…”

Section: Introductionmentioning

confidence: 99%

“…(with a legal right to treatment) or to priority group 3 (without the legal right to treatment) 3. Each patient must be considered according to three criteria: the seriousness of the condition, whether a suitable treatment2 Refs [11][12][13].…”

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confidence: 99%

Norwegian priority guidelines: Estimating the distributional implications across age, gender and SES

Carlsen¹,

Kaarboe²

2010

Health Policy

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“…These stipulate maximum waiting times for elective surgery that health care providers should meet, with rewards and penalties for successful and unsuccessful performance. The inpatient waiting time target has been progressively reduced from 18 months in March 2000 to 15 months in March 2002, 12 months in March 2003 in March 2004 and the current 6 months [6]. The target for the end of 2008 is a maximum wait of 18 weeks from initial referral of a patient by a general practitioner for an outpatient consultation and any subsequent treatment, including a hospital stay if needed.…”

Section: Introductionmentioning

confidence: 99%

Identifying the impact of government targets on waiting times in the NHS

Dimakou

Parkin

Devlin

et al. 2008

Health Care Manag Sci

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Waiting times for elective surgery are a key issue for the NHS. The principal policy response in the English NHS has been to introduce maximum waiting time targets against which performance is measured and rewarded. The aim of this paper is to identify the effect of government targets on the distribution of waiting times in the NHS. Specifically, we investigate the following questions: How does the probability of admission for any given patient vary during the time that they wait? How is the probability of admission for any given waiting time affected by the targets? Can variations in waiting times be explained by clinical, patient, or provider-level characteristics? What implications may be drawn from our results with respect to providers' managerial responses to the targets? This paper investigates these questions by applying duration analysis techniques to waiting time data from 2001/2002 and 2002/2003 for three specialties: general surgery, trauma & orthopaedics and ophthalmology. Estimation of survival functions reveals considerable variations in waiting times between specialties, operative procedures and hospitals. Hazard rates vary over time and peaks in them-high probabilities of admission-coincide with targets and change when targets change. Amongst patient characteristics, whether they are NHS or private and whether they are day or inpatient cases both influence waiting times, but other characteristics such as age, sex and ethnicity do not.

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Do English NHS waiting time targets distort treatment priorities in orthopaedic surgery?

Cited by 36 publications

References 0 publications

Monitoring prioritisation in the public health-care sector by use of medical guidelines. The case of Norway

Monitoring prioritisation in the public health-care sector by use of medical guidelines. The case of Norway

Norwegian priority guidelines: Estimating the distributional implications across age, gender and SES

Identifying the impact of government targets on waiting times in the NHS

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