Scandinavian Working Papers in Economics

Working Papers in Economics,
University of Bergen, Department of Economics

No 07/10: The Impact of Different Prioritisation Policies on Waiting Times: A Comparative Analysis of Norway and Scotland

Jurgita Januleviciute (), Jan Erik Askildsen (), Tor Helge Holmås (), Oddvar Kaarbøe () and Matt Sutton ()
Additional contact information
Jurgita Januleviciute: University of Bergen, Postal: Department of Economics, Fosswinckelsgt. 14, N-5007 Bergen, Norway
Jan Erik Askildsen: Uni Research - Department of Economics, University of Bergen, Postal: Uni Rokkansenteret, Nygårdsgaten 5 , 5015 Bergen, Norway
Tor Helge Holmås: Institute for Research in Economics and Business Administration, Postal: Institute for Research in Economics and Business Administration , Breiviksveien 40, , N-5045 Bergen
Oddvar Kaarbøe: University of Bergen, Postal: Department of Economics, Fosswinckelsgt. 14, N-5007 Bergen, Bergen
Matt Sutton: University of Manchester, Postal: School of Community Based Medicine, University of Manchester, Room 1.304 University Place, Oxford Road, Manchester M13 9PL , U.K.,

Abstract: We compare the distributional consequences of two different waiting times initiatives. The primary focus of Scotland’s recent waiting time reforms has been on reducing maximum waiting times through the imposition of high profile national targets. In Norway, the focus has been on appropriate prioritisation of referrals to hospital based on disease severity, the expected benefit of the treatment and cost-effectiveness. We use large, national administrative datasets from before and after each of these reforms and assign priority groups based on the maximum waiting times stipulated in Norwegian medical guidelines. To equalise case-mix over time, we use Exact Matching to weight the pre-reform patients to the patient composition in the post-reform period. We regress patient-level waiting times on patient characteristics and on a post-reform indicator interacted with the patient’s priority group. The analysis shows that the least-prioritised patients benefited most from both reforms. This was at the cost of longer waiting times for patients that should have been given higher priority in Norway, while Scotland’s high priority patients remained unaffected. This comparative analysis indicates that blanket waiting times initiatives may be more effective in reducing waiting times while preserving prioritisation between patients with different health needs.

Keywords: Waiting times; prioritisation; Norway; Scotland

JEL-codes: I10; I18

30 pages, June 1, 2010

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