The impact of different prioritisation policies on waiting times: Case studies of Norway and Scotland

• Published in: Social science & medicine (1982) 2013-11, Vol.97, p.1-6
• Main Authors: Januleviciute, Jurgita, Askildsen, Jan Erik, Kaarboe, Oddvar, Holmås, Tor Helge, Sutton, Matt
• Format: Article
• Language: English
• Subjects: Biological and medical sciences; Delivery Systems; Health care; Health Care Reform - organization & administration; Health Care Services Policy; Health Priorities - organization & administration; Hospitals; Humans; Medical sciences; Medical treatment; Medicine; Miscellaneous; Norway; Organizational Case Studies; Patients; Priorities; Prioritisation; Public health. Hygiene; Public health. Hygiene-occupational medicine; Reform; Reforms; Scotland; Time Factors; United Kingdom; Waiting Lists; Waiting period; Waiting times
• ISSN: 0277-9536; 1873-5347
• DOI: 10.1016/j.socscimed.2013.07.010

We investigate the distributional consequences of two different waiting times initiatives, one in Norway, and one in Scotland. The primary focus of Scotland's recent waiting time reforms, introduced in 2003, and modified in 2005 and 2007, has been on reducing maximum waiting times through the imposition of high profile national targets accompanied by increases in resources. In Norway, the focus of the reform introduced in September 2004, has been on assigning patients referred to hospital a maximum waiting time based on disease severity, the expected benefit and the cost-effectiveness of the treatment. 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 medical guidelines. The analysis shows that the lowest priority 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. •We investigate the distributional consequences of different waiting times initiatives in Norway and Scotland.•We show that waiting times are reduced for the least-prioritised patients under both regimes.•Waiting times for high priority patients are unaffected when unconditional targets are accompanied increased resources.•Longer waits for high priority group are observed when differential targets are introduced without additional funding.