RATIONING IN PRACTICE- EQUITY IN WAITING TIMES FOR ELECTIVE SURGERY IN SWEDEN

Author(s)

Tinghög G, Andersson DLinköping University, Linköping , Östergötland, Sweden

OBJECTIVES: Health care can be rationed by various mechanisms. In publicly funded health care systems referring patients to waiting lists is a common administrative way to ration care. However, there is little systematic knowledge on how rationing through waiting time actually affects access to care among different socioeconomic groups. And since rationing through waiting lists most often is done implicitly rather than explicitly there is an obvious risk that less powerful groups of patients get discriminated, resulting in a longer waiting time before being treated. The overall objective of this study was to explore the association between patients’ socioeconomic status, ethnical background and waiting time within non-acute surgical specialities. METHODS: Days on waiting list was used as dependant variable in a multiple regression model. This data was collected from the county council of Östergötland in Sweden (N=4634). Data on disposable income, ethnicity and workforce activity were retrieved from national registers. RESULTS: Examining disposable income as a potential predictor, we found that lower disposable income was significantly associated with longer waiting time in orthopedics (p=0.05) and general surgery (p=0.05). In orthopedics, the lowest income group waited on average 28% longer than the highest income group. Examining ethnicity as a potential predictor, the only significant association found was in gynecology where patients with foreign origin surprisingly waited on average 40 % shorter than patients with Swedish origin. For workforce activity, we found that patients excluded from the workforce were significantly associated with longer wait in ophthalmology. CONCLUSIONS: Our results reveal horizontal inequalities in access within several non-acute surgical specialties. However, the mere association between socioeconomic factors and inequalities in waiting times cannot alone support judgements about inequity. Hence, there is both a descriptive and normative question that needs to be assessed when investigating the reasonableness of rationing by waiting time.

Conference/Value in Health Info

2010-11, ISPOR Europe 2010, Prague, Czech Republic

Value in Health, Vol. 13, No. 7 (November 2010)

Code

PHP33

Topic

Health Policy & Regulatory

Topic Subcategory

Health Disparities & Equity

Disease

Multiple Diseases

Explore Related HEOR by Topic


Your browser is out-of-date

ISPOR recommends that you update your browser for more security, speed and the best experience on ispor.org. Update my browser now

×