Waiting times spillovers in a National Health Service hospital network: a little organizational diversity can go a long way.

IF 2.7 3区 经济学 Q1 ECONOMICS
Joana Daniela Ferreira Cima, Alvaro Fernando Santos Almeida
{"title":"Waiting times spillovers in a National Health Service hospital network: a little organizational diversity can go a long way.","authors":"Joana Daniela Ferreira Cima, Alvaro Fernando Santos Almeida","doi":"10.1186/s13561-024-00555-x","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>The objective of this study is to assess if waiting times for elective surgeries within the Portuguese National Health Service (NHS) are influenced by the waiting times at neighboring hospitals. Recognizing these interdependencies, and their extent, is crucial for understanding how hospital network dynamics affect healthcare delivery efficiency and patient access.</p><p><strong>Methods: </strong>We utilized patient-level data from all elective surgeries conducted in Portuguese NHS hospitals to estimate a hospital-specific index for waiting times. This index served as the dependent variable in our analysis. We applied a spatial lag model to examine the potential strategic interactions between hospitals concerning their waiting times.</p><p><strong>Results: </strong>Our analysis revealed a significant positive endogenous spatial dependence, indicating that waiting times in NHS hospitals are strategic complements. Furthermore, we found that NHS contracts with private not-for-profit hospitals not only reduce waiting times within these hospitals but also exert positive spillover effects on other NHS hospitals.</p><p><strong>Conclusions: </strong>The findings suggest that diversifying the organization of the NHS hospital network, particularly through contracts with private entities for marginal patients, can significantly enhance competitive dynamics and reduce waiting times. This effect persists even when patient choice is confined to a small fraction of the patient population, highlighting a strategic avenue for policy optimization in healthcare service delivery.</p>","PeriodicalId":46936,"journal":{"name":"Health Economics Review","volume":"14 1","pages":"87"},"PeriodicalIF":2.7000,"publicationDate":"2024-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11468064/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Health Economics Review","FirstCategoryId":"96","ListUrlMain":"https://doi.org/10.1186/s13561-024-00555-x","RegionNum":3,"RegionCategory":"经济学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"ECONOMICS","Score":null,"Total":0}
引用次数: 0

Abstract

Background: The objective of this study is to assess if waiting times for elective surgeries within the Portuguese National Health Service (NHS) are influenced by the waiting times at neighboring hospitals. Recognizing these interdependencies, and their extent, is crucial for understanding how hospital network dynamics affect healthcare delivery efficiency and patient access.

Methods: We utilized patient-level data from all elective surgeries conducted in Portuguese NHS hospitals to estimate a hospital-specific index for waiting times. This index served as the dependent variable in our analysis. We applied a spatial lag model to examine the potential strategic interactions between hospitals concerning their waiting times.

Results: Our analysis revealed a significant positive endogenous spatial dependence, indicating that waiting times in NHS hospitals are strategic complements. Furthermore, we found that NHS contracts with private not-for-profit hospitals not only reduce waiting times within these hospitals but also exert positive spillover effects on other NHS hospitals.

Conclusions: The findings suggest that diversifying the organization of the NHS hospital network, particularly through contracts with private entities for marginal patients, can significantly enhance competitive dynamics and reduce waiting times. This effect persists even when patient choice is confined to a small fraction of the patient population, highlighting a strategic avenue for policy optimization in healthcare service delivery.

国民健康服务医院网络中的候诊时间溢出效应:组织多样性可以发挥很大作用。
研究背景本研究的目的是评估葡萄牙国家医疗服务体系(NHS)内择期手术的等候时间是否受邻近医院等候时间的影响。认识这些相互依存关系及其程度对于了解医院网络动态如何影响医疗服务效率和患者就医至关重要:我们利用葡萄牙国家医疗服务体系医院开展的所有择期手术的患者层面数据,估算出医院特定的候诊时间指数。该指数是我们分析的因变量。我们采用空间滞后模型来研究医院之间在候诊时间方面的潜在战略互动:我们的分析表明,内生空间依赖性呈显著正相关,表明英国国家医疗服务体系医院的候诊时间具有战略互补性。此外,我们还发现,国家医疗服务体系与非营利性私立医院签订的合同不仅缩短了这些医院的候诊时间,还对其他国家医疗服务体系医院产生了积极的溢出效应:研究结果表明,国家医疗服务体系医院网络组织的多样化,特别是通过与私营实体签订边缘病人合同,可以显著增强竞争活力,减少候诊时间。即使病人的选择只局限于一小部分病人,这种效应也会持续存在,这为医疗服务政策的优化提供了一条战略途径。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 求助全文
来源期刊
CiteScore
3.90
自引率
4.20%
发文量
59
审稿时长
13 weeks
期刊介绍: Health Economics Review is an international high-quality journal covering all fields of Health Economics. A broad range of theoretical contributions, empirical studies and analyses of health policy with a health economic focus will be considered for publication. Its scope includes macro- and microeconomics of health care financing, health insurance and reimbursement as well as health economic evaluation, health services research and health policy analysis. Further research topics are the individual and institutional aspects of health care management and the growing importance of health care in developing countries.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信