Rationalizing Waiting Times in Health Care Delivery: An International Comparison - Governare i tempi di attesa in sanità: un confronto internazionale Comparison -

In health care delivery, waiting lists are perceived to reflect the inadequacy of health care funding. They are portrayed as one of the major problems of publicly funded health systems and are a perpetual source of community and political discomfort. It appears that a trade-off between efficiency (waits as a rationing tool in absence of price) and equity (free access to everyone is in need) arises. Recent international experiences referred to elective surgery suggest to implement demand-side policies instead of supply-side ones. This means recognizing that the free package the citizens are entitled to should comprehend services to be delivered not immediately, but according to individual urgency (horizontal equity) and respecting priority as well, that is ordering access (vertical equity). It is essential, in fact, that those who have the greatest need for surgery and will benefit most from it receive it in a timely manner and before those with lesser need. Results are still under debate and future research is required. -