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The impact of patient choice and waiting time on the demand for health care: results from the London Patient Choice project

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  • Diane Dawson
  • Rowena Jacobs
  • Stephen Martin
  • Peter Smith

Abstract

In a number of countries where health care is publicly funded, policies to introduce greater patient choice are being implemented. In most cases patient choice is seen as an instrument to reduce waiting times for elective (non-emergency) hospital services. An important issue is whether facilitating greater patient choice will increase the demand for health care and thereby undermine the achievement of reduced waiting times. A large scale pilot of choice in the London metropolitan area permits a test of the hypothesis that choice will affect demand. This paper estimates a model of the demand for elective surgery using a panel of 150 English acute hospitals over the period 1995 to 2004 for three surgical specialties. It examines whether demand shifted following the introduction of the London Patient Choice Project in 2002. The results suggest that the choice project only shifted NHS inpatient demand in orthopaedics and that this shift was inwards.

Suggested Citation

  • Diane Dawson & Rowena Jacobs & Stephen Martin & Peter Smith, 2006. "The impact of patient choice and waiting time on the demand for health care: results from the London Patient Choice project," Applied Economics, Taylor & Francis Journals, vol. 38(12), pages 1363-1370.
    • Handle: RePEc:taf:applec:v:38:y:2006:i:12:p:1363-1370
    DOI: 10.1080/00036840500398810
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    References listed on IDEAS

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    1. Cullis, John G & Jones, Philip R, 1986. "Rationing by Waiting Lists: An Implication," American Economic Review, American Economic Association, vol. 76(1), pages 250-256, March.
    2. Hugh Gravelle & Peter Smith & Ana Xavier, 2003. "Performance signals in the public sector: the case of health care," Oxford Economic Papers, Oxford University Press, vol. 55(1), pages 81-103, January.
    3. Lindsay, Cotton M & Feigenbaum, Bernard, 1984. "Rationing by Waiting Lists," American Economic Review, American Economic Association, vol. 74(3), pages 404-417, June.
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    Cited by:

    1. Gan, Lydia L. & Frederick, James R., 2010. "The Willingness to Spend on Healthcare: Evidence from Singapore," Review of Applied Economics, Lincoln University, Department of Financial and Business Systems, vol. 6(1-2), pages 1-15, April.
    2. Debra Dwyer & Hong Liu & John A. Rizzo, 2012. "Does patient trust promote better care?," Applied Economics, Taylor & Francis Journals, vol. 44(18), pages 2283-2295, June.
    3. Meliyanni Johar & Elizabeth Savage, 2010. "Do Private Patients have Shorter Waiting Times for Elective Surgery? Evidence from New South Wales Public Hospitals," Economic Papers, The Economic Society of Australia, vol. 29(2), pages 128-142, June.

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