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Disclosing Total Waiting Times For Joint Replacement: Evidence From The English Nhs Using Linked Hes Data

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  • Elsa Marques
  • Sian Noble
  • Ashley W. Blom
  • William Hollingworth

Abstract

For the last decade, stringent monitoring of waiting time performance targets provided English hospitals with incentives to reduce official waiting times for elective surgery. It is less clear whether the total amount of time patients waited in secondary care, from first referral to outpatient clinic until treatment, has also fallen. We used Hospital Episode Statistics inpatient data for patients undergoing total joint replacement during a period of active monitoring of targets (between 2006/7 and 2008/9) and linked it to outpatient data to reconstruct patients' pathway in the 3 years before surgery and provide alternative measurements of waiting times. Our findings suggest that although official waiting times decreased drastically in our study period, total waiting time in secondary care has not declined. Patients with shorter official waits spent a longer time in a ‘work‐up’ period prior to inclusion in the official waiting list, and socio‐economic inequities persisted in waiting times for joint replacement. We found no evidence that target policies achieved efficiency gains during our study period. Copyright © 2013 John Wiley & Sons, Ltd.

Suggested Citation

  • Elsa Marques & Sian Noble & Ashley W. Blom & William Hollingworth, 2014. "Disclosing Total Waiting Times For Joint Replacement: Evidence From The English Nhs Using Linked Hes Data," Health Economics, John Wiley & Sons, Ltd., vol. 23(7), pages 806-820, July.
  • Handle: RePEc:wly:hlthec:v:23:y:2014:i:7:p:806-820
    DOI: 10.1002/hec.2954
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    References listed on IDEAS

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    Cited by:

    1. Eric French & Elaine Kelly & Richard Cookson & Carol Propper & Miqdad Asaria & Rosalind Raine, 2016. "Socio‐Economic Inequalities in Health Care in England," Fiscal Studies, Institute for Fiscal Studies, vol. 37, pages 371-403, September.
    2. Joanna Thorn & Emma Turner & Luke Hounsome & Eleanor Walsh & Jenny Donovan & Julia Verne & David Neal & Freddie Hamdy & Richard Martin & Sian Noble, 2016. "Validation of the Hospital Episode Statistics Outpatient Dataset in England," PharmacoEconomics, Springer, vol. 34(2), pages 161-168, February.
    3. Lee, Mandy & Martin-Carroll, Margaret & von Mollendorff, Wendy & Condon, Claire & Kavanagh, Matthew & Thomas, Stephen, 2021. "Common patterns in the public reporting of waiting time and waiting list information: Findings from a sample of OECD jurisdictions," Health Policy, Elsevier, vol. 125(8), pages 1002-1012.
    4. Joanna C. Thorn & Emma Turner & Luke Hounsome & Eleanor Walsh & Jenny L. Donovan & Julia Verne & David E. Neal & Freddie C. Hamdy & Richard M. Martin & Sian M. Noble, 2016. "Validation of the Hospital Episode Statistics Outpatient Dataset in England," PharmacoEconomics, Springer, vol. 34(2), pages 161-168, February.

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