Modelling the Dynamics of a Public Health Care System: Evidence from Time-Series Data

Research output: Working paperDiscussion paper

Abstract

The English National Health Service was established in 1948, and has therefore yielded some long time series data on health system performance. Waiting times for inpatient care have been a persistent cause of policy concern since the creation of the NHS. This paper develops a theoretical model of the dynamic interaction between key indicators of health system performance. It then
investigates empirically the relationship between hospital activity, waiting times and population characteristics using aggregate time-series data for the NHS over the period 1952-2005. Structural Vector Auto-Regression suggests that in the long run: a) higher activity is associated with lower waiting times (elasticity = -0.9%); b) a higher proportion of old population is associated with higher
waiting times (elasticity = 1.6%). In the short run, higher lagged waiting time leads to higher activity (elasticity = 0.2%). We also find that shocks in waiting times are countered by higher activity, so the effect is only temporary, while shocks in activity have a permanent effect. We conclude that policies to
reduce waiting times should focus on initiatives that increase hospital activity.
Original languageEnglish
Place of PublicationYork, UK
PublisherCentre for Health Economics, University of York
Number of pages31
Publication statusPublished - Sep 2017

Publication series

NameCHE Research Paper
PublisherCentre for Health Economics, University of York
No.29

Keywords

  • Waiting times
  • Dynamics
  • Vector Auto-Regression

Cite this