Modelling the dynamics of a public health care system: evidence from time-series data

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The English National Health Service (NHS) was established in 1948, and
has therefore yielded some long time series data on health system
performance. Waiting time for inpatient care have been a persistent
policy concern since the creation of the NHS. After developing a simple
theoretical framework of the dynamic interaction between key indicators
of health system performance, we investigate empirically the relationship
between hospital activity, waiting time and population characteristics using
aggregate time-series data for the NHS over the period 1952 to 2003.
Structural Vector Autoregression (S-VAR) suggests that in the long run:
higher activity is associated with lower waiting times (elasticity=-0.9); an
increase in the elderly population is associated with higher waiting time
(elasticity=1.3). In the short run, higher lagged waiting time leads to
higher activity (elasticity=0.12). We also find that shocks in waiting times
are countered by higher activity, so the effect is only temporary.
Original languageEnglish
Pages (from-to)2955-2968
Number of pages14
JournalApplied Economics
Issue number23
Early online date22 Aug 2011
Publication statusPublished - Aug 2012


  • waiting times
  • dynamics
  • vector auto-regression

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