Abstract
Equity of access is a key policy objective in publicly-funded healthcare systems. However, observed inequalities of access by socioeconomic status may result from differences in patients’ choices. Using data on non-emergency coronary revascularisation procedures in the English National Health Service, we found substantive differences in waiting times within public hospitals between patients with different socioeconomic status: up to 35% difference, or 43 days, between the most and least deprived population quintile groups. Using selection models with differential distances as identification variables, we estimated that only up to 12% of these waiting time inequalities can be attributed to patients’ choices of hospital and type of treatment (heart bypass versus stent). Residual inequality, after allowing for choice, was economically significant: patients in the least deprived quintile group benefited from shorter waiting times and the associated health benefits were worth up to £850 per person.
| Original language | English |
|---|---|
| Pages (from-to) | 290-314 |
| Number of pages | 25 |
| Journal | Journal of Health Economics |
| Volume | 57 |
| Early online date | 23 Jun 2017 |
| DOIs | |
| Publication status | Published - Jan 2018 |
Bibliographical note
© 2017, The Authors.Keywords
- Choice
- Inequalities
- Selection bias
- Socioeconomic status
- Waiting times
