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Waiting time distributions and national targets for elective surgery in UK: theoretical modelling and duration analysis

Dimakou, S. (2013). Waiting time distributions and national targets for elective surgery in UK: theoretical modelling and duration analysis. (Unpublished Doctoral thesis, City University London)


Waiting times for elective surgery constitute a key performance indicator for the NHS. The principal policy response has been to introduce maximum waiting time targets against which performance is measured and rewarded. The aim of this thesis is to shed light on the mechanism of patients’ admittance for elective surgery in UK by examining the whole distribution of their waiting times from an empirical and theoretical perspective.

In Chapter 2, we empirically investigate the effect of government targets on the distribution of patients’ waiting times by applying duration analysis techniques to waiting time data from 2001/02 and 2002/03 for three specialties: general surgery, trauma & orthopaedics and ophthalmology. In Chapter 3, we examine further the variation in the way hospitals and surgeons manage their waiting lists by exposing detailed patterns regarding the shape of the survival and hazard curves of patients’ waits. We use an expanded dataset (1997/98 to 2005/06) both in a cross-sectional and across time framework controlling for factors such as size, type and performance rating for hospitals and activity
level for doctors. We also address the issue of the evolution of waiting time distributions over time.

Chapter 4 provides a theoretical supply model on how a hospital manages its stock of patients given its objective function and the constraints it is faced with. We derive the optimal waiting time distribution and identify important factors that could explain the differences between the observed empirical patterns.

Publication Type: Thesis (Doctoral)
Subjects: H Social Sciences > HB Economic Theory
R Medicine > RA Public aspects of medicine
Departments: Doctoral Theses
School of Policy & Global Affairs > Economics
School of Policy & Global Affairs > School of Policy & Global Affairs Doctoral Theses
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