Working Paper: CEPR ID: DP2489
Authors: Carol Propper; Bronwyn Croxson; Arran Shearer
Abstract: Waiting times for hospital care are a significant issue in the UK National Health Service. The reforms of the health service in 1990 gave a subset of family doctors (GP fundholders) both the ability to choose the hospital where their patients were treated and the means to pay for some services. One of the key factors influencing family doctors? choice of hospital was patient waiting time. However, without cash inducements, hospitals would get no direct reward from giving shorter waiting times to a subset of patients. Using a unique data set we investigate whether GP fundholders were able to secure shorter waiting times for their patients, whether they were able to do so in cases where they had no financial rewards to offer hospitals, and whether the impact of fundholding spilled over into shorter waiting times for all patients.
Keywords: physicians; financial incentives; waiting times; hospital care
JEL Codes: I10
Edges that are evidenced by causal inference methods are in orange, and the rest are in light blue.
| Cause | Effect |
|---|---|
| reduction in waiting times for patients undergoing procedures (I14) | shorter waits in specialties with historically long waits (I11) |
| financial incentives of fundholding (G23) | observed reductions in waiting times for specific procedures (C41) |
| GP fundholding (I11) | no overall reduction in waiting times for all types of procedures (L89) |
| GP fundholding (I11) | no spillover effects to non-fundholder patients (H51) |
| GP fundholding (I11) | reduction in waiting times for patients undergoing procedures (I14) |