Siciliani Luigi, Moran Valerie, Borowitz Michael
Department of Economics and Related Studies, University of York, York YO10 5DD United Kingdom.
Directorate for Employment, Labour and Social Affairs, OECD, 2, rue Andre' Pascal, 75775, Paris, Cedex 16, France.
Health Policy. 2014 Dec;118(3):292-303. doi: 10.1016/j.healthpol.2014.08.011. Epub 2014 Sep 1.
Waiting times for elective treatments are a key health-policy concern in several OECD countries. This study describes common measures of waiting times from administrative data across OECD countries. It focuses on common elective procedures, such as hip and knee replacement, and cataract surgery, where waiting times are notoriously long. It provides comparative data on waiting times across 12 OECD countries and presents trends in waiting times over the last decade. Waiting times appear to be low in the Netherlands and Denmark. In the last decade the United Kingdom (in particular England), Finland and the Netherlands have witnessed large reductions in waiting times which can be attributed to a range of policy initiatives, including higher spending, waiting-times target schemes and incentive mechanisms, which reward higher levels of activity. The negative trend in these countries has, however, halted or reversed in recent years. The analysis also emphasizes systematic differences across different waiting-time measures, in particular between the distribution of waiting times of patients treated versus that of patients on the list. Mean waiting times are systematically higher than median waiting times and the difference can be quantitatively large.
在经合组织(OECD)的几个国家中,择期治疗的等待时间是一项关键的卫生政策关注点。本研究描述了经合组织国家行政数据中常见的等待时间衡量指标。它聚焦于常见的择期手术,如髋关节和膝关节置换术以及白内障手术,这些手术的等待时间向来很长。它提供了12个经合组织国家的等待时间比较数据,并呈现了过去十年中等待时间的趋势。荷兰和丹麦的等待时间似乎较低。在过去十年中,英国(尤其是英格兰)、芬兰和荷兰的等待时间大幅减少,这可归因于一系列政策举措,包括增加支出、等待时间目标计划和激励机制,这些举措奖励更高的手术量。然而,近年来这些国家的负面趋势已经停止或逆转。分析还强调了不同等待时间衡量指标之间的系统性差异,特别是已接受治疗患者的等待时间分布与候诊名单上患者的等待时间分布之间的差异。平均等待时间系统性地高于中位数等待时间,且差异可能在数量上很大。