Carlsen Fredrik, Holmås Tor Helge, Kaarboe Oddvar
Department of Economics, NTNU, Trondheim, Norway.
Health & Social Sciences, Norce Research, Bergen, Norway.
Health Econ. 2025 Mar;34(3):371-375. doi: 10.1002/hec.4913. Epub 2024 Dec 5.
Waiting time is a rationing mechanism that is used in publicly funded healthcare systems as a mean to ensure equal access for equal need. However, several studies suggest that individuals with higher socioeconomic status wait less. These studies typically measure patients' socioeconomic status as an aggregate measure from patients' residential area and the results are hence vulnerable for aggregation biases. We shed light on the magnitude of the aggregation bias by analyzing socioeconomic gradients in waiting times when education and income are measured on three different levels: the individual level, the population cell level, and the municipal level. Our individual level socioeconomic gradient is modest compared with the literature. When socioeconomic status is measured on an aggregate level, we observe stronger associations with socioeconomic variables and less accurate estimates. A researcher who only has access to the aggregate data runs the risk of overstating the magnitude of the socioeconomic gradients.
等待时间是一种配给机制，在公共资助的医疗保健系统中被用作确保同等需求获得平等医疗机会的手段。然而，多项研究表明，社会经济地位较高的个体等待时间较短。这些研究通常将患者的社会经济地位作为来自患者居住地区的综合衡量指标，因此结果容易受到汇总偏差的影响。通过分析在三个不同层面（个体层面、人口单元层面和市政层面）衡量教育和收入时等待时间的社会经济梯度，我们揭示了汇总偏差的程度。与文献相比，我们的个体层面社会经济梯度较小。当在综合层面衡量社会经济地位时，我们观察到与社会经济变量的关联更强，估计也不太准确。仅能获取综合数据的研究人员存在高估社会经济梯度幅度的风险。
