Inequalities in waiting times by socioeconomic status - a possible causal mechanism.

Shuli Brammli Greenberg

doi:10.1186/2045-4015-4-2

Abstract

Much like waiting times for health services, the shortage of physicians and other health professionals poses a major health policy issue in many OECD countries. In this short commentary, I present indications that in Israel’s periphery, the demand for advanced health services exceeds supply. This gap creates inequality in waiting times “across” geographical areas in the public sector and, moreover, could act as a causal mechanism of socioeconomic inequality. As a result, policymakers face two challenges: first, to increase the number of physicians in specialties and localities where there is a lack; and second, to take steps to enhance waiting time equality in areas of obvious shortages.

Highlights

Waiting time for a specific health service generally reflects the meeting point between supply and demand for that service or, between the availability and accessibility of health-plan services and a patient’s decision to turn to these services
The seeming advantage of waiting times, compared for example to co-payments, is that waiting times are perceived as equitable by insurees, since the waits are seemingly unrelated to their socio-economic status [3]
Shmueli [4] found that in Israel, the expected waiting times are longer for persons who are more ill and for those who reside in the periphery. All these findings suggest that for Israel’s periphery, demand exceeds supply resulting in longer waiting times and less likelihood of seeing a specialist or having a surgery

Summary

Introduction

Waiting time for a specific health service generally reflects the meeting point between supply and demand for that service or, between the availability and accessibility of health-plan services and a patient’s decision to turn to these services. Waiting time can be used by health plans, operating in accord with a model of managed care, as an administrative mechanism to contain costs. Long waiting times (of a month or more) have been found to negatively affect satisfaction with the level of professionalism of the physician and care, and with the availability and accessibility of health-plan services [1,2].

Results

Conclusion