Socioeconomic status and waiting times for health services: An international literature review and evidence from the Italian National Health System |
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| Affiliation: | 1. Department of Economics and Business Studies, University of Genoa, Genoa, Italy;2. Department of Political Science, University of Genoa, Genoa, Italy;3. Department of Management, University “Ca’ Foscari” Venice, Venice, Italy;1. DISES, Università Politecnica delle Marche, Piazzale Martelli, 8, 60100 Ancona (AN), Italy;2. SPOCRI, Macerata University, Via Don Minzoni, 2, 62100, Macerata (MC), Italy;1. Medical Direction - Hospital of Rovereto, LHU APSS, Corso Verona, 4, 38068 Rovereto, Italy;2. Department of Economics and Related Studies, University of York, York, UK;3. Department of Economics and Management, University of Padua, Padua, Italy;4. Medical Direction – Hospital of Rovereto, LHU APSS, Corso Verona, 4, 38068 Rovereto, Italy;5. Epidemiology Service, LHU APSS, Viale Verona, 38123 Trento, Italy;6. Radiology Department, LHU Ferrara Province, Ferrara, Italy;7. Hospital of Merano, LHU Bozen Province, Merano, Italy;8. LHU Genova, Genova, Italy;9. LHU Ragusa, Ragusa, Italy;10. LHU Lecce, Maglie, Italy;11. Department of Health Information Systems, Regional Health Authority – Umbria Region, Perugia, Italy;12. LHU Savona, Savona, Italy;13. LHU Treviso, Treviso, Italy;14. Governance of Outpatient Service, LHU 2 Lanciano-Vasto-Chieti, Chieti, Italy;15. LHU Feltre, Feltre, Italy;p. Hospital of Potenza, Potenza, Italy;q. Hospital of Viterbo, LHU Viterbo, Italy;r. National Agency on Regional Healthcare Services, Rome, Italy;1. Centre for Health Services and Policy Research, School of Population and Public Health, University of British Columbia, 201 – 2206 East Mall, Vancouver, BC, Canada;2. The Children''s Research Institute of the Children''s Hospital of Wisconsin, Medical College of Wisconsin, Milwaukee, WI, USA;3. Vancouver Coastal Health Authority, Vancouver, Canada;4. VA HSR&D Center for Health Information and Communication, Roudebush VA Medical Center, Indiana University School of Medicine, Department of Medicine, Regenstrief Institute, Inc., Indianapolis, IN, USA;1. Modelling and Analytics, Bristol, North Somerset and South Gloucestershire, Clinical Commissioning Group, National Health Service, Bristol, England, UK;2. Centre for Healthcare Innovation and Improvement, School of Management, University of Bath, Bath, England, UK |
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| Abstract: | In the absence of priority criteria, waiting times are an implicit rationing instrument where the absence or limited use of prices creates an excess of demand. Even in the presence of priority criteria, waiting times may be unfair because they reduce health care demand of patients in lower socio-economic conditions due to high opportunity costs of time or a decay in their health level. Significant evidence has shown a relationship between socioeconomic status and the length of waiting time.The first phase of the study involved an extensive review of the existent literature for the period of 2002–2016 in the main databases (Scopus, PubMed and Science Direct). Twenty-eight met the eligibility criteria. The 27 papers were described and classified.The e mpirical objective of this study was to determine whether socioeconomic characteristics affect waiting time for different health services in the Italian national health system. The services studied were specialist visits, diagnostics tests and elective surgeries.A classification tree and logistic regression models were implemented. Data from the 2013 Italian Health National Survey were used.The analysis found heterogeneous results for different types of service. Individuals with lower education and economic resources have a higher risk of experiencing excessive waiting times for diagnostic and specialist visits. For elective surgery, socioeconomic inequalities are present but appear to be lower. |
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| Keywords: | Waiting time Waiting list Socioeconomic status Equity National health system Deprivation index Health care service Elective surgeries Specialist visits Classification trees |
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