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Horizontal Inequality in Rationing by Waiting Lists

Tinghög, Gustav; Andersson, David; Tinghög, Petter and Lyttkens, Carl Hampus LU (2014) In International Journal of Health Services 44(1). p.169-184
Abstract
The objective of this article was to investigate the existence of horizontal inequality in access to care for six categories of elective surgery in a publicly funded system, when care is rationed through waiting lists. Administrative waiting time data on all elective surgeries (n = 4,634) performed in Östergötland, Sweden, in 2007 were linked to national registers containing variables on socioeconomic indicators. Using multiple regression, we tested five hypotheses reflecting that more resourceful groups receive priority when rationing by waiting lists. Low disposable household income predicted longer waiting times for orthopedic surgery (27%, p < 0.01) and general surgery (34%, p < 0.05). However, no significant differences on the... (More)
The objective of this article was to investigate the existence of horizontal inequality in access to care for six categories of elective surgery in a publicly funded system, when care is rationed through waiting lists. Administrative waiting time data on all elective surgeries (n = 4,634) performed in Östergötland, Sweden, in 2007 were linked to national registers containing variables on socioeconomic indicators. Using multiple regression, we tested five hypotheses reflecting that more resourceful groups receive priority when rationing by waiting lists. Low disposable household income predicted longer waiting times for orthopedic surgery (27%, p < 0.01) and general surgery (34%, p < 0.05). However, no significant differences on the basis of ethnicity and gender were detected. A particularly noteworthy finding was that disposable household income appeared to be an increasingly influential factor when the waiting times were longer. Our findings reveal horizontal inequalities in access to elective surgeries, but only to a limited extent. Whether this is good or bad depends on one's moral inclination. From a policymaker's perspective, it is nevertheless important to recognize that horizontal inequalities arise even though care is not rationed through ability to pay. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
International Journal of Health Services
volume
44
issue
1
pages
169 - 184
publisher
Baywood Publishing Company
external identifiers
  • wos:000331060500010
  • scopus:84894151942
ISSN
1541-4469
DOI
10.2190/HS.44.1.j
language
English
LU publication?
yes
id
4d657896-d996-46c5-be6c-fe4e080f9de8 (old id 4157807)
date added to LUP
2013-11-20 11:49:02
date last changed
2017-01-01 03:08:30
@article{4d657896-d996-46c5-be6c-fe4e080f9de8,
  abstract     = {The objective of this article was to investigate the existence of horizontal inequality in access to care for six categories of elective surgery in a publicly funded system, when care is rationed through waiting lists. Administrative waiting time data on all elective surgeries (n = 4,634) performed in Östergötland, Sweden, in 2007 were linked to national registers containing variables on socioeconomic indicators. Using multiple regression, we tested five hypotheses reflecting that more resourceful groups receive priority when rationing by waiting lists. Low disposable household income predicted longer waiting times for orthopedic surgery (27%, p &lt; 0.01) and general surgery (34%, p &lt; 0.05). However, no significant differences on the basis of ethnicity and gender were detected. A particularly noteworthy finding was that disposable household income appeared to be an increasingly influential factor when the waiting times were longer. Our findings reveal horizontal inequalities in access to elective surgeries, but only to a limited extent. Whether this is good or bad depends on one's moral inclination. From a policymaker's perspective, it is nevertheless important to recognize that horizontal inequalities arise even though care is not rationed through ability to pay.},
  author       = {Tinghög, Gustav and Andersson, David and Tinghög, Petter and Lyttkens, Carl Hampus},
  issn         = {1541-4469},
  language     = {eng},
  number       = {1},
  pages        = {169--184},
  publisher    = {Baywood Publishing Company},
  series       = {International Journal of Health Services},
  title        = {Horizontal Inequality in Rationing by Waiting Lists},
  url          = {http://dx.doi.org/10.2190/HS.44.1.j},
  volume       = {44},
  year         = {2014},
}