Waiting time and doctor shopping in a mixed medical economy.

Waiting time generally acts as a rationing mechanism in the public health care system. In theory, patients who have a higher valuation of time are more likely to seek alternative care (i.e. doctor shopping) if there is a parallel private sector than those who have weaker time preference. However, the existing settings of many health care systems do not allow patients to reveal their preference of such. The data presented in this study suggest a positive association between patients' expressed value of time and doctor shopping behaviour in Hong Kong. Patients who were assigned longer waiting times relative to their expected horizon were more likely to seek private alternative care.

[1]  M Hanning,et al.  Maximum waiting time - a threat to clinical freedom? Implementation of a policy to reduce waiting times. , 2000, Health policy.

[2]  G. Leung,et al.  Efficiency is dependent on the control of supply. , 2001, Hong Kong medical journal = Xianggang yi xue za zhi.

[3]  D. Bishai,et al.  The willingness to pay for wait reduction: the disutility of queues for cataract surgery in Canada, Denmark, and Spain. , 2000, Journal of health economics.

[4]  N. Ireland.  The mix of social and private provision of goods and services , 1990 .

[5]  Philip Jones,et al.  Rationing by Waiting Lists: An Implication , 1986 .

[6]  Stephen Martin,et al.  Rationing by waiting lists: an empirical investigation , 1999 .

[7]  Peter C Smith,et al.  Increase in resources should lead to reduced waiting times , 2003, BMJ : British Medical Journal.

[8]  G. Anderson,et al.  Willingness to pay to shorten waiting time for cataract surgery. , 1997, Health affairs.

[9]  K. Thorpe,et al.  Income-related cost sharing in health insurance. , 1993, Health affairs.

[10]  V. Devaraj,et al.  Reducing non-attendance at outpatient clinics , 1999, Journal of the Royal Society of Medicine.

[11]  D. Sharp,et al.  Non-attendance at general practices and outpatient clinics , 2001, BMJ : British Medical Journal.

[12]  Barton H. Hamilton,et al.  The Impact of the NHS Reforms on Queues and Surgical Outcomes in England: Evidence From Hip Fracture Patients , 1999 .

[13]  P. Danzon.  Hidden overhead costs: is Canada's system really less expensive? , 1992, Health affairs.

[14]  Marriner S. Eccles,et al.  Introducing Market Forces into Health Care: A Tale of Two Countries , 2002 .

[15]  T. Tideman,et al.  Discrimination by Waiting Time in Merit Goods , 1971 .

[16]  Michael G Farnworth.  A game theoretic model of the relationship between prices and waiting times. , 2003, Journal of health economics.

[17]  J. Moatti,et al.  Eliciting several willingness to pay in a single contingent valuation survey: application to health care. , 2003, Health economics.

[18]  A. Hedley,et al.  Doctor-shopping in Hong Kong: implications for quality of care. , 1994, International journal for quality in health care : journal of the International Society for Quality in Health Care.

[19]  S. Yoo,et al.  Modelling willingness to pay responses from dichotomous choice contingent valuation surveys with zero observations , 2001 .

[20]  B S Bloom,et al.  Waiting for Care: Queuing and Resource Allocation , 1987, Medical care.

[21]  M. Tavakoli,et al.  An economic model of the market for hospital treatment for non-urgent conditions. , 1995, Health economics.

[22]  Carol Propper,et al.  Waiting times for hospital admissions: the impact of GP fundholding. , 2002, Journal of health economics.

[23]  Ian Preston,et al.  The demand for private health insurance: do waiting lists matter? , 1999 .

[24]  M Johannesson,et al.  Time spent on waiting lists for medical care: an insurance approach. , 1998, Journal of health economics.

[25]  G. Dutton,et al.  Waiting times for and attendance at paediatric ophthalmology outpatient appointments.. , 1996, BMJ.

[26]  Robert West,et al.  Rationing and Rationality in the National Health Service , 1993 .

[27]  C. Propper.  The Disutility of Time Spent on the United Kingdom's National Health Service Waiting Lists , 1995 .

[28]  E. Dalmau-Matarrodona,et al.  Alternative approaches to obtain optimal bid values in contingent valuation studies and to model protest zeros. Estimating the determinants of individuals' willingness to pay for home care services in day case surgery. , 2001, Health economics.

[29]  M Tavakoli,et al.  Referral rates and waiting lists: some empirical evidence. , 1998, Health economics.

[30]  C. M. Lindsay,et al.  Rationing by waiting lists. , 1984, The American economic review.

[31]  T. Iversen,et al.  The effect of a private sector on the waiting time in national health service. , 1997, Journal of health economics.

[32]  J. Yates,et al.  Why Are We Waiting?: An Analysis of Hospital Waiting-Lists , 1987 .