Waiting Times for Health Services

Abstract

The presence of waiting times in the health sector has been a long-standing challenge in many OECD countries, and the current COVID-19 pandemic will likely worsen waiting times for many non-urgent health services at least in the short-term. At the same time, waiting times are a reflection of the functioning of the health system as a whole and provide an opportunity for policy makers to trigger changes to improve the appropriateness, responsiveness and efficiency in health service delivery and to make health systems more people centred. Waiting times for elective (non-urgent) treatment, which is usually the longest wait, have stalled over the past decade in many countries, and started to rise again in some others even before the COVID-19 outbreak. In response to the COVID-19 crisis, many countries have postponed elective surgery at least temporarily sometime during the first half of 2020 to free up a maximum amount of human resources and hospital beds to deal with the emergency. The postponement of these elective surgery will result in an immediate increase in waiting times for patients on the waiting lists and will result in a significant backlog of surgery that will likely take some time to be resolved after the crisis. In normal circumstances, waiting times and waiting lists generally arise as the result of an imbalance between the demand for and the supply of health services. This can be for a consultation with a general practitioner or a specialist, or getting a diagnostic test or surgical or other elective treatments. Although some waiting times can improve the efficiency in the utilisation of resources by reducing idle capacity, when waiting times become long (e.g. above two or three months for elective treatments) more resources will need to be devoted by providers to manage waiting lists and prioritise patients and patient dissatisfaction will increase. Several policies can be successfully implemented to reduce waiting times. Denmark, England and Finland succeeded in reducing waiting times for many elective health services and maintained these reductions over sustained periods, at least before the current COVID-19 crisis. The right policy mix for each country is likely to depend on the health system. However, successful approaches typically combine the specification of an appropriate maximum waiting time together with supply-side and demand-side interventions and a regular monitoring of progress.