| Abstract: |
The English National Health Service was established in 1948, and has therefore
yielded some long time series data on health system performance. Waiting times
for inpatient care have been a persistent cause of policy concern since the
creation of the NHS. This paper develops a theoretical model of the dynamic
interaction between key indicators of health system performance. It then
investigates empirically the relationship between hospital activity, waiting
times and population characteristics using aggregate time-series data for the
NHS over the period 1952ÃÂâÃÂÃÂÃÂà2005. Structural Vector
Auto-Regression suggests that in the long run: a) higher activity is
associated with lower waiting times (elasticity = -0.9%); b) a higher
proportion of old population is associated with higher waiting times
(elasticity = 1.6%). In the short run, higher lagged waiting time leads to
higher activity (elasticity = 0.2%). We also find that shocks in waiting times
are countered by higher activity, so the effect is only temporary, while
shocks in activity have a permanent effect. We conclude that policies to
reduce waiting times should focus on initiatives that increase hospital
activity. |