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Prioritization and Patients' Rights: Does the Hospital Reform Lead to More Equal Practises Among Hospitals?

Posted: 25 Jun 2007  

Jan Erik Askildsen

University of Bergen - Department of Economics; CESifo (Center for Economic Studies and Ifo Institute)

Oddvar Kaarboe

Dep. Economics, Uni. of Bergen

Tor Helge Holmas

University of Bergen - Department of Economics

Abstract

The Norwegian health care system gives patients with a diagnostic description meeting certain criteria concerning seriousness of the illness, prospects of treatment, and cost-effectiveness of relevant treatment, a prioritised right to treatment in the specialised health care system within a set time frame. This maximum waiting time will vary for different diagnoses. However, the operationalisation of these criteria varies quite dramatically over health care trusts and among hospitals within the health care trusts. This was the case before the government take-over of hospitals in 2002, and it is tills the case. In relation to objectives of equal access to health care for everyone, this variation is of considerable public concern. We raise the question whether the reduction in number of owners resulting from the governmental take-over of hospitals and merging smaller hospitals into a regional health care trusts, has resulted in a more equal prioritization practice. We compare the practise of giving the right to treatment among health care trusts, and among hospitals within the heath care trusts, before and after the reform. We use individual level observations for all patients within several diagnoses that differ in the maximum acceptable waiting time for treatment. Patients within these diagnoses are grouped into five groups, which differ according to maximum waiting time. We control for several other variables affecting treatment intensities, thus isolating a reform effect in terms of changes in geographical variation of waiting time for the patients in the five priority groups. The results show a significant tendency for more homogenous practises at the level of health care trusts, whereas the picture is mixed for actual waiting times among patients within the regional health care trusts.

Keywords: prioritization, evaluation, health care reform

Suggested Citation

Askildsen, Jan Erik and Kaarboe, Oddvar and Holmas, Tor Helge, Prioritization and Patients' Rights: Does the Hospital Reform Lead to More Equal Practises Among Hospitals?. iHEA 2007 6th World Congress: Explorations in Health Economics Paper. Available at SSRN: https://ssrn.com/abstract=996034

Jan Erik Askildsen (Contact Author)

University of Bergen - Department of Economics ( email )

Fosswinckelsgt. 6
N-5007 Bergen
Norway
(+47)55589218 (Phone)
(+47)55589210 (Fax)

CESifo (Center for Economic Studies and Ifo Institute)

Poschinger Str. 5
Munich, DE-81679
Germany

Oddvar M. Kaarboe

Dep. Economics, Uni. of Bergen ( email )

Fosswinckelsgate 14
Bergen, 5007
Norway

HOME PAGE: http://www.uib.no/personer/Oddvar.Kaarboe

Tor Helge Holmas

University of Bergen - Department of Economics ( email )

Fosswinckelsgt. 6
N-5007 Bergen
Norway
+47 55589238 (Phone)
+47 55589210 (Fax)

HOME PAGE: http://www.econ.uib.no/stab/torHelge.html

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