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TitleDynamic hospital competition under rationing by waiting times
Author(s)Sá, Luís
Siciliani, Luigi
Straume, Odd Rune
KeywordsHospital competition
Waiting times
Patient choice
Differential games
Issue date1-Jul-2019
JournalJournal of Health Economics
CitationSá, L., Siciliani, L., & Straume, O. R. (2019). Dynamic hospital competition under rationing by waiting times. Journal of health economics, 66, 260-282
Abstract(s)We develop a dynamic model of hospital competition where (i) waiting times increase if demand exceeds supply; (ii) patients choose a hospital based in part on waiting times; and (iii) hospitals incur waiting time penalties. We show that, whereas policies based on penalties will lead to lower waiting times, policies that promote patient choice will instead lead to higher waiting times. These results are robust to different game-theoretic solution concepts, designs of the hospital penalty structure, and patient utility specifications. Furthermore, waiting time penalties are likely to be more effective in reducing waiting times if they are designed with a linear penalty structure, but the counterproductive effect of patient choice policies is smaller when penalties are convex. These conclusions are partly derived by calibration of our model based on waiting times and elasticities observed in the English NHS for a common treatment (cataract surgery). (C) 2019 Elsevier B.V. All rights reserved.
Publisher version
AccessEmbargoed access (2 Years)
Appears in Collections:NIPE - Artigos em Revistas de Circulação Internacional com Arbitragem Científica

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