The impact of traveling and waiting times in health care emergency service choice : an econometric approach

Detalhes bibliográficos
Autor(a) principal: Alves, Maria Luísa Araújo
Data de Publicação: 2016
Tipo de documento: Dissertação
Idioma: eng
Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
Texto Completo: http://hdl.handle.net/10400.14/23629
Resumo: This study aims at estimating the effect of traveling and waiting times on patients’ choice of emergency care provider. In a model with no outside option, patients choose to demand emergency care from one of two similar hospitals. Using data from two Portuguese public hospitals, a conditional logit model is estimated. Two measures of waiting times are considered: the waiting time between admission and triage and the waiting time between triage and the first medical observation. A negative, statistically significant, impact of traveling time and waiting time between triage and the first medical observation on the probability of choosing a given hospital is found. The magnitude of the effect of waiting time, however, is close to zero. The estimated marginal effect suggests that a supply-induced 30-minutes increase in waiting time reduces, all else equal, the probability of choosing a given hospital by 0.009 percentage points. An increase of the same magnitude in traveling time reduces, all else equal, the probability of utilization by 5.841. Although the data does not allow for the estimation of consumer surplus, and given that the estimated effect captures only the impact of changes in waiting times resulting from supply side decisions, it is plausible to admit their effect on patient welfare would be small.
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spelling The impact of traveling and waiting times in health care emergency service choice : an econometric approachWaiting timeTraveling timeHealth careTempo de esperaTempo de deslocaçãoCuidados de saúdeDomínio/Área Científica::Ciências Sociais::Economia e GestãoThis study aims at estimating the effect of traveling and waiting times on patients’ choice of emergency care provider. In a model with no outside option, patients choose to demand emergency care from one of two similar hospitals. Using data from two Portuguese public hospitals, a conditional logit model is estimated. Two measures of waiting times are considered: the waiting time between admission and triage and the waiting time between triage and the first medical observation. A negative, statistically significant, impact of traveling time and waiting time between triage and the first medical observation on the probability of choosing a given hospital is found. The magnitude of the effect of waiting time, however, is close to zero. The estimated marginal effect suggests that a supply-induced 30-minutes increase in waiting time reduces, all else equal, the probability of choosing a given hospital by 0.009 percentage points. An increase of the same magnitude in traveling time reduces, all else equal, the probability of utilization by 5.841. Although the data does not allow for the estimation of consumer surplus, and given that the estimated effect captures only the impact of changes in waiting times resulting from supply side decisions, it is plausible to admit their effect on patient welfare would be small.Este estudo procura estimar o efeito do tempo de deslocação e de espera na escolha de serviços de urgência por parte dos pacientes. Num modelo sem uma outside option, os utentes escolhem entre dois serviços de urgência de dois hospitais semelhantes. Utilizando dados de dois hospitais públicos Portugueses, um modelo logit condicional é estimado. Duas medidas de tempo de espera são consideradas: o tempo de espera entre a admissão e triagem e o tempo de espera entre a triagem e a primeira observação. Os resultados sugerem a existência de um efeito negativo, estatisticamente significativo, dos tempos de deslocação e de espera entre a triagem e a primeira observação na probabilidade de um paciente escolher determinado hospital. No entanto, a magnitude do efeito dos tempos de espera é próximo de zero. O efeito marginal estimado de um aumento de 30 minutos induzido pelo lado da oferta na probabilidade de escolher um dado hospital é, tudo o resto constante, -0,009 pontos percentuais. Um aumento de igual magnitude no tempo de deslocação reduz, tudo o resto constante, aquela probabilidade em 5,481 pontos percentuais. Apesar de os dados não permitirem a estimação do excedente do consumidor, e dado que o efeito estimado captura apenas o impacto de variações nos tempos de espera causados por decisões de oferta, é razoável concluir que estas não tenham um impacto significativo no bem-estar dos pacientes no caso dos serviços de urgência.Ribeiro, Ricardo Miguel Martins da CostaVeritati - Repositório Institucional da Universidade Católica PortuguesaAlves, Maria Luísa Araújo2017-12-06T08:55:42Z2017-03-0620162017-03-06T00:00:00Zinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/masterThesisapplication/pdfhttp://hdl.handle.net/10400.14/23629TID:201699257enginfo:eu-repo/semantics/openAccessreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAP2023-07-12T17:29:37Zoai:repositorio.ucp.pt:10400.14/23629Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T18:19:24.172318Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse
dc.title.none.fl_str_mv The impact of traveling and waiting times in health care emergency service choice : an econometric approach
title The impact of traveling and waiting times in health care emergency service choice : an econometric approach
spellingShingle The impact of traveling and waiting times in health care emergency service choice : an econometric approach
Alves, Maria Luísa Araújo
Waiting time
Traveling time
Health care
Tempo de espera
Tempo de deslocação
Cuidados de saúde
Domínio/Área Científica::Ciências Sociais::Economia e Gestão
title_short The impact of traveling and waiting times in health care emergency service choice : an econometric approach
title_full The impact of traveling and waiting times in health care emergency service choice : an econometric approach
title_fullStr The impact of traveling and waiting times in health care emergency service choice : an econometric approach
title_full_unstemmed The impact of traveling and waiting times in health care emergency service choice : an econometric approach
title_sort The impact of traveling and waiting times in health care emergency service choice : an econometric approach
author Alves, Maria Luísa Araújo
author_facet Alves, Maria Luísa Araújo
author_role author
dc.contributor.none.fl_str_mv Ribeiro, Ricardo Miguel Martins da Costa
Veritati - Repositório Institucional da Universidade Católica Portuguesa
dc.contributor.author.fl_str_mv Alves, Maria Luísa Araújo
dc.subject.por.fl_str_mv Waiting time
Traveling time
Health care
Tempo de espera
Tempo de deslocação
Cuidados de saúde
Domínio/Área Científica::Ciências Sociais::Economia e Gestão
topic Waiting time
Traveling time
Health care
Tempo de espera
Tempo de deslocação
Cuidados de saúde
Domínio/Área Científica::Ciências Sociais::Economia e Gestão
description This study aims at estimating the effect of traveling and waiting times on patients’ choice of emergency care provider. In a model with no outside option, patients choose to demand emergency care from one of two similar hospitals. Using data from two Portuguese public hospitals, a conditional logit model is estimated. Two measures of waiting times are considered: the waiting time between admission and triage and the waiting time between triage and the first medical observation. A negative, statistically significant, impact of traveling time and waiting time between triage and the first medical observation on the probability of choosing a given hospital is found. The magnitude of the effect of waiting time, however, is close to zero. The estimated marginal effect suggests that a supply-induced 30-minutes increase in waiting time reduces, all else equal, the probability of choosing a given hospital by 0.009 percentage points. An increase of the same magnitude in traveling time reduces, all else equal, the probability of utilization by 5.841. Although the data does not allow for the estimation of consumer surplus, and given that the estimated effect captures only the impact of changes in waiting times resulting from supply side decisions, it is plausible to admit their effect on patient welfare would be small.
publishDate 2016
dc.date.none.fl_str_mv 2016
2017-12-06T08:55:42Z
2017-03-06
2017-03-06T00:00:00Z
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
dc.type.driver.fl_str_mv info:eu-repo/semantics/masterThesis
format masterThesis
status_str publishedVersion
dc.identifier.uri.fl_str_mv http://hdl.handle.net/10400.14/23629
TID:201699257
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dc.language.iso.fl_str_mv eng
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instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação
instacron:RCAAP
instname_str Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação
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repository.name.fl_str_mv Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação
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