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Modelling the dynamics of a public health care system: evidence from time-series data

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The English National Health Service (NHS) was established in 1948, and has therefore yielded some long time series data on health system performance. Waiting time for inpatient care have been a persistent policy concern since the creation of the NHS. After developing a simple theoretical framework of the dynamic interaction between key indicators of health system performance, we investigate empirically the relationship between hospital activity, waiting time and population characteristics using aggregate time-series data for the NHS over the period 1952 to 2003. Structural Vector Autoregression (S-VAR) suggests that in the long run: higher activity is associated with lower waiting times (elasticity = −0.9); an increase in the elderly population is associated with higher waiting time (elasticity = 1.3). In the short run, higher lagged waiting time leads to higher activity (elasticity = 0.12). We also find that shocks in waiting times are countered by higher activity, so the effect is only temporary.

Keywords: H42; H51; I11; I18; dynamics; vector auto-regression; waiting times

Document Type: Research Article


Affiliations: 1: Department of Economics and Related Studies,University of York, Heslington, York, YO10 5DD 2: Imperial College Business School, Exhibition Road, London SW7 2AZ

Publication date: August 1, 2012

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