Equity in specialist waiting times by socioeconomic groups: evidence from Spain


In countries with publicly financed health care systems, waiting time—rather than price—is the rationing mechanism for access to health care services. The normative statement underlying such a rationing device is that patients should wait according to need and irrespective of socioeconomic status or other non-need characteristics. The aim of this paper is to test empirically that waiting times for publicly funded specialist care do not depend on patients’ socioeconomic status. Waiting times for specialist care can vary according to the type of medical specialty, type of consultation (review or diagnosis) and the region where patients’ reside. In order to take into account such variability, we use Bayesian random parameter models to explain waiting times for specialist care in terms of need and non-need variables. We find that individuals with lower education and income levels wait significantly more time than their counterparts.

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    The central government has a residual power and its main function is to coordinate and to lead processes involving the entire SNHS.

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    The 2011 Spanish Health Survey is also available but its questionnaire does not include information on waiting times by specialties which is essential for the purposes of this research.

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    According to the modified OECD equivalence scale, weights are distributed as follows: 1 for the first adult, 0.5 for the rest of individuals older than 14 and 0.3 for each child under 14.

  4. 4.

    And even if it were available, there might be differences across doctors regarding both thresholds for need and notions of priority.


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This paper derives from a research project funded by the Spanish Ministry of Economy and Competitiveness (project ECO2012-36150). The authors are greatful to the Ministry for financial support. We are also grateful for comments on a first version of this paper to the participants at the Sheffield School of Health and Related Research Seminars, on the 30th July 2009. We are also thankful for comments of the two anonymous referees from EJHE. The usual disclaimers apply.

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Correspondence to Ignacio Abásolo.

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Abásolo, I., Negrín-Hernández, M.A. & Pinilla, J. Equity in specialist waiting times by socioeconomic groups: evidence from Spain. Eur J Health Econ 15, 323–334 (2014). https://doi.org/10.1007/s10198-013-0524-x

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  • Equity
  • Waiting times
  • Specialist visits
  • Hierarchical Bayesian models

JEL Classification

  • I1