Waiting Time Policies in the Health Sector

What Works?

image of Waiting Time Policies in the Health Sector

Over the past decade, many OECD countries have introduced new policies to tackle excessive waiting times for elective surgery with some success. However, in the wake of the recent economic downturn and severe pressures on public budgets, waiting times times may rise again, and it is important to understand which policies work.  In addition, the European Union has introduced new regulations to allow patients to seek care in other member states, if there are long delays in treatment.   This book provides a framework to understand why there are waiting lists for elective surgery in some OECD countries and not in others. It also describes how waiting times are measured in OECD countries, which differ widely, and makes recommendations for best practice. Finally, it reviews different policy approaches to tackling excessive waiting times. Some countries have introduced guarantees to patients that they will not wait too long for treatment. These policies work only if they are accompanied by sanctions on health providers to ensure the guarantee is met or if they allow greater choice of health-care providers including the private sector. Many countries have also introduced policies to expand supply of surgical services, but these policies have generally not succeeded in the long-term in bringing down waiting times. Given the increasing demand for elective surgery, some countries have experimented with policies to improve priorisation of who is entitled to elective surgery. These policies are promising, but difficult to implement.



Norway has a predominantly public health care sector. Municipalities have the responsibility for primary care, while specialist health care is organised in regional health authorities owned by the central government. These regional authorities are responsible for specialist health care for the population in their catchment areas, and they own the main providers. There is a system of referral to specialist care, with primary care physicians as gate keepers. The reduction of waiting times in specialist health care has been considered a major political challenge. National guidelines have been developed, which stipulate maximum medically acceptable waiting times for the patients for a range of diagnoses. These vertical and individualised prioritisation rules make the Norwegian system for waiting time regulation quite unique. The chapter details the organisation of the health care sector, and we report some results from empirical analyses of developments in waiting times for specialist health care.




This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error