The impact of traveling and waiting times in health care emergency service choice

: an econometric approach

Abstract

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.

Date of Award	3 Mar 2017
Original language	English
Awarding Institution	Universidade Católica Portuguesa
Supervisor	Ricardo Ribeiro (Supervisor)