Waiting times in healthcare: equal treatment for equal need?
Metadata
Show full item recordEditorial
BMC
Materia
Waiting times Socioeconomic status Inequalities Primary care Specialist care National Health System
Date
2022-12-20Referencia bibliográfica
García-Corchero, J.D., Jiménez-Rubio, D. Waiting times in healthcare: equal treatment for equal need?. Int J Equity Health 21, 184 (2022). [https://doi.org/10.1186/s12939-022-01799-x]
Sponsorship
Spanish Government; Ministry of Science, Innovation and Universities Spanish Government PID2019-105688RB-I00 ECO2015-66553-R FPU18/02663Abstract
Background: In many universal health systems, waiting times act as a non-monetary rationing mechanism, one
that should be based on clinical need rather than the ability to pay. However, there is growing evidence that among
patients with similar levels of need, waiting times often differ according to socioeconomic status. The mechanisms
underlying inequality in access remain unclear.
Methods: Using data for Spain, we study whether waiting times for primary and specialist care depend on patients’
socioeconomic status (SES). Additionally, we make use of the continuous nature of our data to explore whether the
SES-related differences in waiting times found for specialist consultations vary among different points of the waiting
time distribution.
Results: Our results reveal the presence of a SES gradient in waiting times for specialist services explained on the
basis of education, employment status and income. In addition, for primary care, we found evidence of a slightly more
moderate SES gradient mostly based on employment status. Furthermore, although quantile regression estimates
indicated the presence of a SES gradient within the distribution of waiting times for specialist visits, the SES differences
attenuated in the context of longer waiting times in the public sector but did not disappear.
Conclusion: Our findings suggest the principle of equal treatment for equal need, assumed to be inherent to
national health systems such as the Spanish system, is not applied in practice. Determining the mechanism(s) underlying
this selective barrier to healthcare is of crucial importance for policymakers, especially in the current COVID-19
health and economic crises, which could exacerbate these inequalities as increasing numbers of treatments are having
to be postponed.