Policy strategies to reduce waits for elective care: A synthesis of international evidence

Location

International

A synthesis of international evidence, by a Canadian researcher, seeks to assess and explain the effectiveness of policy interventions to reduce elective wait times or lists.

Strategies with the strongest evidence base include paying for activity, buying capacity locally and setting targets with strong incentives. There is also evidence for improving the use of existing capacity. The author notes that limiting demand through rationing can reduce waits, but is ethically problematic. Short-term injections of funding, cross-border treatment schemes, unenforced targets and promotion of private health insurance had the weakest evidence. Available evidence favours options that act fairly directly on supply, demand or local organisations' behaviour, over indirect strategies that depend on a ‘domino effect’. The author goes on to say that further research is needed to determine how to achieve major, system-wide improvements in the use of capacity.

Kreindler, S. (2010). Policy strategies to reduce waits for elective care: a synthesis of international evidence. British Medical Bulletin, 95(1), 7-32.

The full text of this research article is available at http://bmb.oxfordjournals.org/content/95/1/7.full.pdf+html