Who responds to longer wait times? The effects of predicted emergency wait times on the health and volume of patients who present for care
中文摘要
医疗保健通常在就诊环节免费,以使价格不会对患者形成阻碍。然而,就医等待中经常产生的负效用同样可能导致阻碍效应。本文考察当预测等待时间发生准随机变化时,需求急诊医疗的患者数量与类型所出现的反应。我利用一个断点,比较预测等待时间相近、但向患者显示的表观等待时间不同的急诊站点。我使用由局部投影法估计的脉冲响应函数,估计预测等待时间对患者医疗需求的影响。预测等待时间每增加三十分钟,在信息显示后的三小时内,紧急护理中心的候诊患者减少15%,急诊科的候诊患者减少2%。停止使用急诊服务的患者经分诊也被归为更健康一类。然而,当预测等待时间非常高时,包括病情较重患者在内的所有患者的需求均出现下降。
Abstract
Healthcare is often free at the point-of-care so that price does not deter patients. However, the dis-utility from waiting for care that often occurs could also lead to deterrence. I investigate responses in the volume and types of patients that demand emergency care when predicted waiting times quasi-randomly change. I leverage a discontinuity to compare emergency sites with similar predicted wait times but with different apparent wait times displayed to patients. I use impulse response functions estimated by local projections to estimate effects of predicted wait times on patient demand for care. An additional thirty minutes of predicted wait time results in 15% fewer waiting patients at urgent cares and 2% fewer waiting patients at emergency departments within three hours of display. Patients that stop using emergency care are also triaged as healthier. However, at very high predicted wait times, there are reductions in demand for all patients including sicker patients.