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Article: Time costs of waiting, doctor-shopping and private-public sector imbalance: Microdata evidence from Hong Kong

TitleTime costs of waiting, doctor-shopping and private-public sector imbalance: Microdata evidence from Hong Kong
Authors
KeywordsHong Kong
Mixed medical economy
Waiting time
Willingness-to-pay
Issue Date2006
PublisherElsevier Ireland Ltd. The Journal's web site is located at http://www.elsevier.com/locate/healthpol
Citation
Health Policy, 2006, v. 76 n. 1, p. 1-12 How to Cite?
AbstractObjective: To quantify the disutility of waiting for a specialist consultation and to examine whether individuals' willingness-to-pay (WTP) to reduce waiting time is associated with doctor-shopping behavior in outpatient clinics of four large, public hospitals in Hong Kong. Methods: We performed a cross-sectional survey of 6495 outpatients on public sector waiting lists enrolled from July 2000 to October 2001. Main outcome measures were WTP to reduce queue time and odds ratios (ORs) for doctor-shopping according to WTP status. Results: The majority (74.5%) of respondents, excluding those registering "protest zeros", was willing to pay a median of HK$100 (US$13) to reduce queue time by 2 weeks, which represents 14.6% of the total costs of care for a specialist outpatient visit. Respondents' WTP decreased as their expected waiting period increased. Multivariate regression modeling showed that those who were willing to pay more were also more likely to "doctor-shop" (ORs and 95% confidence intervals for doctor-shopping for the 1st through 4th quartile of WTP values respectively = 1.00; 0.88 (0.63, 1.23); 1.19 (0.57, 2.48); 1.52 (1.05, 2.20); p for linear trend = 0.009), in effect reducing waiting time to see a specialist by seeking and paying for care in the private sector. Conclusions: Based on this preliminary evidence, we propose the further examination of a new policy of outsourcing some specialist care services to the private sector to improve allocative and technical efficiency. © 2005 Elsevier Ireland Ltd. All rights reserved.
Persistent Identifierhttp://hdl.handle.net/10722/151623
ISSN
2015 Impact Factor: 2.035
2012 SCImago Journal Rankings: 0.733
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorLeung, GMen_HK
dc.contributor.authorYeung, RYTen_HK
dc.contributor.authorWong, IOLen_HK
dc.contributor.authorCastanCameo, Sen_HK
dc.contributor.authorJohnston, JMen_HK
dc.date.accessioned2012-06-26T06:25:37Z-
dc.date.available2012-06-26T06:25:37Z-
dc.date.issued2006en_HK
dc.identifier.citationHealth Policy, 2006, v. 76 n. 1, p. 1-12en_HK
dc.identifier.issn0168-8510en_HK
dc.identifier.urihttp://hdl.handle.net/10722/151623-
dc.description.abstractObjective: To quantify the disutility of waiting for a specialist consultation and to examine whether individuals' willingness-to-pay (WTP) to reduce waiting time is associated with doctor-shopping behavior in outpatient clinics of four large, public hospitals in Hong Kong. Methods: We performed a cross-sectional survey of 6495 outpatients on public sector waiting lists enrolled from July 2000 to October 2001. Main outcome measures were WTP to reduce queue time and odds ratios (ORs) for doctor-shopping according to WTP status. Results: The majority (74.5%) of respondents, excluding those registering "protest zeros", was willing to pay a median of HK$100 (US$13) to reduce queue time by 2 weeks, which represents 14.6% of the total costs of care for a specialist outpatient visit. Respondents' WTP decreased as their expected waiting period increased. Multivariate regression modeling showed that those who were willing to pay more were also more likely to "doctor-shop" (ORs and 95% confidence intervals for doctor-shopping for the 1st through 4th quartile of WTP values respectively = 1.00; 0.88 (0.63, 1.23); 1.19 (0.57, 2.48); 1.52 (1.05, 2.20); p for linear trend = 0.009), in effect reducing waiting time to see a specialist by seeking and paying for care in the private sector. Conclusions: Based on this preliminary evidence, we propose the further examination of a new policy of outsourcing some specialist care services to the private sector to improve allocative and technical efficiency. © 2005 Elsevier Ireland Ltd. All rights reserved.en_HK
dc.languageengen_US
dc.publisherElsevier Ireland Ltd. The Journal's web site is located at http://www.elsevier.com/locate/healthpolen_HK
dc.relation.ispartofHealth Policyen_HK
dc.rightsHealth Policy. Copyright © Elsevier Ireland Ltd.-
dc.subjectHong Kongen_HK
dc.subjectMixed medical economyen_HK
dc.subjectWaiting timeen_HK
dc.subjectWillingness-to-payen_HK
dc.subject.meshAgeden_US
dc.subject.meshAmbulatory Careen_US
dc.subject.meshChoice Behavioren_US
dc.subject.meshCross-Sectional Studiesen_US
dc.subject.meshFemaleen_US
dc.subject.meshHong Kongen_US
dc.subject.meshHospitals, Publicen_US
dc.subject.meshHumansen_US
dc.subject.meshMaleen_US
dc.subject.meshMiddle Ageden_US
dc.subject.meshPhysician-Patient Relationsen_US
dc.subject.meshPrivate Sectoren_US
dc.subject.meshPublic Sectoren_US
dc.subject.meshWaiting Listsen_US
dc.titleTime costs of waiting, doctor-shopping and private-public sector imbalance: Microdata evidence from Hong Kongen_HK
dc.typeArticleen_HK
dc.identifier.emailLeung, GM: gmleung@hkucc.hku.hken_HK
dc.identifier.emailWong, IOL: iolwong@hku.hken_HK
dc.identifier.emailJohnston, JM: jjohnsto@hku.hken_HK
dc.identifier.authorityLeung, GM=rp00460en_HK
dc.identifier.authorityWong, IOL=rp01806en_HK
dc.identifier.authorityJohnston, JM=rp00375en_HK
dc.description.naturelink_to_subscribed_fulltexten_US
dc.identifier.doi10.1016/j.healthpol.2005.04.004en_HK
dc.identifier.pmid15885847-
dc.identifier.scopuseid_2-s2.0-32644487776en_HK
dc.identifier.hkuros111679-
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-32644487776&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume76en_HK
dc.identifier.issue1en_HK
dc.identifier.spage1en_HK
dc.identifier.epage12en_HK
dc.identifier.isiWOS:000236134400001-
dc.publisher.placeIrelanden_HK
dc.identifier.scopusauthoridLeung, GM=7007159841en_HK
dc.identifier.scopusauthoridYeung, RYT=7102833306en_HK
dc.identifier.scopusauthoridWong, IOL=7102513940en_HK
dc.identifier.scopusauthoridCastanCameo, S=6506861240en_HK
dc.identifier.scopusauthoridJohnston, JM=7403397964en_HK
dc.identifier.citeulike6430972-

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