Waiting for Surgery


In universal health care systems, patients often face significant wait times for treatment when capacity constraints are binding. In this paper, we estimate the effects of wait time for orthopedic surgery (days from referral to surgery) on health and labor market outcomes, using patient data covering all publicly funded orthopedic surgeries in Norway referred in 2010 and 2011. As the system assigns higher priority to more urgent cases, naive OLS estimates linking observed wait times to individual patient outcomes could reflect selection bias. Our identification strategy exploits quasi-random variation in wait times for surgery generated by the idiosyncratic variation in system "congestion" at the time of a specific patient's entry into the queue. Precisely, we instrument a patient's wait time by the average wait time of other patients queued for the same procedure at the same hospital around the same time. We find that longer wait times for surgery significantly increase health related work absence: For every 10 days spent waiting for surgery, sick leave in the two years following referral increases by about 3 days. Moreover, longer wait times do not appear to have any lasting health implications.

Working paper available upon request