Backlogs, waiting times and waiting lists of elective surgeries across OECD countries

Abstract

Background: Many OECD countries suspended elective (non-emergency) care during the pandemic to divert efforts towards COVID-19 patients, which generated a backlog of patients.

Objective: This study measures the extent to which waiting times and volume changed over time before and after COVID-19 in OECD countries (between 2016-2023). We test whether COVID-19 had a different effect on the waiting time of the patients on the list versus the wait of patients treated, two common measures of waiting times. It discusses how waiting times and volume can be used as measures of health system resilience for elective care.

Methods: The study uses data on a selection of high-volume elective surgeries and OECD countries that report waiting times for patients on the list or from addition to the list to treatment. We use regression methods to quantify the extent to which waiting times increased and volumes decreased after the pandemic across OECD countries.

Results: We find that the wait on the list increased on average by 27-30% in the first three years. In contrast, the wait to treatment increased only to a small extent and the effect was not statistically significant. Volume reduced on average by 19% and 10% in the first two years. There were heterogeneous effects across countries, but these do not appear to be systematically related to health spending, physicians and acute beds.

Conclusion: Measures of health system resilience for elective care should monitor both the wait on the list and the wait to treatment, in addition to volumes.

Keywords: Backlogs; Elective surgeries; Healthcare systems; Resilience; Waiting times.