The Waiting Game – How Cooperation Between Public and Private Hospitals Can Help Reduce Waiting Lists

Jorge A. Acuna (), José L. Zayas-Castro, Felipe Feijoo, Sriram Sankaranarayanan, Rodrigo Martinez and Diego A. Martinez
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Jorge A. Acuna: University of South Florida
José L. Zayas-Castro: University of South Florida
Felipe Feijoo: Pontificia Universidad Católica de Valparaíso
Sriram Sankaranarayanan: Indian Institute of Management
Rodrigo Martinez: Universidad de Chile
Diego A. Martinez: Pontificia Universidad Católica de Valparaíso

Health Care Management Science, 2022, vol. 25, issue 1, No 6, 100-125

Abstract: Abstract Prolonged waiting to access health care is a primary concern for nations aiming for comprehensive effective care, due to its adverse effects on mortality, quality of life, and government approval. Here, we propose two novel bargaining frameworks to reduce waiting lists in two-tier health care systems with local and regional actors. In particular, we assess the impact of 1) trading patients on waiting lists among hospitals, the 2) introduction of the role of private hospitals in capturing unfulfilled demand, and the 3) hospitals’ willingness to share capacity on the system performance. We calibrated our models with 2008–2018 Chilean waiting list data. If hospitals trade unattended patients, our game-theoretic models indicate a potential reduction of waiting lists of up to 37%. However, when private hospitals are introduced into the system, we found a possible reduction of waiting lists of up to 60%. Further analyses revealed a trade-off between diagnosing unserved demand and the additional expense of using private hospitals as a back-up system. In summary, our game-theoretic frameworks of waiting list management in two-tier health systems suggest that public–private cooperation can be an effective mechanism to reduce waiting lists. Further empirical and prospective evaluations are needed.

Keywords: Game theory; Operations research; Waiting lists; Universal health care; Health care delivery; Health economics (search for similar items in EconPapers)
Date: 2022
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DOI: 10.1007/s10729-021-09577-x

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