Long waiting times for elective (non-urgent) surgery have been a longstanding issue in many European countries dating back well before the pandemic, but the disruption of elective care during the pandemic exacerbated waiting times as many non-urgent interventions were suspended, generating more backlogs of patients on waiting lists. Long waiting times generate dissatisfaction for patients because the health benefits from treatment are postponed, patients can experience pain and discomfort while waiting, and the wait may worsen health outcomes for patients before and after the intervention.
The data presented in this section focus on waiting times for three high-volume surgical procedures: cataract surgery, hip replacement and knee replacement. They review the experience of patients who have been treated after waiting for a certain period of time and those who were still on the waiting lists. In several countries, the waiting times for patients still on waiting lists have increased more than for those who were treated.
Compared with the situation before the pandemic, the mean waiting times for people who had a cataract surgery in 2023 was close to 2019 in several countries (e.g. Hungary, Italy and Sweden) while it remained slightly higher than before the pandemic in the Netherlands and Spain (Figure 7.26, left panel). For patients still on waiting lists, the proportion who had been waiting for over three months increased in most countries between 2019 and 2023, with the exception of Portugal and Poland where it increased slightly in 2020 but then fell sharply between 2020 and 2023 (Figure 7.26, right panel). The increase between 2019 and 2023 of patients on waiting lists for over three months for a cataract surgery was particularly marked in Iceland and the United Kingdom, although the latest data for the United Kingdom relate to 2022 only. In Hungary, there was also a marked increase in the proportion of patients on waiting times for more than three months in 2020; while this proportion then fell to some extent, it remained higher than before the pandemic in 2023.
In Poland, waiting times for both patients who have been treated and those still on the waiting lists for cataract surgery have fallen sharply since 2019. This reflects the priority in recent years in Poland to reduce waiting times for cataract surgery as well as for hip and knee replacement for patients receiving these operations in the public system. In 2019, changes were introduced in the financing of cataract surgery to provide unlimited financing, meaning that the National Health Fund pays for all cataract operations.
For hip replacement, the mean waiting times for patients treated in 2023 was also close to 2019 levels in several countries (e.g. Netherlands, Denmark, Italy and Portugal), although it remained higher than before the pandemic in Finland, Lithuania, Norway, Spain, Hungary and Sweden (Figure 7.27, left panel). For patients still on the waiting lists, the proportion waiting for a hip replacement for over three months increased markedly in several countries in 2020. By 2023, it had returned back to pre‑pandemic levels in some countries such as Ireland and Portugal, but remained well above 2019 levels in Hungary, the United Kingdom and Sweden (Figure 7.27, right panel).
The cross-country variations and trends over time in waiting times for knee replacement are fairly similar to those for hip replacement, although in most countries the waiting times are generally longer for a knee than a hip replacement. The mean waiting times to get treatment increased greatly between 2019 and 2023 in Lithuania and to a lesser extent in Finland, Hungary, Norway, Spain and Sweden, while it fell in Poland following the priority to reduce waiting times for both knee and hip replacements for public sector patients (Figure 7.28, left panel). For patients still waiting for a knee replacement, the proportion waiting for more than three months increased in nearly all countries in 2020, but then reduced except in Sweden and the United Kingdom where this proportion continued to increase up to 2022 (Figure 7.28, right panel).
Many EU countries have taken actions to address the backlogs and longer waiting lists for elective care that were generated by the disruption of services during the pandemic. Most of these policies have focussed on providing additional funds to boost the supply of surgical operations (OECD/European Union, 2022[1]); Chapter 2). For example, the largest share of health investments of the EU-funded Recovery and Resilience Plan in Finland is dedicated to reducing waiting times for hospital as well as primary care services (OECD/European Observatory on Health Systems and Policies, 2023[2]).
