Long waiting times for health services have been an important policy issue in most OECD countries for many years as they generate dissatisfaction for patients because the expected benefits of diagnoses and treatments are postponed, and the pain and discomfort remain while people wait. The current COVID‑19 pandemic will likely increase waiting times for a range of non-urgent health services in many countries at least in the short-term as a result of treatment and elective surgery being rescheduled and postponed.
Governments in many countries took various measures before the COVID-19 outbreak to reduce waiting times, often supported by additional funding, with mixed success. Waiting times for elective treatment, which is usually the longest wait, stalled between 2010 and 2019 in many countries, and started to rise again in some others prior to the COVID-19 pandemic.
This report was prepared for the most part in 2019 before the COVID-19 crisis. It first reviews the importance of waiting times issues across OECD countries, based on responses to a policy questionnaire administered in 2019 and information gathered directly from citizens through population-based surveys. Second, it provides an overview of how waiting times differ across OECD countries up to 2019, focussing on waiting times for consultations with general practitioners (GPs), specialist consultations and elective treatments, based on survey data and the regular OECD data collection on waiting times for elective surgery. Third, it reviews evidence about the impact of waiting times on access to care and health outcomes for patients, using data on unmet medical care needs from the European Union Survey of Income and Living Conditions (EU-SILC) and a review of the literature from different countries. The fourth and main part of this report reviews a range of policy interventions that countries have used before the COVID-19 pandemic to tackle waiting times for different services, including elective surgery, primary care, cancer care and mental health services, with a focus on identifying successful policies.
The preparation of this report was led by Luigi Siciliani (University of York) and Gaetan Lafortune (OECD). Rie Fujisawa (OECD) and Sabine Vuik (OECD) provided useful data analysis and prepared the section on waiting times for cancer care and primary care, respectively. Emily Hewlett (OECD) drafted the section on waiting times for mental health services. Francesca Colombo (Head of the OECD Health Division) provided useful comments on different parts of this report. Lucy Hulett and Natalie Corry helped in preparing and finalising the manuscript.
The authors of the report thank officials from Health Ministries who provided valuable comments on an earlier draft during the OECD Health Committee meeting that was held in Paris on 11‑12 December 2019. They are also grateful to all the officials from Health Ministries who responded to the policy and data questionnaire that was administered in 2019, which provided a large part of the information contained in this report.