Improving access to services for psychotic patients: does implementing a waiting time target make a difference
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ORIGINAL PAPER
Improving access to services for psychotic patients: does implementing a waiting time target make a difference Anika Kreutzberg1 · Rowena Jacobs2 Received: 23 December 2018 / Accepted: 4 February 2020 © The Author(s) 2020
Abstract Objective In April 2015, the English National Health Service started implementing the first waiting time targets in mental health care. This study aims to investigate the effect of the 14-day waiting time target for early intervention in psychosis (EIP) services after the first six months of its implementation. Study design We analyse a cohort of first-episode psychosis patients from the English administrative Mental Health and Learning Disabilities Dataset 2011 to 2015. We compare patients being treated by EIP services (treatment) with those receiving care from standard community mental health services (control). We combine non-parametric matching with a difference-in-difference approach to account for observed and unobserved group differences. We analyse the probability of waiting below target and look at different percentiles of the waiting time distribution. Results EIP patients had an 11.6–18.4 percentage point higher chance of waiting below target post-policy compared to standard care patients. However, post-policy trends at different percentiles of the waiting time distribution were not different between groups. Conclusions Mental health providers seem to respond to waiting time targets in a similar way as physical health providers. The increased proportion waiting below target did not, however, result in an overall improvement across the waiting time distribution. Keywords Waiting time targets · Mental health · Early intervention in psychosis · Difference-in-difference analysis JEL Classification C31 · D04 · I11
Introduction Providing access to services for people in need of care is a key perspective for health systems around the world [1]. Hence, waiting times are of persistent policy concern in countries with National Health Service systems and universal access such as the United Kingdom, Canada, New Electronic supplementary material The online version of this article (https://doi.org/10.1007/s10198-020-01165-0) contains supplementary material, which is available to authorized users. * Anika Kreutzberg anika.kreutzberg@tu‑berlin.de 1
Department of Health Care Management, Technical University of Berlin, Strasse des 17. Juni 135, 10623 Berlin, Germany
Centre for Health Economics, University of York, Alcuin College, York YO105DD, UK
2
Zealand, or Australia [2, 3]. Waiting lists can serve to stock available demand and optimise utilisation of the scarce supply of resources such as skilled staff and medical equipment [4]. However, excessively long waiting times risk poorer patient outcomes, create anxiety and disability during waiting [5–7] and threaten the desired principles of timely and equitable access to care [8]. A number of countries operate waiting time targets to guarantee patients access to care within a maximum window of time, even th
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