Explaining the Gender Gap in Waiting Times for Scheduled Surgery in the Portuguese National Health Service

Objective: This paper evaluates the gender gap in waiting times for scheduled surgery, using information on 2.6 million surgical episodes in Portuguese National Health Service hospitals covering the period from 2011 to 2015. Methodology: We estimated the gross gender gap, i.e., the differential between the waiting times of men and women, and then add several explanatory variables that can account for this difference to estimate an adjusted gender gap. The variables are added in a way that permits the most flexible parametric specification. Next, we used Gelbach’s decomposition to understand the contribution of each variable to the difference between the gross and the adjusted gender gaps. Results: The gross gender gap of 10% is reduced to a 3% adjusted gender gap after accounting for observable explanatory factors. Gelbach’s decomposition shows that patient priority and hospital-fixed effects are the variables that contribute the most to the explained component of the gap. The analysis suggests that men tend to be ranked with more severe priorities, and that there are hospital specificities that cause men to have shorter waiting times. Conclusions: Overall, we identified a gender bias against women in surgery waiting times, but the size of the bias is smaller than was previously suggested in the literature.