The impact of an increase in foreigners on the waiting times in healthcare in Malta

Abstract

The increasing presence of foreign residents in Malta has raised questions about its impact on essential public services, including healthcare. As Malta’s only major public hospital, Mater Dei Hospital’s Emergency Department (ED) is critical to meeting the healthcare needs of both locals and foreigners. With the continuous growth of the foreign population, concerns have emerged regarding potential strains on the system, particularly in terms of increased waiting times in emergency care. This study investigates the impact of foreign residents on waiting times in Malta’s healthcare system, specifically at Mater Dei Hospital’s Emergency Department (ED). The objective is to assess whether foreign residents experience longer waiting times than Maltese residents and to identify the main factors contributing to these delays. Using data spanning from 2017 to 2023, the research employs an Ordinary Least Squares (OLS) regression model to examine various determinants of ED waiting times, including nationality, age, gender, arrival type, triage level, and the need for admission. The methodology involved comprehensive data cleaning and preparation of over 600,000 anonymous observations from Mater Dei’s records to fully adhere to ethical considerations. Separate regressions were run for the years 2017, 2020, and 2023 to account for temporal variations, particularly the effects of the COVID-19 pandemic. The results showed that although nationality has a statistically significant impact on waiting times, its influence is relatively low compared to other variables. These findings underscore the need for policy measures to manage ED demand, particularly for non-native populations, and improve the overall efficiency of Malta’s healthcare system.