Paying for Efficiency: Incentivising same-day discharges in the English NHS

James Gaughan, Nils Gutacker (), Katja Grasic, Noemi Kreif, Luigi Siciliani and Andrew Street
Additional contact information
James Gaughan: Centre for Health Economics, University of York, York, UK
Katja Grasic: Centre for Health Economics, University of York, York, UK
Noemi Kreif: Centre for Health Economics, University of York, York, UK

No 157cherp, Working Papers from Centre for Health Economics, University of York

Abstract: We study a pay-for-efficiency scheme that encourages hospitals to admit and discharge patients on the same calendar day where clinically appropriate. Since 2010, hospitals in the English NHS receive a higher price for patients treated as same-day discharge than for overnight stays, despite the former being less costly. We analyse administrative data for patients treated for 191 conditions for which same-day discharge is clinically appropriate — of which 32 are incentivised — during 2006-2014. Using interrupted time series, differences-in-differences and synthetic control methods, we find that the policy generally had a positive effect on planned conditions with a statistically significant effect in about a third of conditions. The results are more mixed for emergency conditions. The median elasticity (across all 32 conditions) is 0.09 but above one for six conditions. Condition-specific design features explain some, but not all, of the differential responses.

Keywords: Pay for Performance; Best Practice Tariff; day surgery; same-day discharge; policy evaluation (search for similar items in EconPapers)
JEL-codes: D22 I11 (search for similar items in EconPapers)
Pages: 35 pages
Date: 2018-08
New Economics Papers: this item is included in nep-eur and nep-hea
References: View references in EconPapers View complete reference list from CitEc
Citations: View citations in EconPapers (2)

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https://www.york.ac.uk/media/che/documents/papers/ ... pital_discharges.pdf First version, 2018 (application/pdf)

Related works:
Journal Article: Paying for efficiency: Incentivising same-day discharges in the English NHS (2019)
Working Paper: Paying for efficiency: incentivising same-day discharges in the English NHS (2019)
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