Paying for efficiency: incentivising same-day discharges in the English NHS

James Gaughan, Nils Gutacker (), Katja Grašič, Noemi Kreif, Luigi Siciliani and Andrew Street

LSE Research Online Documents on Economics from London School of Economics and Political Science, LSE Library

Abstract: We study a pay-for-efficiency scheme that encourages hospitals to admit and discharge patients on the same calendar day when clinically appropriate. Since 2010, hospitals in the English NHS are incentivised by 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 during 2006–2014 for 191 conditions for which same-day discharge is clinically appropriate – of which 32 are incentivised. Using difference-in-difference and synthetic control methods, we find that the policy had generally a positive impact with a statistically significant effect in 14 out of the 32 conditions. The median elasticity is 0.24 for planned and 0.01 for emergency conditions. Condition-specific design features explain some, but not all, of the differential responses.

Keywords: activity based funding; DRGs; hospital incentives; pay for performance; policy evaluation; prospective payment systems; synthetic control method (search for similar items in EconPapers)
JEL-codes: I11 (search for similar items in EconPapers)
Pages: 20 pages
Date: 2019-12-01
New Economics Papers: this item is included in nep-eur and nep-hea
References: Add references at CitEc
Citations: View citations in EconPapers (4)

Published in Journal of Health Economics, 1, December, 2019, 68. ISSN: 0167-6296

Downloads: (external link)
http://eprints.lse.ac.uk/101650/ Open access version. (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 (2018)
This item may be available elsewhere in EconPapers: Search for items with the same title.

Export reference: BibTeX RIS (EndNote, ProCite, RefMan) HTML/Text

Persistent link: https://EconPapers.repec.org/RePEc:ehl:lserod:101650

Access Statistics for this paper

More papers in LSE Research Online Documents on Economics from London School of Economics and Political Science, LSE Library LSE Library Portugal Street London, WC2A 2HD, U.K.. Contact information at EDIRC.
Bibliographic data for series maintained by LSERO Manager ().