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.
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.
Original language | English |
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Place of Publication | York |
Publisher | Centre for Health Economics, University of York |
Number of pages | 35 |
Publication status | Published - Aug 2018 |
Publication series
Name | CHE Research Paper |
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Publisher | Centre for Health Economics, University of York |
No. | 157 |
Bibliographical note
© 2018 the author. The full text of this report can be viewed free of charge from the Centre for Health Economics web site at: https://www.york.ac.uk/media/che/documents/papers/researchpapers/CHERP157_financial_incentives_hospital_discharges.pdfKeywords
- Pay for Performance
- Best Practice Tariff
- day surgery
- same-day discharge
- policy evaluation