Paying for Efficiency: Incentivising Same-Day Discharges in the English NHS

Publication date: Available online 21 August 2019Source: Journal of Health EconomicsAuthor(s): James Gaughan, Nils Gutacker, Katja Grašič, Noemi Kreif, Luigi Siciliani, Andrew StreetAbstractWe 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.
Source: Journal of Health Economics - Category: Health Management Source Type: research