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

B-Tier
Journal: Journal of Health Economics
Year: 2019
Volume: 68
Issue: C

Authors (6)

Gaughan, James (not in RePEc) Gutacker, Nils (University of York) Grašič, Katja (not in RePEc) Kreif, Noemi (not in RePEc) Siciliani, Luigi (University of York) Street, Andrew (London School of Economics (LS...)

Score contribution per author:

0.335 = (α=2.01 / 6 authors) × 1.0x B-tier

α: calibrated so average coauthorship-adjusted count equals average raw count

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.

Technical Details

RePEc Handle
repec:eee:jhecon:v:68:y:2019:i:c:s0167629618306696
Journal Field
Health
Author Count
6
Added to Database
2026-01-25