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

Gaughan, James, Gutacker, Nils, Grašič, Katja, Kreif, Noemi, Siciliani, Luigi and Street, Andrew ORCID: 0000-0002-2540-0364 (2019) Paying for efficiency: incentivising same-day discharges in the English NHS. Journal of Health Economics, 68. ISSN 0167-6296

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Identification Number: 10.1016/j.jhealeco.2019.102226


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.

Item Type: Article
Official URL:
Additional Information: © 2019 The Authors
Divisions: Health Policy
Subjects: R Medicine > RA Public aspects of medicine
JEL classification: I - Health, Education, and Welfare > I1 - Health > I11 - Analysis of Health Care Markets
Date Deposited: 18 Sep 2019 08:27
Last Modified: 13 Jun 2024 16:24

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