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

In the latest CHE Research Paper 157, Gaughan et al evaluate 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. Gaughan et al 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, they 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. Condition-specific design features such as the average profit margin explain some, but not all, of the differential responses.

Full Report: CHE Research Paper 157 (PDF , 2,139kb)

Other papers in the CHE Research paper series can be found at: CHE Research Papers