Centre Health Economics Research Paper No 157, August 2018
- Same Day Discharge (SDD) Best Practice Tariff (BPT) involves paying a higher price for SDD than for care that involves an overnight or longer stay in hospital and has been applied to 32 different conditions in the NHS in England. This research examines the effect of price changes on treatment choices.
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
