Cancelled Procedures in the English NHS: Evidence from the 2010 Tariff Reform

• Published in: Health economics 2017-12, Vol.26 (12), p.e126-e139
• Main Authors: Cookson, Graham, Jones, Simon, Laliotis, Ioannis
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; cancelled procedures; Child; Child, Preschool; Costs and Cost Analysis - statistics & numerical data; Elective Surgical Procedures - economics; Elective Surgical Procedures - statistics & numerical data; English NHS; Female; Financial incentives; Health care; Health Care Reform - organization & administration; Health Care Reform - statistics & numerical data; Health economics; Health services; Humans; incentives; Infant; Infant, Newborn; Male; Materials management; Middle Aged; Models, Statistical; Patient admissions; reforms; Reimbursement, Incentive - economics; Reimbursement, Incentive - statistics & numerical data; State Medicine - organization & administration; State Medicine - statistics & numerical data; Tariffs; Time series; United Kingdom
• ISSN: 1057-9230; 1099-1050
• DOI: 10.1002/hec.3486

Summary This paper explores the role of incentives in the English National Health Service. Until financial year 2009/2010, elective procedures that were cancelled after admission received a fixed reimbursement associated with a specific healthcare resource group code. We investigate whether this induced trusts to admit and then cancel, rather than cancel before admission and/or to cancel low fee over high fee work. As the tariff was ended in April 2010, we conduct an interrupted time series analysis to examine if their behaviour was affected after the tariff removal. The results indicate a small, yet statistically significant, decline in the probability of a last minute cancellation in the post‐tariff period, especially for certain types of patients and diagnoses. Copyright © 2017 John Wiley & Sons, Ltd.