Cancelled surgeries and payment by results in the English National Health Service
Publication date
2012Keyword
AdolescentAdult
Aged
80 and over
Appointments and Schedules
Child
Preschool
England
Female
Health Services Research
Humans
Infant
Male
Middle Aged
Models
Statistical
Refusal to Treat
Retrospective Studies
Healthcare organization & administration
Surgical Procedures
Elective
Economics
Statistics & numerical data
Young Adult
Peer-Reviewed
YesOpen Access status
closedAccess
Metadata
Show full item recordAbstract
OBJECTIVES: To model the frequency of 'last minute' cancellations of planned elective procedures in the English NHS with respect to the patient and provider factors that led to these cancellations. METHODS: A dataset of 5,288,604 elective patients spell in the English NHS from January 1st, 2007 to December 31st, 2007 was extracted from the Hospital Episode Statistics. A binary dependent variable indicating whether or not a patient had a Health Resource Group coded as S22--'Planned elective procedure not carried out'--was modeled using a probit regression estimated via maximum likelihood including patient, case and hospital level covariates. RESULTS: Longer waiting times and being admitted on a Monday were associated with a greater rate of cancelled procedures. Male patients, patients from lower socio-economic groups and older patients had higher rates of cancelled procedures. There was significant variation in cancellation rates between hospitals; Foundation Trusts and private facilities had the lowest cancellation rates. CONCLUSIONS: Further research is needed on why Foundation Trusts exhibit lower cancellation rates. Hospitals with relatively high cancellation rates should be encouraged to tackle this problem. Further evidence is needed on whether hospitals are more likely to cancel operations where the procedure tariff is lower than the S22 tariff as this creates a perverse incentive to cancel. Understanding the underlying causes of why male, older and patients from lower socio-economic groups are more likely to have their operations cancelled is important to inform the appropriate policy response. This research suggests that interventions designed to reduce cancellation rates should be targeted to high-cancellation groups.Version
No full-text in the repositoryCitation
McIntosh B, Cookson G and Jones S (2012) Cancelled surgeries and payment by results in the English National Health Service. Journal of Health Services Research and Policy. 17(2): 79-86.Link to Version of Record
https://doi.org/10.1258/jhsrp.2011.011053Type
Articleae974a485f413a2113503eed53cd6c53
https://doi.org/10.1258/jhsrp.2011.011053