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dc.contributor.authorMcIntosh, Bryan*
dc.contributor.authorCookson, G.*
dc.contributor.authorJones, S.*
dc.date.accessioned2014-10-21T16:10:32Z
dc.date.available2014-10-21T16:10:32Z
dc.date.issued2012
dc.identifier.citationMcIntosh, 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.
dc.identifier.urihttp://hdl.handle.net/10454/6502
dc.description.abstractOBJECTIVES: 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.
dc.relation.isreferencedbyhttp://dx.doi.org/10.1258/jhsrp.2011.011053
dc.subjectAdolescent
dc.subjectAdult
dc.subjectAged
dc.subjectAged, 80 and over
dc.subjectAppointments and Schedules
dc.subjectChild
dc.subjectChild, Preschool
dc.subjectEngland
dc.subjectFemale
dc.subjectHealth Services Research
dc.subjectHumans
dc.subjectInfant
dc.subjectMale
dc.subjectMiddle Aged
dc.subjectModels, Statistical
dc.subjectRefusal to Treat
dc.subjectRetrospective Studies
dc.subjectHealthcare organization & administration
dc.subjectSurgical Procedures; Elective; Economics; Statistics & numerical data
dc.subjectYoung Adult
dc.titleCancelled surgeries and payment by results in the English National Health Service
dc.typearticle


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