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Modelling the Dynamic Effects of Elective Hospital Admissions on Emergency Levels in England

Author

Listed:
  • Jimenez-Martin, Sergi

    () (Universitat Pompeu Fabra)

  • Nicodemo, Catia

    () (University of Oxford)

  • Redding, Stuart

    () (University of Oxford)

Abstract

In England as elsewhere, policy makers are trying to reduce the pressure on costs due to rising hospital admissions by encouraging GPs to refer fewer patients to hospital specialists. This could have an impact on elective treatment levels, particularly procedures for conditions which are not life-threatening and can be delayed or perhaps withheld entirely. This study attempts to determine whether cost savings in one area of publicly funded health care may lead to cost increases in another and therefore have unintended consequences by offsetting the cost-saving benefits anticipated by policy makers. Using administrative data from Hospital Episode Statistics (HES) in England we estimate dynamic fixed effects panel data models for emergency admissions at Primary Care Trust and Hospital Trust levels for the years 2004–13, controlling for a group of area-specific characteristics and other secondary care variables. We find a negative link between current levels of elective care and future levels of emergency treatment. This observation comes from a time of growing admissions and there is no guarantee that the link between emergency and elective activity will persist if policy is effective in reducing levels of elective treatment, but our results suggest that the cost-saving benefits to the NHS from reducing elective treatment are reduced by between 5.6 per cent and 15.5 per cent in aggregate as a consequence of increased emergency activity.

Suggested Citation

  • Jimenez-Martin, Sergi & Nicodemo, Catia & Redding, Stuart, 2019. "Modelling the Dynamic Effects of Elective Hospital Admissions on Emergency Levels in England," IZA Discussion Papers 12340, Institute of Labor Economics (IZA).
  • Handle: RePEc:iza:izadps:dp12340
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    References listed on IDEAS

    as
    1. Majid M. Al-Sadoon & Sergi Jiménez-Martín & Jose M. Labeaga, 2019. "Simple methods for consistent estimation of dynamic panel data sample selection models," Economics Working Papers 1631, Department of Economics and Business, Universitat Pompeu Fabra.
    2. Coast, J. & Smith, R. D. & Millar, M. R., 1998. "An economic perspective on policy to reduce antimicrobial resistance," Social Science & Medicine, Elsevier, vol. 46(1), pages 29-38, January.
    3. Ludwig Kuntz & Roman Mennicken & Stefan Scholtes, 2015. "Stress on the Ward: Evidence of Safety Tipping Points in Hospitals," Management Science, INFORMS, vol. 61(4), pages 754-771, April.
    4. Manuel Arellano & Stephen Bond, 1991. "Some Tests of Specification for Panel Data: Monte Carlo Evidence and an Application to Employment Equations," Review of Economic Studies, Oxford University Press, vol. 58(2), pages 277-297.
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    More about this item

    Keywords

    emergency; hospital admissions; elective; NHS;

    JEL classification:

    • I10 - Health, Education, and Welfare - - Health - - - General
    • I14 - Health, Education, and Welfare - - Health - - - Health and Inequality
    • C10 - Mathematical and Quantitative Methods - - Econometric and Statistical Methods and Methodology: General - - - General
    • B12 - Schools of Economic Thought and Methodology - - History of Economic Thought through 1925 - - - Classical (includes Adam Smith)

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