Has payment by results affected how care is recorded?

摘要

Payment by results has changed the recorded inpatient activity of hospitals,1 butwhether this represents a genuine change in activity or a change in the way activity is recorded is not clear. Take as an example upper gastrointestinal endoscopy-a common procedure performed on patients who are not otherwise staying in hospital.Historically, some hospitals recorded these procedures as day case admissions, others as outpatient procedures. It did not matter: the patient got the test, and the hospital got paid under the block contract. Under payment by results, however, the hospital gets more income fora day case admission with procedure than for an outpatient procedure. Astute business managers will ensure that activity is recorded for administrative purposes in whichever legitimate manner will maximise income.