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Long-term care spending and hospital use among the older population in England

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  • Crawford, Rowena
  • Stoye, George
  • Zaranko, Ben

Abstract

This paper examines the impact of changes in public long-term care spending on the use of public hospitals among the older population in England. Mean per-person long-term care spending fell by 31% between 2009/10 and 2017/18, but cuts varied considerably geographically. We instrument public long-term care spending with predicted spending based on historical national funding shares and national spending trends. We find that reductions in public long-term care spending led to substantial increases in the number of emergency department (ED) visits made by patients aged 65 and above, explaining between a quarter and a half of the growth in ED use among this population over this period, and to an increase in the share of patients revisiting the ED within seven days. However, there was no impact on wider use of inpatient or outpatient services (which are more expensive to provide), and consequently little impact on overall hospital costs.

Suggested Citation

  • Crawford, Rowena & Stoye, George & Zaranko, Ben, 2021. "Long-term care spending and hospital use among the older population in England," Journal of Health Economics, Elsevier, vol. 78(C).
    • Handle: RePEc:eee:jhecon:v:78:y:2021:i:c:s016762962100062x
    DOI: 10.1016/j.jhealeco.2021.102477
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    2. Francesco Longo & Karl Claxton & Stephen Martin & James Lomas, 2023. "More long‐term care for better healthcare and vice versa: investigating the mortality effects of interactions between these public sectors," Fiscal Studies, John Wiley & Sons, vol. 44(2), pages 189-216, June.
    3. Loi Tan Nguyen & Phouthakannha Nantharath & Eungoo Kang, 2022. "The Sustainable Care Model for an Ageing Population in Vietnam: Evidence from a Systematic Review," Sustainability, MDPI, vol. 14(5), pages 1-17, February.
    4. Amy H. I. Lee & He-Yau Kang & Yu-Ai Liu, 2021. "A Pilot Study on the Satisfaction of Long-Term Care Services in Taiwan," IJERPH, MDPI, vol. 19(1), pages 1-21, December.
    5. Ludovico Carrino & Vahé Nafilyan & Mauricio Avendano, 2023. "Should I Care or Should I Work? The Impact of Work on Informal Care," Journal of Policy Analysis and Management, John Wiley & Sons, Ltd., vol. 42(2), pages 424-455, March.
    6. Serrano-Alarcón, Manuel & Hernández-Pizarro, Helena & López-Casasnovas, Guillem & Nicodemo, Catia, 2022. "Effects of long-term care benefits on healthcare utilization in Catalonia," Journal of Health Economics, Elsevier, vol. 84(C).

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    More about this item

    Keywords

    Long-term care; Hospital use; Emergency department; Quality of care; Health expenditure; Austerity;
    All these keywords.

    JEL classification:

    • I10 - Health, Education, and Welfare - - Health - - - General
    • H51 - Public Economics - - National Government Expenditures and Related Policies - - - Government Expenditures and Health

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