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Delayed Discharges and Hospital Type: Evidence from the English NHS

Author

Listed:
  • Joan Costa‐Font
  • Edward C. Norton
  • Luigi Siciliani
  • James Gaughan
  • Hugh Gravelle
  • Luigi Siciliani

Abstract

Delayed discharges of patients from hospital, commonly known as bed-blocking, is a long standing policy concern. Delays can increase the overall cost of treatment and may worsen patient outcomes. We investigate how delayed discharges vary by hospital type (Acute, Specialist, Mental Health, Teaching), and the extent to which such differences can be explained by demography, casemix, the availability of long-term care and hospital governance as reflected in whether the hospital has Foundation Trust status, which gives greater financial autonomy and flexibility in staffing and pay. We use a new panel database of delays in all English NHS hospital Trusts from 2011/12 to 2013/14. Employing count data models, we find that a greater local supply of long-term care (care home beds) is associated with fewer delays. Hospitals which are Foundation Trusts have fewer delayed discharges and might therefore be used as exemplars of good practice in managing delays. Mental Health Trusts have more delayed discharges than Acute Trusts but a smaller proportion of them are attributed to the NHS, possibly indicating a relatively greater lack of adequate community care for mental health patients.
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Suggested Citation

  • Joan Costa‐Font & Edward C. Norton & Luigi Siciliani & James Gaughan & Hugh Gravelle & Luigi Siciliani, 2017. "Delayed Discharges and Hospital Type: Evidence from the English NHS," Fiscal Studies, Institute for Fiscal Studies, vol. 38, pages 495-519, September.
    • Handle: RePEc:ifs:fistud:v:38:y:2017:i::p:495-519
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    Cited by:

    1. Jim G. Dai & Pengyi Shi, 2021. "Recent Modeling and Analytical Advances in Hospital Inpatient Flow Management," Production and Operations Management, Production and Operations Management Society, vol. 30(6), pages 1838-1862, June.
    2. DeVolder, Russell & Serra-Sastre, Victoria & Zamora, Bernarda, 2020. "Examining the variation across acute trusts in patient delayed discharge," Health Policy, Elsevier, vol. 124(11), pages 1226-1232.
    3. Dan Liu & Maria Lucia Pace & Maria Goddard & Rowena Jacobs & Raphael Wittenberg & Anne Mason, 2021. "Investigating the relationship between social care supply and healthcare utilization by older people in England," Health Economics, John Wiley & Sons, Ltd., vol. 30(1), pages 36-54, January.
    4. Brendan Walsh & Seán Lyons & Samantha Smith & Maev‐Ann Wren & James Eighan & Edgar Morgenroth, 2020. "Does formal home care reduce inpatient length of stay?," Health Economics, John Wiley & Sons, Ltd., vol. 29(12), pages 1620-1636, December.
    5. Ozbugday, Fatih Cemil & Tirgil, Abdullah & Kose, Elif Gul, 2020. "Efficiency changes in long-term care in OECD countries: A non-parametric Malmquist Index approach," Socio-Economic Planning Sciences, Elsevier, vol. 70(C).
    6. 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.
    7. Moura, Ana, 2021. "Essays in health economics," Other publications TiSEM c93abd22-fa4a-42a5-b172-d, Tilburg University, School of Economics and Management.
    8. Moura, Ana, 2022. "Do subsidized nursing homes and home care teams reduce hospital bed-blocking? Evidence from Portugal," Journal of Health Economics, Elsevier, vol. 84(C).
    9. Bosque-Mercader, Laia & Conroy, Simon & Lasserson, Daniel & Mannion, Russell & Nicodemo, Catia & Wittenberg, Raphael, 2025. "Resilience of the acute sector in recovery from COVID-19 pressures," Social Science & Medicine, Elsevier, vol. 375(C).
    10. Ghazalbash, Somayeh & Zargoush, Manaf & Mowbray, Fabrice & Costa, Andrew, 2022. "Impact of multimorbidity and frailty on adverse outcomes among older delayed discharge patients: Implications for healthcare policy," Health Policy, Elsevier, vol. 126(3), pages 197-206.

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