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Delayed Discharges and Hospital Type: Evidence from the English NHS

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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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    References listed on IDEAS

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    1. Rossella Verzulli & Rowena Jacobs & Maria Goddard, 2011. "Do hospitals respond to greater autonomy? Evidence from the English NHS," Working Papers 064cherp, Centre for Health Economics, University of York.
    2. Kolstad, Jonathan T. & Kowalski, Amanda E., 2012. "The impact of health care reform on hospital and preventive care: Evidence from Massachusetts," Journal of Public Economics, Elsevier, vol. 96(11), pages 909-929.
    3. repec:wly:japmet:v:1:y:1986:i:1:p:29-53 is not listed on IDEAS
    4. James Gaughan & Hugh Gravelle & Luigi Siciliani, 2014. "Testing the bed-blocking hypothesis: does higher supply of nursing and care homes reduce delayed hospital discharges?," Working Papers 102cherp, Centre for Health Economics, University of York.
    5. A. Colin Cameron & Pravin K. Trivedi, 1986. "Econometric models based on count data. Comparisons and applications of some estimators and tests," Journal of Applied Econometrics, John Wiley & Sons, Ltd., vol. 1(1), pages 29-53, January.
    6. de Meijer, Claudine & Koopmanschap, Marc & d' Uva, Teresa Bago & van Doorslaer, Eddy, 2011. "Determinants of long-term care spending: Age, time to death or disability?," Journal of Health Economics, Elsevier, vol. 30(2), pages 425-438, March.
    7. Kuhn, Michael & Nuscheler, Robert, 2011. "Optimal public provision of nursing homes and the role of information," Journal of Health Economics, Elsevier, vol. 30(4), pages 795-810, July.
    8. Julien Forder, 2009. "Long-term care and hospital utilisation by older people: an analysis of substitution rates," Health Economics, John Wiley & Sons, Ltd., vol. 18(11), pages 1322-1338.
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