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Long-term care provision, hospital bed blocking, and discharge destination for hip fracture and stroke patients

Author

Listed:
  • James Gaughan

    (University of York)

  • Hugh Gravelle

    (University of York)

  • Rita Santos

    (University of York)

  • Luigi Siciliani

    (University of York
    University of York)

Abstract

We examine the relationship between long-term care supply (care home beds and prices) and (i) the probability of being discharged to a care home and (ii) length of stay in hospital for patients admitted to hospital for hip fracture or stroke. Using patient level data from all English hospitals and allowing for a rich set of demographic and clinical factors, we find no association between discharge destination and long-term care beds supply or prices. We do, however, find evidence of bed blocking: hospital length of stay for hip fracture patients discharged to a care home is shorter in areas with more long-term care beds and lower prices. Length of stay is over 30% shorter in areas in the highest quintile of care home beds supply compared to those in the lowest quintile.

Suggested Citation

  • James Gaughan & Hugh Gravelle & Rita Santos & Luigi Siciliani, 2017. "Long-term care provision, hospital bed blocking, and discharge destination for hip fracture and stroke patients," International Journal of Health Economics and Management, Springer, vol. 17(3), pages 311-331, September.
    • Handle: RePEc:kap:ijhcfe:v:17:y:2017:i:3:d:10.1007_s10754-017-9214-z
    DOI: 10.1007/s10754-017-9214-z
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    1. Cookson R & Laudicella M, 2009. "Do the poor still cost more? The relationship between small area income deprivation and length of stay for elective hip replacement in the English NHS from 2001/2 to 2006/7," Health, Econometrics and Data Group (HEDG) Working Papers 09/07, HEDG, c/o Department of Economics, University of York.
    2. K. Bolin & B. Lindgren & P. Lundborg, 2008. "Informal and formal care among single‐living elderly in Europe," Health Economics, John Wiley & Sons, Ltd., vol. 17(3), pages 393-409, March.
    3. Bryan, Karen & Gage, Heather & Gilbert, Ken, 2006. "Delayed transfers of older people from hospital: Causes and policy implications," Health Policy, Elsevier, vol. 76(2), pages 194-201, April.
    4. Bonsang, Eric, 2009. "Does informal care from children to their elderly parents substitute for formal care in Europe?," Journal of Health Economics, Elsevier, vol. 28(1), pages 143-154, January.
    5. 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.
    6. Jose-Luis Fernandez & J. Forder, 2008. "Consequences of local variations in social care on the performance of the acute health care sector," Applied Economics, Taylor & Francis Journals, vol. 40(12), pages 1503-1518.
    7. Tor Holmås & Mohammad Kamrul Islam & Egil Kjerstad, 2013. "Between two beds: inappropriately delayed discharges from hospitals," International Journal of Health Economics and Management, Springer, vol. 13(3), pages 201-217, December.
    8. Gabriel Picone & R. Mark Wilson & Shin‐Yi Chou, 2003. "Analysis of hospital length of stay and discharge destination using hazard functions with unmeasured heterogeneity," Health Economics, John Wiley & Sons, Ltd., vol. 12(12), pages 1021-1034, December.
    9. Adelina Comas-Herrera & Raphael Wittenberg & Linda Pickard, 2012. "From Commission to Commission: Financing Long-Term Care in England," Palgrave Macmillan Books, in: Joan Costa-Font & Christophe Courbage (ed.), Financing Long-Term Care in Europe, chapter 9, pages 151-169, Palgrave Macmillan.
    10. Glendinning, Caroline, 2003. "Breaking down barriers: integrating health and care services for older people in England," Health Policy, Elsevier, vol. 65(2), pages 139-151, August.
    11. 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.
    12. Van Houtven, Courtney Harold & Norton, Edward C., 2004. "Informal care and health care use of older adults," Journal of Health Economics, Elsevier, vol. 23(6), pages 1159-1180, November.
    13. 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, November.
    14. Mundlak, Yair, 1978. "On the Pooling of Time Series and Cross Section Data," Econometrica, Econometric Society, vol. 46(1), pages 69-85, January.
    15. Heckman, James, 2013. "Sample selection bias as a specification error," Applied Econometrics, Russian Presidential Academy of National Economy and Public Administration (RANEPA), vol. 31(3), pages 129-137.
    16. Adriana Castelli & Mauro Laudicella & Andrew Street, 2008. "Measuring NHS Output Growth," Working Papers 043cherp, Centre for Health Economics, University of York.
    17. Jeffrey M Wooldridge, 2010. "Econometric Analysis of Cross Section and Panel Data," MIT Press Books, The MIT Press, edition 2, volume 1, number 0262232588, December.
    18. James Gaughan & Hugh Gravelle & Rita Santos & Luigi Siciliani, 2013. "Long term care provision, hospital length of stay and discharge destination for hip fracture and stroke patients," Working Papers 086cherp, Centre for Health Economics, University of York.
    19. Stephen Allan & Julien Forder, 2015. "The Determinants of Care Home Closure," Health Economics, John Wiley & Sons, Ltd., vol. 24, pages 132-145, March.
    20. Cookson, Richard & Laudicella, Mauro, 2011. "Do the poor cost much more? The relationship between small area income deprivation and length of stay for elective hip replacement in the English NHS from 2001 to 2008," Social Science & Medicine, Elsevier, vol. 72(2), pages 173-184, January.
    21. Stephen Allan & Julien Forder, 2015. "The Determinants of Care Home Closure," Health Economics, John Wiley & Sons, Ltd., vol. 24(S1), pages 132-145, March.
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    2. 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.
    3. Rachet-Jacquet, Laurie, 2022. "Do breaks from surgery improve the performance of orthopaedic surgeons?," Journal of Health Economics, Elsevier, vol. 85(C).
    4. Quitterie Roquebert & Remi Kabore & Jerome Wittwer, 2018. "Decentralized policies and formal care use by the disabled elderly," Working Papers halshs-01877829, HAL.
    5. Snorre Kverndokk & Hans Olav Melberg, 2021. "Using fees to reduce bed-blocking: a game between hospitals and long-term care providers," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 22(6), pages 931-949, August.
    6. 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.
    7. Amada Pellico-López & David Cantarero & Ana Fernández-Feito & Paula Parás-Bravo & Joaquín Cayón de las Cuevas & María Paz-Zulueta, 2019. "Factors Associated with Bed-Blocking at a University Hospital (Cantabria, Spain) between 2007 and 2015: A Retrospective Observational Study," IJERPH, MDPI, vol. 16(18), pages 1-13, September.
    8. Maria Lucia Pace & Dan Liu & Maria Goddard & Rowena Jacobs & Raphael Wittenberg & Gerard McGonigal & Anne Mason, 2020. "The relationship between social care resources and healthcare utilisation by older people in England:an exploratory investigation," Working Papers 174cherp, Centre for Health Economics, University of York.
    9. 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).
    10. 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).
    11. Christian Kümpel, 2019. "Do financial incentives influence the hospitalization rate of nursing home residents? Evidence from Germany," Health Economics, John Wiley & Sons, Ltd., vol. 28(11), pages 1235-1247, November.
    12. 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.
    13. Rowena Crawford & George Stoye & Ben Zaranko, 2018. "The impact of cuts to social care spending on the use of Accident and Emergency departments in England," IFS Working Papers W18/15, Institute for Fiscal Studies.
    14. Walsh, Brendan & Wren, Maev-Ann & Smith, Samantha & Lyons, Seán & Eighan, James & Morgenroth, Edgar, 2019. "An analysis of the effects on Irish hospital care of the supply of care inside and outside the hospital," Research Series, Economic and Social Research Institute (ESRI), number RS91, June.

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    More about this item

    Keywords

    Hospitals; Length of stay; Long-term care; Care homes; Bed blocking; Substitution;
    All these keywords.

    JEL classification:

    • I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets

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