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Testing the Bed‐Blocking Hypothesis: Does Nursing and Care Home Supply Reduce Delayed Hospital Discharges?


  • James Gaughan
  • Hugh Gravelle
  • Luigi Siciliani


Hospital bed‐blocking occurs when hospital patients are ready to be discharged to a nursing home, but no place is available, so that hospital care acts as a more costly substitute for long‐term care. We investigate the extent to which greater supply of nursing home beds or lower prices can reduce hospital bed‐blocking using a new Local Authority (LA) level administrative data from England on hospital delayed discharges in 2009–2013. The results suggest that delayed discharges respond to the availability of care home beds, but the effect is modest: an increase in care home beds by 10% (250 additional beds per LA) would reduce social care delayed discharges by about 6–9%. We also find strong evidence of spillover effects across LAs: more care home beds or fewer patients aged over 65 years in nearby LAs are associated with fewer delayed discharges. © 2015 The Authors. Health Economics Published by John Wiley & Sons Ltd.

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  • James Gaughan & Hugh Gravelle & Luigi Siciliani, 2015. "Testing the Bed‐Blocking Hypothesis: Does Nursing and Care Home Supply Reduce Delayed Hospital Discharges?," Health Economics, John Wiley & Sons, Ltd., vol. 24, pages 32-44, March.
  • Handle: RePEc:wly:hlthec:v:24:y:2015:i::p:32-44

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    Cited by:

    1. Francesco Longo & Luigi Siciliani & Hugh Gravelle & Rita Santos, 2017. "Do hospitals respond to rivals’ quality and efficiency? a spatial econometrics approach," Working Papers 144cherp, Centre for Health Economics, University of York.
    2. repec:eee:jhecon:v:61:y:2018:i:c:p:233-243 is not listed on IDEAS
    3. repec:spr:eujhec:v:20:y:2019:i:3:d:10.1007_s10198-018-0999-6 is not listed on IDEAS
    4. repec:esr:resser:rs91 is not listed on IDEAS

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