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Does formal home care reduce inpatient length of stay?

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  • Walsh, Brendan
  • Lyons, Seán
  • Smith, Samantha
  • Wren, Maev-Ann
  • Eighan, James
  • Morgenroth, Edgar

Abstract

Formal home care is an appropriate substitute for acute hospital care for many older people. However, limited empirical evidence exists on the extent of substitution between the supply of home care and hospital use. This study examines whether patients from areas with a better supply of home care have lower inpatient length of stay (LOS). We link administrative data on over 300,000 public hospital inpatient admissions in Ireland between 2012 and 2015 to region‐year panel data on public home care supply. In addition to modeling average LOS, we estimate unconditional quantile regressions to examine whether home care supply has a disproportionately strong impact on long LOS. We find that inpatients from areas with higher per capita home care supply have lower average LOS; a 10% increase in home care is associated with a 1.2%–2.1% reduction in LOS. This result is driven by the subset of patients with the longest LOS, likely delayed discharges. Stronger results were found for stroke and hip fracture patients, who might be expected to have higher than average propensity to use home care services, and for patients from a region that experienced an unusually large increase in home care supply.
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Suggested Citation

  • Walsh, Brendan & Lyons, Seán & Smith, Samantha & Wren, Maev-Ann & Eighan, James & Morgenroth, Edgar, 2020. "Does formal home care reduce inpatient length of stay?," Papers RB202029, Economic and Social Research Institute (ESRI).
    • Handle: RePEc:esr:wpaper:rb202029
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    Blog mentions

    As found by EconAcademics.org, the blog aggregator for Economics research:
    1. Chris Sampson’s journal round-up for 7th December 2020
      by Chris Sampson in The Academic Health Economists' Blog on 2020-12-07 12:00:03

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    Cited by:

    1. 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.
    2. Moura, Ana, 2021. "Essays in health economics," Other publications TiSEM c93abd22-fa4a-42a5-b172-d, Tilburg University, School of Economics and Management.
    3. 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).
    4. Andrea Salas‐Ortiz & Francesco Longo & Karl Claxton & James Lomas, 2025. "Unpacking the care‐related quality of life effect of England's publicly funded adult social care. A panel data analysis," Health Economics, John Wiley & Sons, Ltd., vol. 34(2), pages 246-266, February.
    5. Walsh, Brendan & Lyons, Se n, 2021. "Demand for the Statutory Home Care Scheme," Research Series, Economic and Social Research Institute (ESRI), number RS122.
    6. Keegan, Conor & Brick, Aoife & Bergin, Adele & Wren, Maev-Ann & Whyte, Richard & Henry, Edward, 2020. "Projections of expenditure for public hospitals in Ireland, 2018 2035, based on the Hippocrates Model," Research Series, Economic and Social Research Institute (ESRI), number RS117.
    7. Walsh, Brendan & Kakoulidou, Theano, 2025. "Projections of regional demand and bed capacity requirements for older people’s care in Ireland, 2022–2040: Based on the Hippocrates model," Research Series, Economic and Social Research Institute (ESRI), number SUSTAT135.

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