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International Journal of Health Economics and Management
Published in: International Journal of Health Economics and Management 3/2017

Open Access 01-09-2017 | Research Article

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

Authors: James Gaughan, Hugh Gravelle, Rita Santos, Luigi Siciliani

Published in: International Journal of Health Economics and Management | Issue 3/2017

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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.
Appendix
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Footnotes
1
“Care home” is the usual term in England for a residential institution providing long-term personal care such as help with bathing and dressing. Some care homes also provide nursing care and are referred to as nursing homes (Age UK 2015). A care home which does not provide nursing care has, in the past, been sometimes referred to as a residential home. Other countries use a different terminology. For example, in the U.S. care homes might be referred to as Assisted Living, Personal Care Home or Residential Care Facilities with precise definitions determined at the state level. Skilled Nursing Facilities or Nursing Homes perform the same general function as nursing homes in the U.K. (Pioneer Network 2011). As this study uses English data, we use the English terminology definitions and so care homes include nursing and residential homes.
 
2
The 152 Local Authorities (LAs) with responsibility for social care are elected political bodies funded by local taxes and central government grants. The 166 local acute health trusts are part of the NHS and are appointed by the Department of Health.
 
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Metadata
Title
Long-term care provision, hospital bed blocking, and discharge destination for hip fracture and stroke patients
Authors
James Gaughan
Hugh Gravelle
Rita Santos
Luigi Siciliani
Publication date
01-09-2017
Publisher
Springer US
Published in
International Journal of Health Economics and Management / Issue 3/2017
Print ISSN: 2199-9023
Electronic ISSN: 2199-9031
DOI
https://doi.org/10.1007/s10754-017-9214-z

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