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

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  • James Gaughan
  • Hugh Gravelle
  • Luigi Siciliani

Abstract

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(S1), pages 32-44, March.
    • Handle: RePEc:wly:hlthec:v:24:y:2015:i:s1:p:32-44
    DOI: 10.1002/hec.3150
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    1. Joshua D. Angrist & Jörn-Steffen Pischke, 2009. "Mostly Harmless Econometrics: An Empiricist's Companion," Economics Books, Princeton University Press, edition 1, number 8769.
    2. Forder, Julien & Allan, Stephen, 2014. "The impact of competition on quality and prices in the English care homes market," Journal of Health Economics, Elsevier, vol. 34(C), pages 73-83.
    3. Martin, Stephen & Rice, Nigel & Jacobs, Rowena & Smith, Peter, 2007. "The market for elective surgery: Joint estimation of supply and demand," Journal of Health Economics, Elsevier, vol. 26(2), pages 263-285, March.
    4. Laurie Brown & Annie Abello & Linc Thurecht, 2011. "Length of Hospital Stay by Older Australians: Bed-blocking or Not?," NATSEM Working Paper Series 11/08, University of Canberra, National Centre for Social and Economic Modelling.
    5. 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.
    6. Lindsay, Cotton M & Feigenbaum, Bernard, 1984. "Rationing by Waiting Lists," American Economic Review, American Economic Association, vol. 74(3), pages 404-417, June.
    7. 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.
    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. Hugh Gravelle & Peter Smith & Ana Xavier, 2003. "Performance signals in the public sector: the case of health care," Oxford Economic Papers, Oxford University Press, vol. 55(1), pages 81-103, January.
    10. Mundlak, Yair, 1978. "On the Pooling of Time Series and Cross Section Data," Econometrica, Econometric Society, vol. 46(1), pages 69-85, January.
    11. Holmås, Tor Helge & Kjerstad, Egil & Lurås, Hilde & Straume, Odd Rune, 2010. "Does monetary punishment crowd out pro-social motivation? A natural experiment on hospital length of stay," Journal of Economic Behavior & Organization, Elsevier, vol. 75(2), pages 261-267, August.
    12. 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.
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    3. Moura, Ana, 2021. "Essays in health economics," Other publications TiSEM c93abd22-fa4a-42a5-b172-d, Tilburg University, School of Economics and Management.
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    8. Huan Liu, 2021. "Formal and Informal Care: Complementary or Substitutes in Care for Elderly People? Empirical Evidence From China," SAGE Open, , vol. 11(2), pages 21582440211, May.
    9. Jim G. Dai & Pengyi Shi, 2021. "Recent Modeling and Analytical Advances in Hospital Inpatient Flow Management," Production and Operations Management, Production and Operations Management Society, vol. 30(6), pages 1838-1862, June.
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    12. Lu, Bei & Mi, Hong & Yan, Gaoyun & Lim, Jonathan K.H. & Feng, Guanggang, 2020. "Substitutional effect of long-term care to hospital inpatient care?," China Economic Review, Elsevier, vol. 62(C).

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