Delayed discharges of patients from hospital, commonly known as bed-blocking, is a long standing
policy concern. Delays can increase the overall cost of treatment and may worsen patient
outcomes. We investigate how delayed discharges vary by hospital type (Acute, Specialist, Mental
Health, Teaching), and the extent to which such differences can be explained by demography, casemix,
the availability of long-term care and hospital governance as reflected in whether the hospital
has Foundation Trust status, which gives greater financial autonomy and flexibility in staffing and
pay. We use a new panel database of delays in all English NHS hospital Trusts from 2011/12 to
2013/14. Employing count data models, we find that a greater local supply of long-term care (care
home beds) is associated with fewer delays. Hospitals which are Foundation Trusts have fewer
delayed discharges and might therefore be used as exemplars of good practice in managing delays.
Mental Health Trusts have more delayed discharges than Acute Trusts but a smaller proportion of
them are attributed to the NHS, possibly indicating a relatively greater lack of adequate community
care for mental health patients.
|Name||CHE Research Paper|
|Publisher||Centre for Health Economics, University of York|
© 2016, James Gaughan, Hugh Gravelle, Luigi Siciliani.