Testing the bed-blocking hypothesis: does nursing and care home supply reduce delayed hospital discharges?

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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.
Original languageEnglish
Pages (from-to)32-44
Number of pages13
JournalHealth Economics
Issue number(suppl 1)
Publication statusPublished - Mar 2015


  • delayed discharges; long-term care; nursing and care homes; bed blocking; substitution

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