Open access Coordinating hospital discharges: bed blocking in England

Jose-Luis Fernandez, Alistair McGuire, Maria Raikou (2017)

Journal of Health Economics

In spite of significant policy interest in improving the integration of health and social care services, little is known about the economics of coordination of the two systems. We use data collected from administrative records to fit survival models exploring the link between two proxy indicators for intersystemic complexity of discharge arrangements and post operative length of stay in hospital for older people undergoing hip replacements. The results suggest that the number of local authorities involved in care planning and commissioning of social care services for discharges from a given hospital is significantly positively correlated with post-operative lengths of stay, other things being equal. A particularly strong effect is found between variability through time in the number of authorities involved in discharges from a given hospital and lengths of stay. The results suggest that improving information systems and joint assessment processes used during the discharge of patients with social care needs is likely to achieve significant efficiency gains in the care system as a whole.