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

Health Econ. 2015 Mar;24 Suppl 1(Suppl 1):32-44. doi: 10.1002/hec.3150.


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.

Keywords: bed blocking; delayed discharges; long-term care; nursing and care homes; substitution.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • England / epidemiology
  • Home Nursing / statistics & numerical data*
  • Humans
  • Long-Term Care / statistics & numerical data*
  • Models, Econometric
  • Models, Theoretical
  • Nursing Homes / statistics & numerical data*
  • Nursing Homes / supply & distribution
  • Patient Discharge / statistics & numerical data*
  • Time Factors
  • Waiting Lists