The influence of home care supply on delayed discharges from hospital in England

Abstract Background Delayed transfers of care (DTOC) of patients from hospital to alternative care settings are a longstanding problem in England and elsewhere, having negative implications for patient outcomes and costs to health and social care systems. In England, a large proportion of DTOC are a...

Descripción completa

Guardado en:

Detalles Bibliográficos
Autores principales:	Stephen Allan, Daniel Roland, Gintare Malisauskaite, Karen Jones, Kate Baxter, Kate Gridley, Yvonne Birks
Formato:	article
Lenguaje:	EN
Publicado:	BMC 2021
Materias:	Delayed discharges Delayed transfers of care Home care Health care Social care Supply Public aspects of medicine RA1-1270
Acceso en línea:	https://doaj.org/article/2a956ea0a9074cb4b5843407be3cfa2b
Etiquetas:	Agregar Etiqueta Sin Etiquetas, Sea el primero en etiquetar este registro!

id	oai:doaj.org-article:2a956ea0a9074cb4b5843407be3cfa2b
record_format	dspace
spelling	oai:doaj.org-article:2a956ea0a9074cb4b5843407be3cfa2b2021-12-05T12:06:41ZThe influence of home care supply on delayed discharges from hospital in England10.1186/s12913-021-07206-51472-6963https://doaj.org/article/2a956ea0a9074cb4b5843407be3cfa2b2021-12-01T00:00:00Zhttps://doi.org/10.1186/s12913-021-07206-5https://doaj.org/toc/1472-6963Abstract Background Delayed transfers of care (DTOC) of patients from hospital to alternative care settings are a longstanding problem in England and elsewhere, having negative implications for patient outcomes and costs to health and social care systems. In England, a large proportion of DTOC are attributed to a delay in receiving suitable home care. We estimated the relationship between home care supply and delayed discharges in England from 2011 to 2016. Methods Reduced form fixed effects OLS models of annual DTOC attributed to social care at local authority (LA)-level from 2011 to 2016 were estimated, using both number of days and patients as the dependent variable. A count of home care providers at LA-level was utilised as the measure of home care supply. Demand (e.g. population, health, income) and alternative supply (e.g. care home places, local unemployment) measures were included as controls. Instrumental Variable (IV) methods were used to control for any simultaneity in the relationship between DTOC and home care supply. Models for DTOC attributed to NHS and awaiting a home care package were used to assess the adequacy of the main model. Results We found that home care supply significantly reduced DTOC. Each extra provider per 10 sq. km. in the average local authority decreased DTOC by 14.9% (equivalent to 449 days per year), with a per provider estimate of 1.6% (48 days per year). We estimated cost savings to the public sector over the period of analysis from reduced DTOC due to increased home care provision between £73 m and £274 m (95% CI: £0.24 m to £545.3 m), with a per provider estimate of savings per year of £12,600 (95% CI: £900 to £24,500). Conclusion DTOC are reduced in LAs with better supply of home care, and this reduces costs to the NHS. Further savings could be achieved through improved outcomes of people no longer delayed. Appropriate levels of social care supply are required to ensure efficiency in spending for the public sector overall.Stephen AllanDaniel RolandGintare MalisauskaiteKaren JonesKate BaxterKate GridleyYvonne BirksBMCarticleDelayed dischargesDelayed transfers of careHome careHealth careSocial careSupplyPublic aspects of medicineRA1-1270ENBMC Health Services Research, Vol 21, Iss 1, Pp 1-11 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Delayed discharges Delayed transfers of care Home care Health care Social care Supply Public aspects of medicine RA1-1270
spellingShingle	Delayed discharges Delayed transfers of care Home care Health care Social care Supply Public aspects of medicine RA1-1270 Stephen Allan Daniel Roland Gintare Malisauskaite Karen Jones Kate Baxter Kate Gridley Yvonne Birks The influence of home care supply on delayed discharges from hospital in England
description	Abstract Background Delayed transfers of care (DTOC) of patients from hospital to alternative care settings are a longstanding problem in England and elsewhere, having negative implications for patient outcomes and costs to health and social care systems. In England, a large proportion of DTOC are attributed to a delay in receiving suitable home care. We estimated the relationship between home care supply and delayed discharges in England from 2011 to 2016. Methods Reduced form fixed effects OLS models of annual DTOC attributed to social care at local authority (LA)-level from 2011 to 2016 were estimated, using both number of days and patients as the dependent variable. A count of home care providers at LA-level was utilised as the measure of home care supply. Demand (e.g. population, health, income) and alternative supply (e.g. care home places, local unemployment) measures were included as controls. Instrumental Variable (IV) methods were used to control for any simultaneity in the relationship between DTOC and home care supply. Models for DTOC attributed to NHS and awaiting a home care package were used to assess the adequacy of the main model. Results We found that home care supply significantly reduced DTOC. Each extra provider per 10 sq. km. in the average local authority decreased DTOC by 14.9% (equivalent to 449 days per year), with a per provider estimate of 1.6% (48 days per year). We estimated cost savings to the public sector over the period of analysis from reduced DTOC due to increased home care provision between £73 m and £274 m (95% CI: £0.24 m to £545.3 m), with a per provider estimate of savings per year of £12,600 (95% CI: £900 to £24,500). Conclusion DTOC are reduced in LAs with better supply of home care, and this reduces costs to the NHS. Further savings could be achieved through improved outcomes of people no longer delayed. Appropriate levels of social care supply are required to ensure efficiency in spending for the public sector overall.
format	article
author	Stephen Allan Daniel Roland Gintare Malisauskaite Karen Jones Kate Baxter Kate Gridley Yvonne Birks
author_facet	Stephen Allan Daniel Roland Gintare Malisauskaite Karen Jones Kate Baxter Kate Gridley Yvonne Birks
author_sort	Stephen Allan
title	The influence of home care supply on delayed discharges from hospital in England
title_short	The influence of home care supply on delayed discharges from hospital in England
title_full	The influence of home care supply on delayed discharges from hospital in England
title_fullStr	The influence of home care supply on delayed discharges from hospital in England
title_full_unstemmed	The influence of home care supply on delayed discharges from hospital in England
title_sort	influence of home care supply on delayed discharges from hospital in england
publisher	BMC
publishDate	2021
url	https://doaj.org/article/2a956ea0a9074cb4b5843407be3cfa2b
work_keys_str_mv	AT stephenallan theinfluenceofhomecaresupplyondelayeddischargesfromhospitalinengland AT danielroland theinfluenceofhomecaresupplyondelayeddischargesfromhospitalinengland AT gintaremalisauskaite theinfluenceofhomecaresupplyondelayeddischargesfromhospitalinengland AT karenjones theinfluenceofhomecaresupplyondelayeddischargesfromhospitalinengland AT katebaxter theinfluenceofhomecaresupplyondelayeddischargesfromhospitalinengland AT kategridley theinfluenceofhomecaresupplyondelayeddischargesfromhospitalinengland AT yvonnebirks theinfluenceofhomecaresupplyondelayeddischargesfromhospitalinengland AT stephenallan influenceofhomecaresupplyondelayeddischargesfromhospitalinengland AT danielroland influenceofhomecaresupplyondelayeddischargesfromhospitalinengland AT gintaremalisauskaite influenceofhomecaresupplyondelayeddischargesfromhospitalinengland AT karenjones influenceofhomecaresupplyondelayeddischargesfromhospitalinengland AT katebaxter influenceofhomecaresupplyondelayeddischargesfromhospitalinengland AT kategridley influenceofhomecaresupplyondelayeddischargesfromhospitalinengland AT yvonnebirks influenceofhomecaresupplyondelayeddischargesfromhospitalinengland
_version_	1718372243922223104

The influence of home care supply on delayed discharges from hospital in England

Ejemplares similares