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

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 higher supply of nursing home beds or lower prices can reduce hospital bed blocking. We use new Local Authority level administrative data from England on hospital delayed discharges in 2010-13. The results suggest that delayed discharges do respond to the availability of care-home beds but the effect is modest: an increase in care-homes bed by 10% (250 additional beds per Local Authority) would reduce delayed discharges by about 4%-7%. We also find strong evidence of spillover effects across Local Authorities: higher availability of care homes or fewer patients aged over 65 in nearby Local Authorities are associated with fewer delayed discharges.