Investigating the relationship between social care supply and healthcare utilization by older people in England.

Liu, D; Pace, ML; Goddard, M; Jacobs, R; Wittenberg, R; Mason, A

Investigating the relationship between social care supply and healthcare utilization by older people in England.

Liu, D

Pace, ML Goddard, M Jacobs, R Wittenberg, R Mason, A

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Publisher:: WILEY
Publication Type:: Journal Article
Citation:: Health economics, 2021, 30, (1), pp. 36-54
Issue Date:: 2021-01

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Field	Value	Language
dc.contributor.author	Liu, D https://orcid.org/0000-0002-1891-9352
dc.contributor.author	Pace, ML
dc.contributor.author	Goddard, M
dc.contributor.author	Jacobs, R
dc.contributor.author	Wittenberg, R
dc.contributor.author	Mason, A
dc.date.accessioned	2021-02-04T02:25:46Z
dc.date.available	2020-10-02
dc.date.available	2021-02-04T02:25:46Z
dc.date.issued	2021-01
dc.identifier.citation	Health economics, 2021, 30, (1), pp. 36-54
dc.identifier.issn	1057-9230
dc.identifier.issn	1099-1050
dc.identifier.uri	http://hdl.handle.net/10453/145804
dc.description.abstract	Since 2010, adult social care spending in England has fallen significantly in real terms whilst demand has risen. Reductions in social care supply may also have impacted demand for NHS services, particularly for those whose care is provided at the interface of the health and care systems. We analyzed a panel dataset of 150 local authorities (councils) to test potential impacts on hospital utilization by people aged 65 and over: emergency admission rates for falls and hip fractures ("front-door" measures); and extended stays of 7 days or longer; and 21 days or longer ("back-door" measures). Changes in social care supply were assessed in two ways: gross current expenditure (per capita 65 and over) adjusted by local labor costs and social care workforce (per capita 18 and over). We ran negative binomial models, controlling for deprivation, ethnicity, age, unpaid care, council class, and year effects. To account for potential endogeneity, we ran instrumental variable regressions and dynamic panel models. Sensitivity analysis explored potential effects of funding for integrated care (the Better Care Fund). There was no consistent evidence that councils with higher per capita spend or higher social care staffing rates had lower hospital admission rates or shorter hospital stays.
dc.format	Print-Electronic
dc.language	eng
dc.publisher	WILEY
dc.relation.ispartof	Health economics
dc.relation.isbasedon	10.1002/hec.4175
dc.rights	info:eu-repo/semantics/openAccess
dc.subject	1117 Public Health and Health Services, 1402 Applied Economics, 1403 Econometrics
dc.subject.classification	Health Policy & Services
dc.title	Investigating the relationship between social care supply and healthcare utilization by older people in England.
dc.type	Journal Article
utslib.citation.volume	30
utslib.location.activity	England
utslib.for	1117 Public Health and Health Services
utslib.for	1402 Applied Economics
utslib.for	1403 Econometrics
pubs.organisational-group	/University of Technology Sydney/Faculty of Business
pubs.organisational-group	/University of Technology Sydney/Strength - CHERE - Centre for Health Economics Research and Evaluation
pubs.organisational-group	/University of Technology Sydney
utslib.copyright.status	open_access	*
dc.date.updated	2021-02-04T02:25:41Z
pubs.issue	1
pubs.publication-status	Published
pubs.volume	30
utslib.citation.issue	1

Abstract:

Since 2010, adult social care spending in England has fallen significantly in real terms whilst demand has risen. Reductions in social care supply may also have impacted demand for NHS services, particularly for those whose care is provided at the interface of the health and care systems. We analyzed a panel dataset of 150 local authorities (councils) to test potential impacts on hospital utilization by people aged 65 and over: emergency admission rates for falls and hip fractures ("front-door" measures); and extended stays of 7 days or longer; and 21 days or longer ("back-door" measures). Changes in social care supply were assessed in two ways: gross current expenditure (per capita 65 and over) adjusted by local labor costs and social care workforce (per capita 18 and over). We ran negative binomial models, controlling for deprivation, ethnicity, age, unpaid care, council class, and year effects. To account for potential endogeneity, we ran instrumental variable regressions and dynamic panel models. Sensitivity analysis explored potential effects of funding for integrated care (the Better Care Fund). There was no consistent evidence that councils with higher per capita spend or higher social care staffing rates had lower hospital admission rates or shorter hospital stays.

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http://hdl.handle.net/10453/145804