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

Liu, Dan, Pace, Maria Lucia, Goddard, Maria, Jacobs, Rowena, Wittenberg, Raphael ORCID: 0000-0003-3096-2721 and Mason, Anne (2020) Investigating the relationship between social care supply and healthcare utilization by older people in England. Health Economics (United Kingdom). ISSN 1057-9230

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Identification Number: 10.1002/hec.4175

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.

Item Type: Article
Official URL: https://onlinelibrary.wiley.com/journal/10991050
Additional Information: © 2020 The Authors
Divisions: Personal Social Services Research Unit
Subjects: R Medicine > RA Public aspects of medicine
H Social Sciences > HV Social pathology. Social and public welfare. Criminology
Date Deposited: 29 Oct 2020 13:39
Last Modified: 20 Nov 2020 02:53
URI: http://eprints.lse.ac.uk/id/eprint/107097

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