Abstract：
BACKGROUND:Poor co-ordination and collaboration have been identified by many governments as a major and growing weakness of their health care systems. Better integrated care for the elderly individuals is one field of particular importance. In this study, we ask to what extent local authorities' social care services create cost externalities by prolonging hospital length of stay (LOS) because of inadequate service capacity and/or service quality. METHODS:The data set is constructed by merging in-patient data from the Norwegian Patient Register with Statistics Norway's local authority variables for the period from 2007 to 2009. The sample includes ∼386 000 observations of in-patients aged ≥ 67 years. Using the quantile regression (QR) technique, we analyse the impact of social care services along the entire distribution of LOS. The QR estimates are compared with ordinary least square estimates (OLS). Patient variables in the analyses include age, gender and case-mix variables. Hospital and time-fixed effects are also controlled for variables. RESULTS:More resources to the social care services give shorter LOS, and the QR analysis shows that resources matter more for patients in the long tail of the distribution compared with those in the lower quantiles. LOS is longer for patients with change of residence after discharge from hospital compared with those patients that do not change residence. CONCLUSIONS:Increased supply of social care services contributes to a reduction in aggregate societal costs of treatment and nursing of elderly patients by shortening comparatively costly hospital LOS.
journal_name
Eur J Public Healthjournal_title
European journal of public healthauthors
Holmås TH,Islam MK,Kjerstad Edoi
10.1093/eurpub/cks171subject
Has Abstractpub_date
2013-12-01 00:00:00pages
927-33issue
6eissn
1101-1262issn
1464-360Xpii
cks171journal_volume
23pub_type
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