scholarly journals Market concentration, supply, quality and prices paid by local authorities in the English care home market

2021 ◽  
Author(s):  
Ferran Espuny Pujol ◽  
Ruth Hancock ◽  
Morten Hviid ◽  
Marcello Morciano ◽  
Stephen Pudney
Author(s):  
David Alexander Gunn Henderson ◽  
Jennifer Kirsty Burton ◽  
Ellen Lynch ◽  
David Clark ◽  
Julie Rintoul ◽  
...  

IntroductionLinked health care datasets have been used effectively in Scotland for some time. Use of social care data has been much more limited, partly because responsibility for these services is distributed across multiple local authorities. However, there are substantial interactions between health and social care (also known internationally as long-term care) services, and keen policy interest in better understanding these. We introduce two social care resources that can now be linked to health datasets at a population level across Scotland to study these interdependencies. These data emerge from the Scottish Government’s centralised collation of data from mandatory returns provided by local authorities and care homes. MethodsDeterministic and Probabilistic methods were used to match the Social Care Survey (SCS) and Scottish Care Home Census (SCHC) to the Community Health Index (CHI) number via the National Records of Scotland (NRS) Research Indexing Spine. ResultsFor the years 2010/11 to 2015/16, an overall match rate of 91.2% was achieved for the SCS to CHI from 31 of Scotland’s 32 local authority areas. This rate varied from 76.7% to 98.5% for local authority areas. A match rate of 89.8% to CHI was achieved for the SCHC in years 2012/13 to 2015/16 but only 52.5% for the years 2010/11 to 2011/12. ConclusionIndexing of the SCS and SCHC to CHI offers a new and rich resource of data for health and social care research.


2005 ◽  
Vol 25 (6) ◽  
pp. 319-338 ◽  
Author(s):  
ANN NETTEN ◽  
JACQUETTA WILLIAMS ◽  
ROBIN DARTON

In the United Kingdom, as in many other developed countries, there is an established market in the provision of long-term care-homes for older people. Implicit in the market mechanism is the assumption that homes will close, but it was not until 1999–2000 that closures of care-homes received widespread public attention. This paper draws on a multi-method study that investigated home closures in England from several perspectives. The rate of home closures rose substantially between 1998 and 2000 and, although sources give different estimates, it subsequently appears to have remained at about five per cent each year. The net result has been a reduction in capacity, particularly in smaller homes. While their emphases differed, both regulators and providers broadly pointed to the same factors behind the closures: the local authorities, the majority purchasers of care-home places, were under pressure to keep fees down, and national policies that raised costs were coming into force or were anticipated, notably the National Minimum Wage and the National Care Standards. Other factors, such as problems in recruiting suitable staff, particularly those with nursing qualifications, also played a role. The government's response, driven primarily by concerns about the effect on delayed discharges from acute hospital beds, was to retreat on the Standards and to increase funding to local authorities. While this has been a helpful step, more needs to be done to prevent good homes closing and to provide incentives that will retain and promote diverse provision.


2002 ◽  
Vol 4 (3) ◽  
pp. 136-138
Author(s):  
Jeremy Cooper
Keyword(s):  

2020 ◽  
pp. 1-21
Author(s):  
Stefanie Ettelt ◽  
Lorraine Williams ◽  
Jacqueline Damant ◽  
Margaret Perkins ◽  
Raphael Wittenberg

Abstract This paper examines how care home managers in England conceptualised the approach to delivering personalised care in the homes they managed. We conducted interviews with care home managers and mapped the approaches they described on two distinct characterisations of personalised care prominent in the research and practitioner literature: the importance of close care relationships and the degree of resident choice and decision-making promoted by the care home. We derived three ‘types’ of personalised care in care homes. These conceptualise the care home as an ‘institution’, a ‘family’ and a ‘hotel’. We have added a fourth type, the ‘co-operative’, to propose a type that merges proximate care relationships with an emphasis on resident choice and decision-making. We conclude that each approach involves trade-offs and that the ‘family’ model may be more suitable for people with advanced dementia, given its emphasis on relationships. While the presence of a range of diverse approaches to personalising care in a care home market may be desirable as a matter of choice, access to care homes in England is likely to be constrained by availability and cost.


Author(s):  
Jennifer Gibb ◽  
Helena Jelicic ◽  
Ivana La Valle ◽  
Sally Gowland ◽  
Rachel Kinsella ◽  
...  

1997 ◽  
Vol 17 (03) ◽  
pp. 166-169
Author(s):  
Judith O’Brien ◽  
Wendy Klittich ◽  
J. Jaime Caro

SummaryDespite evidence from 6 major clinical trials that warfarin effectively prevents strokes in atrial fibrillation, clinicians and health care managers may remain reluctant to support anticoagulant prophylaxis because of its perceived costs. Yet, doing nothing also has a price. To assess this, we carried out a pharmacoe-conomic analysis of warfarin use in atrial fibrillation. The course of the disease, including the occurrence of cerebral and systemic emboli, intracranial and other major bleeding events, was modeled and a meta-analysis of the clinical trials and other relevant literature was carried out to estimate the required probabilities with and without warfarin use. The cost of managing each event, including acute and subsequent care, home care equipment and MD costs, was derived by estimating the cost per resource unit, the proportion consuming each resource and the volume of use. Unit costs and volumes of use were determined from established US government databases, all charges were adjusted using cost-to-charge ratios, and a 3% discount rate was applied to costs incurred beyond the first year. The proportions of patients consuming each resource were estimated by fitting a joint distribution to the clinical trial data, stroke outcome data from a recent Swedish study and aggregate ICD-9 specific, Massachusetts discharge data. If nothing is done, 3.2% more patients will suffer serious emboli annually and the expected annual cost of managing a patient will increase by DM 2,544 (1996 German Marks), from DM 4,366 to DM 6,910. Extensive multiway sensitivity analyses revealed that the higher price of doing nothing persists except for very extreme combinations of inputs unsupported by literature or clinical standards. The price of doing nothing is thus so high, both in health and economic terms, that cost-consciousness as well as clinical considerations mandate warfarin prophylaxis in atrial fibrillation.


2012 ◽  
pp. 63-87
Author(s):  
Anh Mai Ngoc ◽  
Ha Do Thi Hai ◽  
Huyen Nguyen Thi Ngoc

This study uses descriptive statistical method to analyze the income and life qual- ity of 397 farmer households who are suffering social exclusion in an economic aspect out of a total of 725 households surveyed in five Northern provinces of Vietnam in 2010. The farmers’ opinions of the impact of the policies currently prac- ticed by the central government and local authorities to give them access to the labor market are also analyzed in this study to help management officers see how the poli- cies affect the beneficiaries so that they can later make appropriate adjustments.


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