The Nuffield Trust, 59 New Cavendish Street, London, W1G 7LP, UK.
BMC Health Serv Res. 2012 Oct 31;12:377. doi: 10.1186/1472-6963-12-377.
Information about how long people stay in care homes is needed to plan services, as length of stay is a determinant of future demand for care. As length of stay is proportional to cost, estimates are also needed to inform analysis of the long-term cost effectiveness of interventions aimed at preventing admissions to care homes. But estimates are rarely available due to the cost of repeatedly surveying individuals.
We used administrative data from three local authorities in England to estimate the length of publicly-funded care homes stays beginning in 2005 and 2006. Stays were classified into nursing home, permanent residential and temporary residential. We aggregated successive placements in different care home providers and, by linking to health data, across periods in hospital.
The largest group of stays (38.9%) were those intended to be temporary, such as for rehabilitation, and typically lasted 4 weeks. For people admitted to permanent residential care, median length of stay was 17.9 months. Women stayed longer than men, while stays were shorter if preceded by other forms of social care. There was significant variation in length of stay between the three local authorities. The typical person admitted to a permanent residential care home will cost a local authority over £38,000, less payments due from individuals under the means test.
These figures are not apparent from existing data sets. The large cost of care home placements suggests significant scope for preventive approaches. The administrative data revealed complexity in patterns of service use, which should be further explored as it may challenge the assumptions that are often made.
需要了解人们在养老院中停留的时间，以便规划服务，因为停留时间是未来对护理需求的决定因素。由于停留时间与成本成正比，因此还需要估算，以告知分析旨在预防入住养老院的干预措施的长期成本效益。但是，由于反复调查个人的成本高昂，因此很少有估算。
我们使用了英格兰三个地方当局的行政数据来估算 2005 年和 2006 年开始的公共资助养老院入住时间。入住时间分为疗养院、永久性住所和临时住所。我们将不同养老院提供者的连续安置情况进行了汇总，并通过与健康数据进行链接，在医院的不同时期进行了汇总。
停留时间最长的群体（38.9％）是那些旨在进行临时康复等的群体，通常持续 4 周。对于入住永久性住所的人，中位停留时间为 17.9 个月。女性的停留时间长于男性，而如果在其他形式的社会护理之前进行护理，则停留时间会更短。三个地方当局之间的停留时间差异很大。典型的永久性住所养老院入住者将花费地方当局超过 38,000 英镑，而个人在经济状况调查下应支付的款项则更少。
这些数字在现有数据集上并不明显。养老院安置的高成本表明有很大的预防方法的空间。行政数据揭示了服务使用模式的复杂性，应进一步探讨，因为这可能会挑战通常做出的假设。
