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Length of stay in care homes

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Care home placements constitute the majority (57%) of net council spending in England on social care for older people. Information about the expected length of stay for people admitted to a care home is important for predicting lifetime costs and for understanding the implications of reforming funding arrangements for social care. To date there has been very little research able to give us an accurate picture of how long people live in care homes before they die. In this study, we draw on anonymised information about all the residents (11,565 residents in total) that died in Bupa care homes in the period Nov 2008 to May 2010. The availability of this Bupa data has given the opportunity to produce some needed and timely research on the question of length of stay. The results of this study will help to fill some of the gaps in our knowledge on this subject. Residents of the 305 Bupa homes are largely representative of the England average in relation to age, sex and funding source. Bupa have more people in nursing beds with a higher level of frailty than the average in England, but we are able to re-weight the results to estimate average lengths of stay that more closely reflect the England situation. In the Bupa sample, the average length of stay was 801 days, but with a considerable tail of long-stayers. Half of residents had died by 462 days. Around 27% of people lived for more than three years, with the longest stayer living for over 20 years. People had a 55% chance of living for the first year after admission, which increased to nearly 70% for the second year before falling back over subsequent years. Lengths of stay for the Bupa sample and those estimated for England are given in Table One (below). Adjusted figures show a bigger difference between nursing beds and residential beds than the unadjusted figures as they account for people that might have changed from a residential to a nursing bed during their stay in the home. Length of stay information can be combined with information about the unit (e.g. weekly) costs of a care home placement to calculate expected costs of care for people newly admitted to care homes (see Table One). At £550 per week (before inflation), an 832-day expected stay would cost £65,400. The total cost for around a quarter of people would exceed £94,700 at this weekly rate, and for 10% it would be more than £166,000.

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