This paper examines the impact of changes in public long-term care spending on the use of public hospitals among the older population in England. Mean per-person long-term care spending fell by 31% between 2009/10 and 2017/18, but cuts varied considerably geographically. We instrument public long-term care spending with predicted spending based on historical national funding shares and national spending trends. We find that reductions in public long-term care spending led to substantial increases in the number of emergency department (ED) visits made by patients aged 65 and above, explaining between a quarter and a half of the growth in ED use among this population over this period, and to an increase in the share of patients revisiting the ED within seven days. However, there was no impact on wider use of inpatient or outpatient services (which are more expensive to provide), and consequently little impact on overall hospital costs.

本文研究了公共长期护理支出的变化对英格兰老年人口使用公立医院的影响。2009/10 至 2017/18 年间，人均长期护理支出平均下降了 31%，但降幅因地域而异。我们根据历史国家资金份额和国家支出趋势预测支出来衡量公共长期护理支出。我们发现，公共长期护理支出的减少导致 65 岁及以上患者的急诊科 (ED) 就诊次数大幅增加，这解释了这一人群中急诊科 (ED) 使用增长的四分之一至二分之一在此期间，并增加了在 7 天内再次访问 ED 的患者比例。然而，