Stephen Allan
Hundreds of thousands of people in England with long-term care needs are supported by more than 10,000 home care agencies. However, little is known about the supply of home care, either in England or internationally, and in particular what factors help or hinder local home care supply.
To understand the reasons for home care agency closure in England.
We used national data of all home care agencies registered to provide services with the Care Quality Commission (CQC) for the period 2015-17. We performed a statistical analysis to assess what factors influenced closure. In the statistical analysis we included measures of quality, competition and other local area demand and supply factors, such as population, needs and rurality.
One in seven home care agencies had closed one year after observation, with some differences seen by region of England. Statistical analysis confirmed that higher competition and lower quality increased the chance of home care agency closure. The findings indicated that the chance of closure would increase by a quarter for an average home care agency if a new agency were to open in the immediate vicinity. Being in a rural location did not influence the chance of closure.
There were data limitations to the analysis, with no information on size of agencies and assumptions made on where they delivered care.
Competitive effects in home care markets must be carefully considered given the importance of ensuring fair access to care. The findings also confirm the important role in quality regulation that the CQC provides.
Stephen Allan s.allan@kent.ac.uk
