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The Public/Private Mix in Irish Acute Public Hospitals: Trends and Implications

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  • Jacqueline O'Reilly

    (Economic and Social Research Institute (ESRI))

  • Miriam M. Wiley

    (Economic and Social Research Institute (ESRI))

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    Abstract

    The public/private mix in Irish health care is nowhere more evident than in the acute hospital system where both public and private patients can be treated in public hospitals by the same consultant. By undertaking new analyses of data from the Hospital In-Patient Enquiry Scheme, this study investigates this public/private mix and its impact on utilisation of hospital services. Demand- and supply-side factors were both found to be statistically significant in explaining the ratio of private to public discharges across hospitals and over time. Private discharges are found to have higher levels of utilisation of surgical procedures, even though the level of comorbidity did not appear to be any greater for this group. The analysis also found that ?excess utilisation? of public hospital facilities by private discharges in particular hospitals increased over the time period of the study. Despite limitations of available data and methods, this study provides useful insights into the factors driving private and public utilisation in the acute public hospital system in Ireland.

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    File URL: http://www.esri.ie/UserFiles/publications/20071121091821/WP218.pdf
    File Function: First version, 2007
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    Bibliographic Info

    Paper provided by Economic and Social Research Institute (ESRI) in its series Papers with number WP218.

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    Length: 42 pages
    Date of creation: Nov 2007
    Date of revision:
    Handle: RePEc:esr:wpaper:wp218

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    1. Thomas C. Buchmueller & Agnès Couffinhal & Michel Grignon & Marc Perronnin, 2004. "Access to physician services: does supplemental insurance matter? Evidence from France," Health Economics, John Wiley & Sons, Ltd., vol. 13(7), pages 669-687.
    2. Nolan, Anne & Nolan, Brian, 2004. "Ireland's Health Care System: Some Issues and Challenges," Papers HRBWP14, Economic and Social Research Institute (ESRI).
    3. Luigi Siciliani & Jeremy Hurst, 2003. "Explaining Waiting Times Variations for Elective Surgery Across OECD Countries," OECD Health Working Papers 7, OECD Publishing.
    4. Manning, Willard G, et al, 1987. "Health Insurance and the Demand for Medical Care: Evidence from a Randomized Experiment," American Economic Review, American Economic Association, vol. 77(3), pages 251-77, June.
    5. Madden, David & Nolan, Anne & Nolan, Brian, 2004. "GP Reimbursement and Visiting Behaviour in Ireland," Papers HRBWP09, Economic and Social Research Institute (ESRI).
    6. Nolan, Anne & Nolan, Brian, 2003. "A Cross-Sectional Analysis of the Utilisation of GP Services in Ireland: 1987-2001," Papers HRBWP01, Economic and Social Research Institute (ESRI).
    7. Miriam M. Wiley, 2005. "The Irish health system: developments in strategy, structure, funding and delivery since 1980," Health Economics, John Wiley & Sons, Ltd., vol. 14(S1), pages S169-S186.
    8. Antonia Morga & Ana Xavier, . "Hospital specialists' private practice and its impact on the number of NHS patients treated and on the delay for elective surgery," Discussion Papers 01/01, Department of Economics, University of York.
    9. Nolan, Brian, 2004. "Health Insurance in Ireland: Issues and Challenges," Papers HRBWP10, Economic and Social Research Institute (ESRI).
    10. Colm Harmon & Brian Nolan, 2001. "Health insurance and health services utilization in Ireland," Health Economics, John Wiley & Sons, Ltd., vol. 10(2), pages 135-145.
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