The Spatial Pattern of Health Service Utilisation in Ireland

The aim of this paper is to establish whether there are spatial variations in acute hospital utilisation in Ireland and if so, what are the micro-level factors influencing this variation? Firstly, an alignment process is used to calibrate the acute in-patient attendance and nights spent in hospital variables produced by a spatial microsimulation model at both the national and sub-national level. Comparing the results of the national and sub-national alignment allows us to examine whether there are spatial variations in acute hospital utilisation in Ireland. Secondly, on establishing that there is a significant spatial pattern to hospital utilisation, we use a nationally representative survey to assert which individual-level factors significantly affect inpatient attendance and the number of nights spent in hospital. Using the calibrated data from the afore mentioned spatial microsimulation model, we examine whether the spatial pattern of those variables found to influence hospital utilisation match the spatial pattern of actual hospital utilisation rates at the small area, electoral division (ED) level. That is, are the individuals/areas with the highest demand for acute hospital services utilising acute hospital services? Finally, the results of this research are discussed in relation to both the national and international literature.