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A two-tiered public-private health system: Who stays in (private) hospitals in Ireland?

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  • Murphy, Aileen
  • Bourke, Jane
  • Turner, Brian

Abstract

Despite efforts to create a universal, single-tiered Irish health system, an unequal "two-tiered" system persists. The future blueprint for Irish health care, Sláintecare, recommends a separation of public and private hospital treatment. This study examines patterns of overall and private hospital utilisation in Ireland that could help identify some of the impacts of the proposed separation of public and private hospital treatment. Using data from EU-SILC (2016) (n = 10,131) the factors associated with inpatient hospitalisation and private inpatient hospitalisation are estimated using probit models.

Suggested Citation

  • Murphy, Aileen & Bourke, Jane & Turner, Brian, 2020. "A two-tiered public-private health system: Who stays in (private) hospitals in Ireland?," Health Policy, Elsevier, vol. 124(7), pages 765-771.
    • Handle: RePEc:eee:hepoli:v:124:y:2020:i:7:p:765-771
    DOI: 10.1016/j.healthpol.2020.04.003
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    1. Conor Keegan & Aoife Brick & Brendan Walsh & Adele Bergin & James Eighan & Maev‐Ann Wren, 2019. "How many beds? Capacity implications of hospital care demand projections in the Irish hospital system, 2015‐2030," International Journal of Health Planning and Management, Wiley Blackwell, vol. 34(1), pages 569-582, January.
    2. Damien S. Eldridge & Ilke Onur & Malathi Velamuri, 2017. "The impact of private hospital insurance on the utilization of hospital care in Australia," Applied Economics, Taylor & Francis Journals, vol. 49(1), pages 78-95, January.
    3. Terence C. Cheng & Alfons Palangkaraya & Jongsay Yong, 2014. "Hospital utilization in mixed public--private system: evidence from Australian hospital data," Applied Economics, Taylor & Francis Journals, vol. 46(8), pages 859-870, March.
    4. Denise Doiron & Nathan Kettlewell, 2018. "The Effect of Health Insurance on the Substitution between Public and Private Hospital Care," The Economic Record, The Economic Society of Australia, vol. 94(305), pages 135-154, June.
    5. Propper, Carol, 2000. "The demand for private health care in the UK," Journal of Health Economics, Elsevier, vol. 19(6), pages 855-876, November.
    6. Sloan, Frank A. & Picone, Gabriel A. & TaylorJr., Donald H. & Chou, Shin-Yi, 2001. "Hospital ownership and cost and quality of care: is there a dime's worth of difference?," Journal of Health Economics, Elsevier, vol. 20(1), pages 1-21, January.
    7. Keegan, Conor & Brick, Aoife & Wren, Maev-Ann, 2018. "An examination of activity in public and private hospitals in Ireland, 2015," Papers WP601, Economic and Social Research Institute (ESRI).
    8. Smith, Samantha & Walsh, Brendan & Wren, Maev-Ann & Barron, Steve & Morgenroth, Edgar & Eighan, James & Lyons, Se n, 2019. "Geographic profile of healthcare needs and non-acute healthcare supply in Ireland," Research Series, Economic and Social Research Institute (ESRI), number RS90.
    9. Edward C. Norton & Hua Wang & Chunrong Ai, 2004. "Computing interaction effects and standard errors in logit and probit models," Stata Journal, StataCorp LLC, vol. 4(2), pages 154-167, June.
    10. Burke, Sara Ann & Normand, Charles & Barry, Sarah & Thomas, Steve, 2016. "From universal health insurance to universal healthcare? The shifting health policy landscape in Ireland since the economic crisis," Health Policy, Elsevier, vol. 120(3), pages 235-240.
    11. Turner, Brian, 2015. "Unwinding the State subsidisation of private health insurance in Ireland," Health Policy, Elsevier, vol. 119(10), pages 1349-1357.
    12. Srivastava, P & Zhao, X, 2008. "Impact of Private Health Insurance on the Choice of Public versus Private Hospital Services," Health, Econometrics and Data Group (HEDG) Working Papers 08/17, HEDG, c/o Department of Economics, University of York.
    13. Jill R. Horwitz, 2005. "Does Corporate Ownership Matter? Service Provision in the Hospital Industry," NBER Working Papers 11376, National Bureau of Economic Research, Inc.
    14. Mark G. Duggan, 2000. "Hospital Ownership and Public Medical Spending," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 115(4), pages 1343-1373.
    15. Bjorvatn, Afsaneh, 2018. "Private or public hospital ownership: Does it really matter?," Social Science & Medicine, Elsevier, vol. 196(C), pages 166-174.
    16. 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, March.
    17. McHugh, Sheena & Droog, E. & Foley, Conor & Boyce, M. & Healy, O. & Browne, J.P., 2019. "Understanding the impetus for major systems change: A multiple case study of decisions and non-decisions to reconfigure emergency and urgent care services," Health Policy, Elsevier, vol. 123(8), pages 728-736.
    18. Cheng, Terence C. & Haisken-DeNew, John P. & Yong, Jongsay, 2015. "Cream skimming and hospital transfers in a mixed public-private system," Social Science & Medicine, Elsevier, vol. 132(C), pages 156-164.
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    1. Connolly, Sheelah & Wren, Maev-Ann, 2023. "Towards universal healthcare in Ireland – what can we learn from the literature?," Research Series, Economic and Social Research Institute (ESRI), number SUSTAT121.
    2. Xidong Guo & Eóin T. Flaherty & Huihui Li & Jiming Zhu, 2024. "The More Private Patients, the Fewer Public Patients? Evaluating the 2014 Hospitals Reform in Ireland," Working Papers 202403, Geary Institute, University College Dublin.
    3. Penno, Erin & Sullivan, Trudy & Barson, Dave & Gauld, Robin, 2021. "Private choices, public costs: Evaluating cost-shifting between private and public health sectors in New Zealand," Health Policy, Elsevier, vol. 125(3), pages 406-414.

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