The public/private mix in Irish acute public hospitals : trends and implications

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.