Projected private hospital expenditure in Ireland, 2018–2035: What role for demographics, cost, and Sláintecare?. (17th November 2021)

• Record Type: Journal Article
• Authors: Keegan, Conor; Brick, Aoife; Henry, Edward; Bergin, Adele
• Is Part Of: International journal of health planning and management. Volume 37:Number 2(2022)
• Page Start: 999
• Page End: 1017
• Publication Date: 2021-11-17
• Subjects: expenditure -- Irish health system -- private hospitals -- projections -- Sláintecare; Health planning -- Periodicals; Health services administration -- Periodicals; Santé publique -- Planification -- Périodiques; Santé, Services de -- Administration -- Périodiques; 362.1068
• DOI: 10.1002/hpm.3381
• Languages: English
• ISSNs: 0749-6753

Abstract

Abstract: Despite private hospitals occupying an important role in the delivery of acute hospital care in Ireland, an understanding of future spending pressures on these services is limited. Particularly, a key dimension of Ireland's ambitious roadmap for healthcare reform (Sláintecare) seeks to remove private practice from public hospitals. However, to date, there has been no examination of how this reform could impact private hospital demand and expenditure, and ultimately, the capacity to treat public patients. Using previously unavailable administrative health insurer data and a healthcare macro‐simulation projection model, we project real (volume‐based) and nominal expenditure on private hospital services over the medium‐term (2018–2035). We develop a number of projection scenarios that vary assumptions in relation to population growth and ageing, healthy ageing, and the future cost of care delivery. Additionally, by developing profiles of private activity in public hospitals, we examine how the removal of private practice from public hospitals could impact on demand and expenditure in private hospitals over time. Findings from this analysis have implications for capital investment and workforce planning in private hospitals, and failure to meet future demand could have implications for access to care in public hospitals. Moreover, should private practice be ended in public hospitals, most complex private in‐patient and emergency care is likely to remain within the public hospitals with limited capacity benefits for the public system. Highlights: Demographic change and, particularly, the cost of care delivery will drive projected private hospital expenditure requirements Removal of private practice from public hospitals may largely impact demand for private hospital day patient services Removal of private practice from public hospitals is unlikely to free up significant public hospital capacity Findings have implications for private hospital capital investment and workforce planning