Hospital discharges up despite funding cuts

Activity in Irish hospitals continues to increase despite constraints in funding in recent years, according to a report from the Economic and Social Research Institute (ESRI).

The report shows that more people are being treated and the average length of stay has fallen.

Last year, there were more than 1.54m discharges from the country’s acute public hospitals, compared to 1.47m in 2011, an increase of 4.8%.

Day patient numbers increased to 916,081 last year and accounted for about 60% of total discharges, an increase of 4.2% since 2011.

The number of day patients seen in 2008 was 771.145.

The ‘2012 Activity in Acute Public Hospitals in Ireland’ report shows that the average length of stay last year was 4.1 days, a decrease of 4.7% since 2011.

The head of the ESRI’s health research information division, Prof Miriam Wiley, said the reduction hospital stay was very much in line with international practice.

The report presents information on discharges from 57 acute public hospitals that participated in the Hospital In-Patient Enquiry scheme last year.

The HIPE scheme is managed by the ESRI on behalf of the HSE.

“What we are seeing is an ongoing increase in the proportion of public patients treated and a slight decrease in the proportion of private patients,” said Prof Wiley.

Public patients accounted for about 80% of total in-patient bed days, a rise of 5.5% since 2011 and an average annual increase of 4.4% since 2008.

While the number of private discharges increased by 1.2% between 2011 and 2012, the trend has been downwards since 2008, with an average annual decrease of about 3%.

The report also shows an increase in the number of patients with medical cards — they accounted for 53.7% of total discharges last year, an increase of 5.6% over the previous year.

A third of total discharges were aged 65 years and older in 2012 — an increase of 6.4% over the past two years.

The older age group also used the largest proportion of bed days, at 47.3%, an increase of almost 2% on the 2011 figure.

Prof Wiley said voluntary hospitals continued to have longer lengths of stay.

Voluntary hospitals recorded an acute inpatient average length of stay of 5.2 days for public discharges and 5.6 days for private discharges.

For regional hospitals, the acute in-patient average length of stay was four days for public discharges and 4.1 days for private discharges.

Long stay patients — those who stayed for more than 30 days — accounted for 2.5% of in-patient discharges and 28.5% of in-patient bed days.

While the number of extended stay in-patients increased slightly from 2011 to 2012, there was an average annual decline of 1.4% since 2008.

Maternity discharges increased annually by almost 1% between 2008 and 2012 from 133,502 to 137,522.

Over 58% of delivery discharges were in the 25- to 34-year-old age group.

Natural births accounted for 56.4% of discharges; caesarean section discharges were 28.2%, while 15.4% of discharges were instrumental deliveries.


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