Journal of Public Health Medicine 22:68-73 (2000)
© 2000 Faculty of Public Health Medicine of the Royal Colleges of Physicians of the United Kingdom
Patients and procedures in short-stay independent hospitals in England and Wales, 1997-1998
B Williamsz
P Whatmough
J McGill
L Rushtonzz
Division of Public Health Medicine, School of Community Health Sciences, Faculty of Medicine, University of Nottingham, Queen's Medical Centre, Nottingham NG7 2UH, UK
z Corresponding author
zz Present appointment: Head of Epidemiology, Medical Research Council Institute for Environment and Health, University of Leicester, 94 Regent Road, Leicester LE1 7DD, UK
Background.Private hospitals' activities are not routinely reported, so what services they provide and for whom is not known. This study describes the clientele and case-mix of independent hospitals in England and Wales in 1997-1998.
Method.Person, clinical and funding data were collected on samples of patients admitted to 215 of 221 independent hospitals open in 1997-1998. Sample numbers were weighted to reflect sampling duration, region, season and non-response.
Results.A total of 37 434 sampled records represented 828 422 admissions: 406 843 in-patients (5 per cent fewer than in 1992-1993) and 421 580 day cases (69 per cent more); 806 509 were residents of England and Wales (up 24 per cent); 16 628 came from overseas (down 20 per cent). Numbers increased in all age groups except children; 25 per cent were 65 or over (18 per cent in 1992-1993). The commonest procedures were abortion (11 per cent), endoscopy of the gastro-intestinal tract (10 per cent) or joints (5 per cent), lens operations (5 per cent), hernia repairs (3 per cent), and other common National Health Service (NHS) elective operations. The NHS funded 84 561 patients (11 per cent of the total) including 41 942 non-abortion cases (6 per cent). A total of 540 996 (76 per cent) paid through insurance; 119 101 (17 per cent) were self-funded including 30 per cent of the over-75s. Ninety-five per cent of patients went home, 0.3 per cent died and 0.2 per cent were transferred to NHS hospitals.
Conclusions.Demand for short-stay independent hospital care is rising. The clientele is becoming older, and readier to pay out of pocket. Clinical activity is mainly surgical and similar to NHS elective surgical demand. One year's caseload equals 10 weeks' elective admissions to NHS hospitals, in that sense relieving the NHS. The scale of transfer to NHS hospitals (three per day) is small.
Keywords: independent health care, private medical insurance, NHS funding, elective surgery
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