Drop in average length of hospital stay means patients treated faster, says ESRI

The number of times people used Irish hospitals last year increased by 1.6 per cent, though the average length of stay has fallen, new figures from the Economic and Social Research Institute show.

Day patients account for the increase in hospital users, and a decline of 3 per cent in the number of bed days indicates that more people are being treated faster.

The Activity in Acute Public Hospitals in Ireland 2011 report is published this morning and finds more than 1.47 million discharges were reported last year by hospitals participating in the report, compared with 1.45 million in 2010.

The number of day patients treated rose by 160,000, or 5.2 per cent, between 2007 and 2011. The number of inpatients dropped slightly in the same period, by just 0.3 per cent.

Those aged 65 and older accounted for 32.7 per cent of the total number of hospital service users.

The ESRI’s Prof Miriam Wiley said, “To us, that’s very much a reflection of efficiency where you have more people being treated faster. In an environment where you have serious constraints in terms of resources and staff, it’s pretty impressive”.

Prof Wiley said efforts by the HSE to admit patients on the day of surgery rather than sooner, and clinical programmes to speed up treatment, “deserve some credit in terms of reducing the length of stay and improving efficiency”.

57 hospitals

The report presents information on discharges from 57 acute public hospitals participating in the Hospital Inpatient scheme.

The hospitals collect demographic and clinical information on every patient.

The only buck to the trend of shorter stays was in voluntary hospitals.

At 5.6 days, acute inpatients stayed there for a day and a half longer than the average of 4.2 days.

“That’s a big difference,” Prof Wiley said. “We are looking at an overall reduction in average length of stay, so voluntary hospitals buck the trend a little bit.”

Reflecting the decline in private health insurance, the figures show a decrease in those privately treated.

Between 2007 and 2011, there was an average annual decrease of those privately treated of 2.2 per cent. Between 2010 and 2011, however, the decrease was 7.5 per cent.

The number of medical card patients treated in hospital, meanwhile, has jumped by over 120,000 in just four years. Prof Wiley said the figures reflected public policy.

“Utilisation of beds should be consistent with their designation so that where you have 20 per cent of the beds designated as private, you shouldn’t have any more than that in terms of private patients being treated – we’re seeing the figures are very consistent with public policy.”

The largest number of in-patient bed days for medical card patients was in the 75-84 age group which accounted for 604,604 bed days.

At 6.5 per cent, HSE West had the highest number of inpatients discharged to nursing homes versus almost half that amount in HSE Dublin Mid Leinster.

Figures on births show a quarter of women giving birth on a public basis in Ireland do so by Caesarean section.

In 46 per cent of those births, the procedure was planned or elective rather than an emergency.

Of women who gave birth in private hospitals, 36 per cent had a Caesarean section. This was elective in 62 per cent of cases.

Elective Caesareans

A larger proportion of older mothers, 21 per cent for mothers aged 35-44, delivered by elective Caesarean section, compared to 12 per cent for mothers aged 25-34.

The average length of hospital stay for mothers who had a non-instrumental vaginal delivery was 2.5 days versus 5.3 days for those who had section deliveries.

Single women accounted for 37.5 per cent of those admitted to hospital in relation to their pregnancy while 59.9 per cent of those admitted were married.