Why Are So Many People In Hospital In Ireland ?

23 Feb 2017

Key Point

Ireland has very high hospitalisation rates by international standards particularly when account is taken of our relatively young, healthy population.

Rates of Hospitalisation

In 2015, over 1.5 million people¹ received either inpatient or day case treatment in our hospitals. Of these 644,990 were inpatients and 878,821 were treated as day cases (excluding dialysis).

Eurostat data suggests we have very high rates of hospitalisation.

“The highest discharge rates for all hospitalised patients were in Ireland, Austria, Belgium and Romania. Combining discharge rates in 2014 for in-patients and day care patients, the highest discharge rates for all hospitalised patients were in Ireland, Austria, Belgium (2013 data) and Romania which were the only EU Member States with rates over 30 thousand per 100 000 inhabitants, while the lowest discharge rate was in Cyprus with a rate of 9.5 thousand per 100 000 inhabitants.

Turning to day care patients, relative to population size, discharge rates among the EU Member States in 2014 were generally in the range 1.5–10.3 thousand per 100 000 inhabitants. The Netherlands (2012 data), Belgium (2013 data) and the United Kingdom reported rates that were somewhat higher (13.9–16.3 thousand per 100 000 inhabitants), while Ireland reported by far the highest rate (20.8 thousand per 100 000 inhabitants).”.

We know that hospitalisation rates increase with age. The Irish data is even more surprising given our relatively young population. OECD data shows that 12.7 % of the population in Ireland was over 65 compared to an EU average of 18 %.

Issues

This raises a number of issues

Are there elements in our system which drive people towards hospital care when it would be better if they were treated elsewhere ?.
Has the 2001 Primary Care Strategy ² which has been a focus of policy for over 15 years failed ?
Does the solution to our waiting list problem lie in providing more hospital capacity or do better remedies lie elsewhere ?.

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Notes:

¹ Source : HSE Annual Report. This number includes repeat visits by the same individual.

² “Primary Care : A New Direction”

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