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  • Title: Who's that sleeping in my bed? Potential and actual utilization of public and private in-patient beds in Irish acute public hospitals.
    Author: O'Reilly J, Wiley M.
    Journal: J Health Serv Res Policy; 2010 Oct; 15(4):210-4. PubMed ID: 20592047.
    Abstract:
    OBJECTIVE: To examine the impact of the unusual public/private mix on public and private in-patient bed utilization within Irish acute public hospitals. METHODS: Data from the Department of Health and Children and the Hospital In-Patient Enquiry were used to estimate and compare potential and actual utilization of public and private designated in-patient beds in 54 acute public hospitals from 2000 to 2004. RESULTS: Private in-patients used more bed days than were potentially available to them in 14.1% of hospital-year observations. The equivalent figure for public in-patients was 12.6%. Although the prevalence of excess utilization of private beds was relatively small, it did increase over the study period. Hospitals with excess private utilization were characterized by a relatively low proportion of private- or non-designated beds despite their patient profile being broadly similar to that of hospitals where there was no excess private utilization. CONCLUSIONS: Despite policies designed to limit private practice in Irish acute public hospitals, some hospitals have apparently been able to overcome these restrictions. In a system where financial incentives to treat private patients exist both for consultants and hospitals, it is not clear whether this excess private practice in public hospitals reflects a more efficient utilization of resources (when demand from public patients is low) or the displacement of public patients in favour of private patients. However, that a smaller number on hospital waiting lists possess private health insurance provides some support for the displacement hypothesis. Thus, it appears that policy-makers may need to reconsider attempts to ensure an appropriate division of acute public hospital resources between public and private patients.
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