HOSPITAL DISCHARGES in the Republic are rising, pointing toward increased efficiency of services, according to the 2007 annual report on Activity in Acute Public Hospitals.
In 2007 there was an increase of 80,000 discharges in hospitals on the previous year – totalling 1.32 million – which, according to Prof Miriam Wiley from the Economic and Social Research Institute (ESRI), is an indicator of increased efficiency but also of the ageing population.
“There is more throughput and a reduction of the length of stay,” according to Prof Wiley, whose organisation compiled the report.
“Day patients have increased by nearly 9 per cent, while inpatients have only increased by 2.7 per cent. This indicates that there is a faster throughput and higher capacity.
“In part this is due to the different types of service available and that some of the previous treatments no longer require a person to be an inpatient,” she said.
Over three times as many discharges, per 1,000 patients, were seen among 75-84 year olds than the average amount of discharges across all age groups.
The 75-84 age group also made up more than one-fifth of all bed days used, while accounting for only 11.2 per cent of total inpatient discharges.
“What is important is that we have the appropriate mix of services available to suit the emerging age profile. Obviously the more older people [who] can be treated out of hospital, the better,” said Prof Wiley.
Medical card holders comprised 45 per cent of inpatients and remained in hospital on average 3.7 days longer than non-medical card holders – a disproportionate amount given that they account for less than a third of the population, according to Prof Wiley.
This is explained by the higher incidence among medical card holders of older people and people from poorer backgrounds, who often have a poorer health status, according to Prof Wiley.
One factor currently militating against increasing capacity and efficiency is the low number of discharges on weekends. The largest amount of admissions occur at the beginning of the week, while the largest number of discharges occur on a Friday, according to the report.
Hospitals operate differently on weekdays than at weekends, and discharge policies should be addressed to ensure that people well enough to be sent home are discharged at the weekend, according to Prof Wiley.
The length of stay for inpatients differs dramatically depending on the type of hospital. For example, voluntary hospitals recorded an average length of stay of 6.1 days, while regional and county hospitals reported 4.7 days and 4.3 days respectively.
The differences require further research, said Prof Wiley, citing the complexity of medical conditions that present themselves in the different hospitals as a possible factor.