Education And Debate

Patient characteristics and clinical caseload of short stay independent hospitals in England and Wales, 1992-3

BMJ 1994; 308 doi: (Published 25 June 1994) Cite this as: BMJ 1994;308:1699
  1. B T Williams,
  2. J P Nicholl
  1. Medical Care Research Unit, Department of Public Health Medicine, University of Sheffield Medical School, Sheffield S10 2RX
  1. Correspondence to: Professor Williams.


    Objective: To describe and quantify the patients and clinical activities of independent short stay hospitals.

    Design: Retrospective survey of hospital records for sampled periods of one financial year and comparison with data from 1981 to 1986.

    Setting: 217 independent hospitals in England and Wales, 1992-3.

    Main outcome measures: Distributions of sex, age groups, and areas of residence of patients, clinical procedures, financial provision. Results - Data were obtained fro 201 (93%) hospitals. An estimated 429 172 inpatients (7% more than 1986) and 249531 day cases (an increase of 154%) from 1986 were treated in the year. The number of overseas patients was half that in 1986. Clinical case mix remained similar to 1986. Abortion remained the commonest procedure (13% v 19% in 1986). Lens operations, heart operations, endoscopies, and non-surgical cases showed the largest increases from 1986. Proportionately more overseas patients had abortions (30% v 12% for England and Wales residents) and they received 41% of coronary artery bypass grafting. Three quarters of the patients were aged 15-64. The proportion of patients aged over 65 had changed little (19% v 17% in 1986). Estimated average bed occupancy was only 48%. Only one in 20 patients was treated under NHS contract; 90% of episodes were funded through private health insurance.

    Conclusions: The demand for treatment in private hospitals continues to increase despite additional investment in the NHS, but the overseas market is falling. Overall, the range of clinical activity has changed little.

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