Patients and procedures in short-stay independent hospitals in England andWales, 1997-1998

Background Private hospitals' activities are not routinely reported, so wha t services they provide and for whom is nor known. This study describes the clientele and case-mix of independent hospitals in England and Wales in 19 97-1998. Method Person, clinical and funding data were collected on samples of patie nts admitted to 215 of 221 independent hospitals open in 1997-1998. Sample numbers were weighted to reflect sampling duration, region, season and non- response. Results A total of 37434 sampled records represented 828422 admissions: 406 843 in-patients (5 per cent fewer than in 1992-1993) and 421 580 day cases (69 per cent more); 806509 were residents of England and Wales (up 24 per c ent); 16628 came from overseas (down 20 per cent). Numbers increased in all age groups except children; 25 per cent were 65 or over (18 per cent in 19 92-1993). The commonest procedures were abortion (11 per cent), endoscopy o f the gastro-intestinal tract (10 per cent) or joints (5 per cent), lens op erations (5 per cent), hernia repairs (3 per cent), and other common Nation al Health Service (NHS) elective operations. The NHS funded 84561 patients (11 per cent of the total) including 41942 non-abortion cases (6 per cent). A total of 540996 (76 per cent) paid th rough insurance; 119101 (17 per ce nt) were self-funded including 30 per cent of the over-75s. Ninety-five per cent of patients went home, 0.3 per cent died and 0.2 per cent were transf erred to NHS hospitals. Conclusions Demand for short-stay independent hospital care is rising. The clientele is becoming older, and readier to pay out of pocket. Clinical act ivity is mainly surgical and similar to NHS elective surgical demand. One y ear's caseload equals 10 weeks' elective admissions to NHS hospitals, in th at sense relieving the NHS. The scale of transfer to NHS hospitals (three p er day) is small.