Review of acute hospital services in the Mid - Health Service Executive
Review of acute hospital services in the Mid - Health Service Executive
Review of acute hospital services in the Mid - Health Service Executive
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Current service delivery<br />
Regional self sufficiency<br />
<strong>Review</strong> <strong>of</strong> <strong>acute</strong> <strong>hospital</strong> <strong>services</strong> <strong>in</strong> HSE <strong>Mid</strong>-West<br />
An action plan for <strong>acute</strong> and community <strong>services</strong><br />
With<strong>in</strong> <strong>the</strong> National Hospitals Office (NHO), <strong>the</strong>re is a move towards achiev<strong>in</strong>g regional self<br />
sufficiency and address<strong>in</strong>g any significant gaps <strong>in</strong> <strong>acute</strong> service provision with<strong>in</strong> regions to<br />
ensure geographical equity 49 .<br />
Exam<strong>in</strong><strong>in</strong>g <strong>the</strong> extent to which HSE <strong>Mid</strong>-West has achieved regional self sufficiency can be<br />
seen through an analysis <strong>of</strong> <strong>hospital</strong> discharges us<strong>in</strong>g HIPE data. This shows that 81.1 per<br />
cent <strong>of</strong> residents <strong>in</strong> <strong>Mid</strong>-West use <strong>the</strong> <strong>acute</strong> <strong>hospital</strong> <strong>services</strong> <strong>in</strong> HSE <strong>Mid</strong>-West. Fur<strong>the</strong>r<br />
analysis shows that <strong>the</strong> residents <strong>in</strong> County North Tipperary when compared with <strong>the</strong> o<strong>the</strong>r<br />
counties are more likely to access <strong>services</strong> outside <strong>of</strong> HSE <strong>Mid</strong>-West, predom<strong>in</strong>antly<br />
access<strong>in</strong>g <strong>services</strong> <strong>in</strong> Waterford and Dubl<strong>in</strong>. Only 4.5 per cent <strong>of</strong> residents <strong>in</strong> Limerick City<br />
access <strong>services</strong> outwith HSE <strong>Mid</strong>-West. Table 26 shows a pr<strong>of</strong>ile <strong>of</strong> this activity by county.<br />
Table 26: Residents treated with<strong>in</strong> and outwith HSE <strong>Mid</strong>-West<br />
County<br />
<strong>Mid</strong> West<br />
Discharges<br />
Outside Total<br />
% Outflow Ma<strong>in</strong> Areas for outflows and %<br />
Limerick City 18,206 849 19,055 4.5% Limerick: 13.8% = Dubl<strong>in</strong> (8%),<br />
Limerick County 19,566 5,188 24,754 21.0% Cork (5%), and Galway (1%)<br />
Clare 20,493 4,232 24,725 17.1%<br />
Galway (10%), Dubl<strong>in</strong> (5%),<br />
and Cork (2%)<br />
Waterford (14%), Dubl<strong>in</strong> (8%),<br />
North Tipperary 11,748 6,096 17,844 34.2% <strong>Mid</strong>lands (5%), Galway (4%),<br />
and Cork (3%)<br />
Total <strong>Mid</strong>-West 70,013 16,365 86,378 18.9%<br />
Source: Analysis <strong>of</strong> HIPE data, 2005.<br />
Given this pr<strong>of</strong>ile <strong>of</strong> activity, with 19 per cent <strong>of</strong> patients travell<strong>in</strong>g outside <strong>of</strong> HSE <strong>Mid</strong>-West<br />
to access <strong>acute</strong> <strong>hospital</strong> <strong>services</strong> it is reasonable to assume, that <strong>in</strong> <strong>the</strong> future, this pattern<br />
will cont<strong>in</strong>ue but at a reduced level.<br />
There is also a proportion <strong>of</strong> patient activity occurr<strong>in</strong>g at <strong>acute</strong> <strong>hospital</strong>s <strong>in</strong> HSE <strong>Mid</strong>-West<br />
which arises from patients who are resident outside <strong>of</strong> HSE <strong>Mid</strong>-West. The majority <strong>of</strong> <strong>the</strong>se<br />
patients are resident <strong>in</strong> <strong>the</strong> HSE South area. These patients are be<strong>in</strong>g admitted for<br />
emergency general medic<strong>in</strong>e, emergency general surgery and elective orthopaedics.<br />
Tak<strong>in</strong>g <strong>in</strong>to account <strong>the</strong> <strong>in</strong>flows and outflows <strong>of</strong> <strong>acute</strong> <strong>hospital</strong> activity for <strong>the</strong> <strong>Mid</strong>-West, <strong>the</strong>n<br />
<strong>the</strong>re is a net loss <strong>in</strong> activity as presented <strong>in</strong> Table 27.<br />
49 National <strong>Service</strong> Plan, <strong>Health</strong> <strong>Service</strong> <strong>Executive</strong>, January 2007.<br />
98