The comparison of activity and costs between hospitals is managed by the national Casemix programme. Casemix is an internationally accepted management system for the monitoring and evaluation of health services which allows for the collection, categorisation and interpretation of hospital patient data related to the types of cases treated, in order to assist hospitals to define their products, measure their productivity and assess quality.
The national Casemix programme presently operates in 34 hospitals nationally and is used inter alia to compare cost effectiveness between hospitals. Over 4,000 different procedures are performed in Irish hospitals. However, to establish relative cost comparisons between hospitals an individual hospital base price — the cost of a standard case when all national data has been aggregated and taking into account each hospitals unique mix of cases and differing complexity — is calculated. While this is the cost of treating a similar case in each hospital, one must take cognisance of the fact that teaching costs, accident and emergency services and national centres of excellence all contribute to differing costs in each hospital. Hospital base prices for 2004 are in Table A and range from €2169 to €4654. With regard to the average cost of an in-patient and day case procedure over time, Table B below details the aggregated national average base price of a day case and in-patient since 1998.
Regarding VHI payment levels, reimbursement arrangements with service providers are a matter for the VHI board. I as Minister for Health and Children do not have any statutory or administrative role in such arrangements, provided cover complies with the provision of the Health Insurance Acts and related regulations.
Table A
Hospital
|
Inpatient Base Price
|
Major Teaching Hospitals
|
€
|
Beaumont
|
3,796
|
Cork University
|
3,939
|
James Connolly
|
4,654
|
Mater
|
3,834
|
St James’s
|
4,073
|
Tallaght AMNCH
|
3,976
|
UCH Galway
|
3,568
|
Others
|
|
Cavan
|
2,640
|
Croom
|
3,242
|
Letterkenny
|
2,731
|
Limerick
|
3,240
|
Longford/Westmeath
|
2,717
|
Lourdes Drogheda
|
3,111
|
Louth General
|
2,533
|
Mallow
|
2,876
|
Mayo General
|
3,450
|
Mercy
|
3,094
|
Merlin Park
|
2,880
|
Navan
|
3,200
|
Portiuncula
|
3,113
|
Portlaoise
|
3,181
|
South Infirmary
|
2,969
|
Sligo
|
3,082
|
St Columcilles
|
3,831
|
St Lukes Kilkenny
|
3,186
|
St Mary’s Gurranebraher
|
3,458
|
Tralee
|
3,231
|
Tullamore
|
3,414
|
Waterford Regional
|
3,002
|
Wexford General
|
2,906
|
Maternities
|
|
Coombe
|
2,777
|
National Maternity, Holles St
|
2,202
|
Rotunda
|
2,169
|
Table B
Activity and Cost Data Relating to Year:
|
Published Year
|
National Average Base Price* Inpatients €
|
National Average Base Price* Daycases €
|
1998
|
2000
|
2,002
|
425
|
1999
|
2001
|
2,325
|
457
|
2000
|
2002
|
2,454
|
523
|
2001
|
2003
|
2,910
|
604
|
2002#
|
2004
|
3,467
|
547
|
* Base price is the average cost of all cases nationally.
# The latest year for which audited data is available.