Dáil Éireann díospóireacht -
Tuesday, 24 Oct 2000

Vol. 524 No. 5

Written Answers. - Hospital Costs.

Michael Noonan

Ceist:

263 Mr. Noonan asked the Minister for Health and Children the estimated cost of providing an additional medical bed in an acute hospital in terms of capital and current expenditure; and if he will make a statement on the matter. [23305/00]

Richard Bruton

Ceist:

332 Mr. R. Bruton asked the Minister for Health and Children the average cost of constructing and of operating a bed in an acute hospital, in a convalescent hospital and in a long stay nursing home. [23182/00]

Minister for Health and Children (Mr. Martin):

I propose to take Questions Nos. 263 and 332 together.

The cost per bed depends very much on the mix of support services to be considered in making up an average cost.

The total project cost* of a major teaching and tertiary referral hospital with the full range of support services at October 2000 price base date is in the region of £450,000 per bed.

The total project cost* of an additional ward bed to a major teaching and tertiary referral hospital at October 2000 price base date is in the region of £100,000 per bed.

The total project cost* of a long-term community nursing unit with full support services i.e. rehabilitation and catering etc. at October 2000 price base date is in the region of £150,000 per bed.

*Total project cost includes construction costs, design team fees, equipping and other costs.

The in-patient revenue cost per bed-day for the 31 acute public hospitals which participated in the national casemix programme in 1998, the latest date for which audited data is available, is detailed in the following table. It should be noted that there are many factors which affect in-patient cost per bed-day and these include the complexity of the workload, teaching obligations, tertiary referrals, etc. The figures exclude costs and activity attributable to day-cases, out-patient services, long-stay cases, dialysis, obstetrics and psychiatry and do not take account of capital costs.

The cost of maintaining a person in a public nursing unit or long-stay hospital, within which convalescent care can also be provided, varies considerably, from high dependency units at £91 per day to lesser dependency units at £30 daily.

Average cost per day in hospitals who submit costs as part of the national casemix programme

See Notes below

	Hospitals	1998 perday costs
		£
Group 1 Hospitals	Beaumont	273
	Cork University	292
	James Connolly Memorial	209
	Mater	268
	St. James's,	286
	St. Vincent's	262
	UCH Galway	247
Group 2 Hospitals	Cavan General	153
	St. Mary's Orthopaedic, Cork	232
	Letterkenny	188
	Limerick Regional	216
	Drogheda	204
	Dundalk	153
	Mallow	200
	Mayo General	193
	Mercy, Cork	250
	Merlin Park, Galway	207
	Monaghan General	182
	Mullingar General	185
	Navan General	225
	Portiuncula	168
	Portlaoise	221
	Sligo General	210
	South Infirmary, Cork	210
	St. Luke's, Kilkenny	180
	Loughlinstown	200
	Tralee General	198
	Tullamore General	187
	Waterford Regional	197
	Wexford General	202
	Croom orthopaedic, Limerick	280

Note 1: Only costs from specialties are included

Note 2: casemix costs are compiled for comparative purposes. Costs unique to particular hospitals may be excluded in overall costs if their inclusion skews accurate comparison between hospitals – e.g. national specialty work.

Note 3: Costs for daycases, psychiatry, dialysis, geriatric care, obstetrics, capital, outpatients accident and emergency and "extems" (services between hospitals) are excluded.

Note 4: Factors affecting in-patient costs include complexity of workload, teaching obligations tertiary referrals, etc.

Note 5: Group 1 hospitals are the main teaching hospitals, while group 2 are not. Hospitals are grouped for more accurate cost comparison.