Industry News

MEDIA RELEASE

08 June 2009

In Categories: Industry News , Industry News > General

HOSPITAL ASSOCIATION OF SA

Do SA private hospitals have enough capacity to treat more patients?

Friday, 5 June 2009: As government seeks to extend healthcare to more people under a National Health Insurance System (NHI), the issue of determining whether private hospitals have enough spare capacity should be a key input into the planning process.

There are currently roughly 25 000 beds in the private sector, which services nearly 8 million people on medical aid. 

“With indications that the public hospital system is under severe strain, the question arises as to whether the private hospital industry has the capacity to absorb further demand – regardless of whatever form the funding of these patients might take,” says consulting actuary at Lighthouse Actuarial Consulting, Barry Childs.

Childs’ research, which was presented at the Hospital Association of South Africa’s (HASA) annual conference currently underway in Durban, is based on 80% of the private hospital market or 20 500 private hospital beds and shows that private hospitals are operating at near full capacity during the week.

During 2008, the average occupancy of private hospitals was 65,5%, up from 60% in 2006, due mainly to nearly 700 000 more people having joined medical aid schemes.  However, these occupancy rates include quieter periods such as weekends and December holidays. 

Childs calculates that if another 2 million people used private hospitals, increasing demand for private hospital beds by 15%, overall hospital occupancy would increase to 77.8%. The probability of patients arriving at full hospitals would then almost double from 18% to 35%.

“Under this scenario, one in nine patients arriving at a private hospital would find no beds available,” he says. 

If 4 million more people used private hospitals, increasing demand by 25%, one in five patients would arrive at a hospital and find it full. 

“Depending on how many new people are brought into the system, we may find that waiting lists for procedures in the private sector may become a reality,” he said

Occupancy rates of more than 80% are undesirable because they place strain on hospital support services such as cleaning and catering, increase pressure on nursing staff and affect the quality of patient care. High occupancy rates also increase the risk of adverse events such as medication errors and patient injuries, and present challenges for infection control.

Private hospitals would also experience a shortage of doctors and nurses to treat increased numbers of patients.  “The current shortage of doctors in South Africa in the public and private sectors, coupled with the long development lead-time for specialists in particular, is of great concern and will need to be addressed if quality of care standards are to be maintained alongside an increased demand for private hospital care,” says Childs.

His research shows that the private sector would need 3700 more nurses if another 2m more people were brought into private hospitals to keep nursing ratios where they are now. If 4m people were brought into the net, private hospitals would need 6700 more nurses.

Childs says capacity could be used in more innovative ways which would involve changing patient schedules to include weekends and holidays more effectively, but that this was difficult in an environment with a short supply of doctors and nurses.

Other solutions to the shortage of hospital beds presented at the conference include public private partnerships which allow private hospital groups to use existing, mothballed public facilities to treat more patients.

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