PMI hospital admissions hit fresh record as self-pay slips – PHIN

The first three months of the year witnessed another record quarter in the use of private medical insurance (PMI) which was up more than 4.3% from the final quarter of last year.

Data from the Private Healthcare Information Network (PHIN) showed there were 168,000 private hospital admissions from January to March for patients using PMI, this was the highest number recorded and up around 7,000 from 161,000 in October to December, which marked the previous high.

 

The figure was also up 6% on the first quarter of 2023.

The PHIN data showed the surge in PMI numbers had driven private hospital admissions to their highest ever level for a single quarter in the same period.

There were 238,000 admissions in January to March 2024, a 3% increase on the former highest quarter – Q1 2023 – and a 4% increase from Q4 2023.

This marked the second quarterly increase in a row following a slight dip in Q2 and Q3 2023.

Insured admissions were up across every age group except 70-79 year olds with the largest increases coming from those aged 20-29 and 30-39.

There were nearly 100,000 more admissions paid for by private medical insurance than by those self-paying. This was the biggest gap in the payment methods since before the Covid pandemic (Q4 2019).

Self-pay has consistently been more popular than it was before the pandemic but has flat-lined over the last year and was down 3,000 or 4.1% from the high of 73,000 a year earlier.

The data underlines a trend pointed to by Fiona Booth, head of external affairs and stakeholder engagement at Healthcode at Health & Protection‘s second annual Health Summit at Tylney Hall in Hampshire at the start of the year.

At the Summit, Booth revealed insured claims volumes handled by the service broke through the 10 million barrier in 2023 which was 20% higher than 2022, while unique patient numbers were still increasing.

 

PMI admissions grow; self-pay steady

When comparing Q1 2024 to Q1 2023, the number of admissions funded by PMI grew across every English region. The North East had the fewest insured admissions (2,000) in these quarters.

London continued to post the most insured admissions, rising from 56,000 to 61,000, followed by the South East which rose from 30,000 to 31,000.

Insured admissions were also up in each of the devolved nations.

Self-pay was down in every region except London when comparing Q1 2024 to Q1 2023; in London it rose by 1,000 to 15,000 admissions.

Self-pay admissions also rose in Northern Ireland and Wales, but fell in Scotland.

 

Procedures

There were more episodes in eight of the top 10 procedures by volume when comparing Q1 2023 and Q1 2024. Only therapeutics – chemotherapy and diagnostic colonoscopy – bowel had fewer admissions.

Outside the top 10, diagnostics – blood test had the biggest increase in admissions by percentage (192%) and was only just behind peripheral nerve block in terms of volume increase.

 

Active consultants in private healthcare

PHIN noted the number of consultants active in private healthcare regularly fluctuates and was up 280 (2.7%) from Q1 2023 to Q1 2024.

The number of active consultants in Q1 2024 was the highest Q1 figure since before the pandemic and the joint second highest of any quarter since the lockdowns.

The largest increase in active consultants in the top 10 procedure groups was in ophthalmology with an extra 32 consultants (3.9%). Clinical oncology had the second largest increase in volume (an extra 26 consultants) and the largest percentage increase of 14%.

The specialties of gastroenterology (-6), and plastic surgery’ (-17), ear nose and throat (ENT) (-7) and general surgery (-10) all had reductions in the number of consultants operating.

 

Patient demographics

There was an increased number of insured admissions and reduction in self-paid admissions among both men and women compared to the same quarter in 2023.

The growth in insured admissions for males was 5,000 (7%) compared to 4,825 (6%) for females.

The drop in self-pay was also more pronounced for male admissions at 2,025 (-7%) compared to 1,255 (-3%) for females.

Admissions for females continue to be higher than for males across both payment methods.

Admissions in all age groups up to and including 60-69 year-olds increased when comparing Q1 2023 and Q1 2024.

Overall, the largest increase by volume and percentage came in the 30-39 year-old age group. However, this age group was still only the fifth highest for admissions with the most being in the 50-59 group.

The following three age groups (70-79, 80-89 and 90-99) all had a decrease before an increase in the 100-109 year-olds (+5).

Comparing Q1 2023 and Q1 2024, the use of insurance to pay for admissions was up across every age group except 70-79 year olds. The largest increase by volume was in the 30-39 year-old group. The largest percentage increase (13%) was shared by the 20-29 and 30-39 year-olds.

In contrast, the use of self-pay reduced in every age group except 0-9 and 100-109 year-olds where there was a slight increase. The largest decrease by volume came in the 70-79 year-old group (1,020) and the largest percentage decrease was for 90-99 year-olds (10%).

 

Inevitable increase

Emily Jones, client consulting director at Broadstone, said: “Following a record 2023, private health admissions continued to surge through the first three months of 2024 to further all-time highs as the NHS crisis pushes hundreds of thousands of patients private.

“It seems inevitable that we will soon be seeing over a million private health admissions every year.

“It is little surprise that this trend is being almost entirely driven by private medical insurance as employers recognise the threat of poor health which has manifested itself in soaring economic inactivity figures.

“As a consequence, our clients have elevated healthcare to a board level priority as they look to rapidly expand coverage of PMI and put in place preventative steps like access to virtual GPs, direct access services and on-site health screenings.

“These strategies aim to help employees catch health issues earlier and then ensure the rapid treatment needed to avoid to more complex, expensive treatments. Until NHS waiting lists come down significantly, we expect to see continued corporate investment in private healthcare solutions to support the wellbeing of their staff.”

 

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