Determinants of private health care use in the UK - Did a decade of NHS budget expansion change the demand for private inpatient care?

Marian Schmidt, LMU, University of Munich; Helmholtz Zentrum München, German Research Center for Environmental Health

Marian Schmidt

health, health care, private health care, NHS budget, private hospital care

Objectives: To investigate the determinants of private health care demand in the UK, by assessing whether NHS budget expansion changes the demand for private hospital care, with particular focus on the patient’s financial situation.

Methods: Using household survey data (BHPS) from 1991-2008 a panel analysis is conducted to identify determinants of private hospital care demand. Further, the time periods 1991-1997 and 2002-2008 will be compared to investigate the influence of NHS budget expansion.

Findings: From 1991 to 2008 demand for private hospital care decreased more rapidly than demand for public inpatient care. After the NHS budget expansion, education and employment are nowadays more important predictors of private hospital care use than a patient’s income. Due to the small number of observations no significant reduction of private health care use by patients with financial problems could be detected.

Conclusions: The expansion of the NHS budget strengthened the universality principle of the UK health system by including more patients to receive public care. In future times of financial austerity, a reduction in depth of NHS services will likely increase the share of private health care finance in total health expenditure and may threaten both universality and equity of the health system.