Would a Healthier Population Consume Fewer Health Service Resources? — A Life-Table Analysis Using Hospital In-Patient Enquiry (HIPE) Bed-Usage Statistics as a Proxy for Hospital Treatment Costs
St Leger A S (Department of Community Medicine, University of Manchester, Stopford Building, Oxford Road, Manchester M13 9PT, UK) Would a healthier population consume fewer health service resources? — A life-table analysis using hospital in-patient enquiry (HIPE) bed-usage statistics as a proxy for hospital treatment costs. International Journal of Epidemiology 1989, 18: 227–231. The long-term effects upon acute-care hospital costs of reductions of morbidity and mortality from various causes are explored. The daily number of beds used per million population for all diagnostic categories is suggested as a proxy measure of hospital costs. An index of lifetime bed usage for a hypothetical cohort of persons living out their lives under specified age-specific mortality and morbidity patterns is derived. Examples of the application of this index are given for differing assumptions about mortality and morbidity in males. It is shown that reducing ischaemic heart disease or cancer morbidity will lead to increased overall hospital costs whereas reductions in the rate of occurrence of accidents, injuries and poisonings would reduce overall costs. The assumptions underlying the use of the index are discussed and extensions to the population model are proposed.