Investment leads to drastically different productivity changes across hospitals

By Cillian Sherlock, PA

University Hospital Limerick (UHL) has seen the highest productivity increase since before Covid-19, according to a new analysis of HSE data.

The Department of Health has launched a new dashboard which examines productivity improvements compared to increases in expenditure and staffing.

Officials have designed a “composite activity output” which is a high-level illustration of aggregated, cumulative activity in each hospital setting and is based on the costs of delivering inpatient, day case, outpatient and emergency department care.

It can be used to distil years-long increases in productivity across different types of care into a single figure to allow for comparisons against workforce and expenditure increases.

Officials said it showed that some hospitals are “notably better” at converting their input into activity, adding that they wish to determine the reasons for that.

The data shows that UHL was the hospital with the most productivity change between 2019 and 2024, at up 36 per cent – although the boost followed some of the highest levels of increased investment.

On roughly the same percentage workforce and expenditure increases as UHL, University Hospital Waterford was only able to translate that investment into a 17 per cent increase of productivity, less than half that of the top-performing hospital.

Still, UH Waterford was the fourth-highest performing hospital on metric of productivity increases, behind UHL, Connolly Hospital Blanchardstown, and Tallaght University Hospital.

The worst performing hospitals were St Vincent’s University Hospital and St James’ Hospital with roughly 3 per cent productivity increases, followed by MRH Portlaoise – on just 0.19 per cent.

This was with a 42 per cent increase in expenditure and 21 per cent increase in workforce.

While MRH Portlaoise was towards the lower end of the scale when it came to increases on expenditure and whole-time equivalents, it still under performed against other hospitals with similar support.

On even lower percentage increases on those metrics, Our Lady of Lourdes Hospital vastly outperformed Portlaoise with a 13.51 per cent increase in productivity.

Elsewhere, the data also examines the number of appointments taken by consultants at hospitals across the country and compares that to a 2016 baseline.

Nationally, the appointment-per-consultant stood at 1,686 in 2016 but has declined to 1,216 in 2024 – despite the number of whole-time equivalent consultants increasing by 70 per cent in that period.

The Department of Health says it means that consultants across the country could have 40% more appointments last year if they had been operating at the same productivity in 2016.

The two worst performing hospitals under this metric are CHI at Tallaght and Croom Orthopedic Hospital.

CHI at Tallaght had 16,390 appointments last year but the Department estimates it could have 2.7 times as many based on 2016 levels of productivity.

The data also estimates that Croom could have more than tripled its 8,950 appointments last year by the same calculation.

MRH Portlaoise, CHI at Tallaght and Croom Orthopedic Hospital have been contacted for comment.