In 2018 the largest percentage of physicians saw between 11 and 20 patients per day. Just 1.3% of physicians saw between 51 and 60 patients per day during that year. When doctors face a high patient burden on a daily basis, research indicates that burn out or medical malpractice could be a result.

Physician time with patients

Physicians and patient time is an important part of a medical relationship. Among all practices, a majority of physicians spent between 17 and 24 minutes with patients. A lack of time between patients and physicians can also lead to patient mistrust. A recent survey indicated that just around half of patients trusted that their doctor prescribed drugs for them because it was the best possible product for them at the time.

Burn out among physicians

Another result of large patient burdens could be burn out. A large majority of physicians have had feelings of burnout in recent years. Different physician specialties have different levels of burnout. The top three specialties for burn out in recent years were urology, neurology and physical medicine/rehabilitation. Among the major causes of burnout among U.S. physicians, over one third of physicians indicated that spending too many hours was a primary factor that causes burnout.

In 2022, primary care physicians in Germany saw an average of 254 patients during their typical work week, which is the highest number among surveyed countries. On the other hand, with 43 patients, Sweden reported the lowest average count of patients seen per week by primary care physicians.

In France, the average number of patients seen by a full-fledged active physician (APE) can be different depending on the type of medical specialty. In 2017, there were more than two thousand patients per cardiologist, and a little less than 400 patients per psychiatrist.

Among physicians in the United States the work relative value units (RVUs) were highest among anesthesiologists, followed by ophthalmologists. Among anesthesiologists, the work relative value units were 10,891 as of 2016. The specialty with the least work RVUs at that time was psychiatry with 4,079 RVUs. Relative value units are used by Medicare to determine physician fees for services rendered.

Medicare population

Medicare is a federal health insurance program in the United States aimed at providing affordable health services to those aged 65 and older and those with disabilities or certain other conditions. In recent years the percentage of the U.S. population that is covered by Medicare has increased dramatically in recent years. A majority of Medicare beneficiaries are enrolled in the program based on age, while the proportion of those qualified based on disability is significantly less.

Physicians and Medicare

Medicare has three parts (Part A, Part B and Part C) that cover various aspects of health care. Among all parts of Medicare coverage most recent estimates suggest that Medicare Part B made the largest share of Medicare payments. Medicare Part B is a medical insurance that covers doctors’ appointments, outpatient visits, medical supplies and prevention services. Medicare spending and payments to physicians also varies by specialty. According to recent estimates, internal medicine physicians and ophthalmologists received the most Medicare payments.

The acute-care pathway (from the emergency department (ED) through acute medical units or ambulatory care and on to wards) is the most visible aspect of the hospital health-care system to most patients. Acute hospital admissions are increasing yearly and overcrowded emergency departments and high bed occupancy rates are associated with a range of adverse patient outcomes. Predicted growth in demand for acute care driven by an ageing population and increasing multimorbidity is likely to exacerbate these problems in the absence of innovation to improve the processes of care.

Key targets for Emergency Medicine services are changing, moving away from previous 4-hour targets. This will likely impact the assessment of patients admitted to hospital through Emergency Departments.

This data set provides highly granular patient level information, showing the day-to-day variation in case mix and acuity. The data includes detailed demography, co-morbidity, symptoms, longitudinal acuity scores, physiology and laboratory results, all investigations, prescriptions, diagnoses and outcomes. It could be used to develop new pathways or understand the prevalence or severity of specific disease presentations.

PIONEER geography: The West Midlands (WM) has a population of 5.9 million & includes a diverse ethnic & socio-economic mix.

Electronic Health Record: University Hospital Birmingham is one of the largest NHS Trusts in England, providing direct acute services & specialist care across four hospital sites, with 2.2 million patient episodes per year, 2750 beds & an expanded 250 ITU bed capacity during COVID. UHB runs a fully electronic healthcare record (EHR) (PICS; Birmingham Systems), a shared primary & secondary care record (Your Care Connected) & a patient portal “My Health”.

Scope: All patients with a medical emergency admitted to hospital, flowing through the acute medical unit. Longitudinal & individually linked, so that the preceding & subsequent health journey can be mapped & healthcare utilisation prior to & after admission understood. The dataset includes patient demographics, co-morbidities taken from ICD-10 & SNOMED-CT codes. Serial, structured data pertaining to process of care (timings, admissions, wards and readmissions), physiology readings (NEWS2 score and clinical frailty scale), Charlson comorbidity index and time dimensions.

Available supplementary data: Matched controls; ambulance data, OMOP data, synthetic data.

Available supplementary support: Analytics, Model build, validation & refinement; A.I.; Data partner support for ETL (extract, transform & load) process, Clinical expertise, Patient & end-user access, Purchaser access, Regulatory requirements, Data-driven trials, “fast screen” services.

The National Treatment Purchase Fund (NTPF) is responsible for the collection, collation and validation of Inpatient, Day Case and Outpatient waiting lists.

The IPDC Waiting List report shows the total number of patients waiting, across the various time bands, for Inpatient and Day case treatment in each Specialty (these numbers do not include GI Endoscopies, see separate report). Each report lists the numbers waiting per Hospital in each particular specialty. To preserve confidentiality, where there are <5 patients waiting in a particular specialty/hospital, we have aggregated the numbers under a ‘Small Volume’ heading.

Each report is aggregated data on a monthly basis over a year. The current year’s report will be appended to each month.

Adult/Child classification: From 1/1/2015 this is based on each hospital’s designation, for example all Children’s Hospitals will have all patients set as Child, all Adult-only hospitals have all patients set as Adult and all mixed Adult/Child hospitals have the patients designated based on age (0-15 = Child). Prior to 1/1/2015 each hospital managed their own adult/child classification ages.

Please note that NTPF does not collect activity data i.e. numbers treated or removed. We collect a snapshot of the number of patients waiting in each hospital and publish the numbers monthly on our website.

Boards and management of individual public hospitals are responsible for the accuracy and the integrity of patient data submitted to NTPF.

Work on the quality of this data is ongoing between NTPF and individual hospitals and technical and administrative issues will be addressed as they arise.

Notes for consideration:.

• From August 2015 NTPF standardised the Time band categories on our published reports. We now show 0-3 Months, 3-6, 6-9, 9-12, 12-15, 15-18 and 18+. This aligns to the DoH/HSE clearance targets for waiting lists, in line with maximum allowable waiting times directed by the Minister for Health. • St. Michaels Hospital, Dun Laoghaire - Inpatient/Day case file since Nov 2015. • From July 2015 Tallaght Paediatrics and Adults figures were shown separately. • Due to PAS system upgrade in University Hospital Limerick no file was received from July 2015 until September 2015. • Due to PAS system upgrade in St John's Hospital Limerick no file was received from March 2016 to May 2016. • Due to a PAS system upgrade in Nenagh Hospital no files were received for October 2016.

Analysis of ‘Inpatient/Day Case Waiting List 2014 - Mar 2021’ provided by Analyst-2 (analyst-2.ai), based on source dataset retrieved from http://data.europa.eu/88u/dataset/5fca9a76-9ab6-4d27-afe9-0a1cab9f7dd8 on 14 January 2022.

--- Dataset description provided by original source is as follows ---

The National Treatment Purchase Fund (NTPF) is responsible for the collection, collation and validation of Inpatient, Day Case and Outpatient waiting lists.

The IPDC Waiting List Open Data report shows the total number of people waiting, across the various time bands, for Inpatient and Day case treatment in each Specialty (these numbers do not include GI Endoscopies, see separate report).

The Children’s Health Act 2018 came into effect on 1st January 2019. Under this act, Children’s Health Ireland was established and all assets, liabilities and records were transferred from Our Lady’s Children’s Hospital Crumlin, Temple Street Children’s University Hospital and National Childrens Hospital at Tallaght University Hospital to the new body. From 1st January 2019, all NTPF reports reflect this change and data from the three sites of Children’s Health Ireland are reported as one entity. On the 31st of July 2019 Children's Health Ireland opened a new Paediatric Outpatient Department and Urgent Care Centre at CHI Connolly in Blanchardstown. The waiting lists for this site are incorporated into the Children's Health Ireland figures.

Please note that NTPF does not collect activity data, i.e., numbers treated or removed. A snapshot of the number of patients waiting in each hospital is collected and published, monthly, on the NTPF website.

Boards and management of individual public hospitals are responsible for the accuracy and the integrity of patient data submitted to NTPF.

--- Original source retains full ownership of the source dataset ---

TABLE 4.25: HIPE Report: TABLE 4.25 Total Discharges: MDC 23 Factors Influencing Health Status and Other Contacts with Health Services: AR-DRG by Patient Type (N, In-Patient Length of Stay) ,2015. Published by Health Service Executive. Available under the license cc-by (CC-BY-4.0).MDC 23 Factors Influencing Health Status and Other Contacts with Health Services: AR-DRG by Patient Type (day patient and in-patient).The MDC is a category generally based on a single body system or aetiology that is associated with a particular medical specialty. DRGs are clusters of cases with similar clinical attributes and resource requirements. In Ireland, Australian Refined Diagnosis Related Group (AR-DRG) have been in use in Ireland since 2005, in 2015 Version 6.0 was used to group discharges. Activity in Acute Public Hospitals in Ireland Annual Report, 2015, is a report on in-patient and day patient discharges from acute public hospitals participating in the Hospital In-Patient Enquiry (HIPE) scheme in 2015. Discharge activity is examined by type of patient (day patient/in-patient), admission type (elective/emergency/maternity) and hospital group, and by demographic parameters (such as age and sex). Particular issues of relevance to the Irish health care system covered in the report relate to the composition of discharges by medical card and public/private status. Discharges are also analysed by diagnoses, procedures, major diagnostic categories, and diagnosis related groups. The analysis is presented at the national level. In 2015 HIPE discharges were coded using ICD-10-AM/ACHI/ACS 8th Edition and grouped into AR-DRG Version 6.0. See the complete Activity in Acute Public Hospitals in Ireland Annual Report 2015 at http://www.hpo.ie/latest_hipe_nprs_reports/HIPE_2015/HIPE_Report_2015.pdf...

TABLE 4.18: HIPE Report: TABLE 4.18 Total Discharges: MDC 16 Diseases and Disorders of Blood, Blood Forming Organs, Immunological Disorders: AR-DRG by Patient Type (N, In-Patient Length of Stay) ,2015. Published by Health Service Executive. Available under the license cc-by (CC-BY-4.0).MDC 16 Diseases and Disorders of Blood, Blood Forming Organs, Immunological Disorders: AR-DRG by Patient Type (day patient and in-patient).The MDC is a category generally based on a single body system or aetiology that is associated with a particular medical specialty. DRGs are clusters of cases with similar clinical attributes and resource requirements. In Ireland, Australian Refined Diagnosis Related Group (AR-DRG) have been in use in Ireland since 2005, in 2015 Version 6.0 was used to group discharges. Activity in Acute Public Hospitals in Ireland Annual Report, 2015, is a report on in-patient and day patient discharges from acute public hospitals participating in the Hospital In-Patient Enquiry (HIPE) scheme in 2015. Discharge activity is examined by type of patient (day patient/in-patient), admission type (elective/emergency/maternity) and hospital group, and by demographic parameters (such as age and sex). Particular issues of relevance to the Irish health care system covered in the report relate to the composition of discharges by medical card and public/private status. Discharges are also analysed by diagnoses, procedures, major diagnostic categories, and diagnosis related groups. The analysis is presented at the national level. In 2015 HIPE discharges were coded using ICD-10-AM/ACHI/ACS 8th Edition and grouped into AR-DRG Version 6.0. See the complete Activity in Acute Public Hospitals in Ireland Annual Report 2015 at http://www.hpo.ie/latest_hipe_nprs_reports/HIPE_2015/HIPE_Report_2015.pdf...

The National Treatment Purchase Fund (NTPF) is responsible for the collection, collation and validation of Inpatient, Day Case and Outpatient waiting lists.

The IPDC GI Endoscopy Waiting List report shows the total number of patients waiting, across the various time bands, for GI Endoscopy treatment. Each report lists the numbers waiting per Hospital in each particular specialty. To preserve confidentiality, where there are <5 patients waiting in a particular specialty/hospital, we have aggregated the numbers under a ‘Small Volume’ heading.

Each report is aggregated data on a monthly basis over a year. The current year’s report will be appended to each month.

Adult/Child classification: From 1/1/2015 this is based on each hospital’s designation, for example all Children’s Hospitals will have all patients set as Child, all Adult-only hospitals have all patients set as Adult and all mixed Adult/Child hospitals have the patients designated based on age (0-15 = Child). Prior to 1/1/2015 each hospital managed their own adult/child classification ages.

Please note that NTPF does not collect activity data i.e. numbers treated or removed. We collect a snapshot of the number of patients waiting in each hospital and publish the numbers monthly on our website.

Boards and management of individual public hospitals are responsible for the accuracy and the integrity of patient data submitted to NTPF.

Work on the quality of this data is on-going between NTPF and individual hospitals and technical and administrative issues will be addressed as they arise.

Notes for consideration:.

• From August 2015 NTPF standardised the Time band categories on our published reports. We now show 0-3 Months, 3-6, 6-9, 9-12, 12-15, 15-18 and 18+. This aligns to the DoH/HSE clearance targets for waiting lists, in line with maximum allowable waiting times directed by the Minister for Health. • St. Michaels Hospital, Dun Laoghaire - Inpatient/Day case file since Nov 2015. • From July 2015 Tallaght Paediatrics and Adults figures were shown separately. • Due to PAS system upgrade in University Hospital Limerick no file was received from July 2015 until September 2015. • Due to PAS system upgrade in St John's Hospital Limerick no file was received from March 2016 to May 2016. • Due to a PAS system upgrade in Nenagh Hospital no files were received for October 2016.

MDC 18 Infectious and Parasitic Diseases, Systemic or Unspecified Sites: AR-DRG Version 8.0 by Patient Type (day patient and in-patient).The MDC is a category Generally based on a single body system or aetiology that is associated with a particular medical specialty. DRGs are clusters of cases with similar clinical Attributes and resource requirements. In Ireland, Australian Refined Diagnosis Related Group (AR-DRG) have been in use in Ireland since 2005, in 2017 Version 8.0 was used to group Discharges. Activity in Acute Public Hospitals in Ireland Annual Report, 2017, is a report on in-patient and day patient Discharges from acute public hospitals participating in the Hospital In-Patient Enquiry (HIPE) scheme in 2017. Discharge activity is Examined by type of patient (day patient/in-patient), admission type (elective/emergency/maternity) and hospital group, and by demographic parameters (such as age and sex). Certain issues of relevance to the Irish health care system covered in the report relate to the composition of Discharges by medical card and public/private status. Charges are also analysed by diagnoses, procedures, major Diagnostic categories, and Diagnosis related groups. The analysis is presented at the national level. In 2017 HIPE Discharges were coded using ICD-10-AM/Achi/ACS 8th Edition and grouped into AR-DRG Version 8.0. See the complete Activity in Acute Public Hospitals in Ireland Annual Report 2017 at http://www.hpo.ie/latest_hipe_nprs_reports/HIPE_2017/HIPE_Report_2017.pdf

This table provides statistics on the Average Number of Distinct Patients, Claims and Payments per Day by Alberta Health Services Geographic Zone and Specialty under the Alberta Health Care Insurance Care Plan (AHCIP). These reports include payment and service information for services provided by Alberta physicians to people registered with the Alberta Health Care Insurance Plan (AHCIP). Payments and Services provided to Albertans while they are out of country or out of province are excluded from these reports.

MDC 19 Mental Diseases and Disorders: AR-DRG Version 8.0 by Patient Type (day patient and in-patient).The MDC is a category generally based on a single body system or aetiology that is associated with a particular medical specialty. DRGs are clusters of cases with similar clinical attributes and resource requirements. In Ireland, Australian Refined Diagnosis Related Group (AR-DRG) have been in use in Ireland since 2005, in 2016 Version 8.0 was used to group discharges. Activity in Acute Public Hospitals in Ireland Annual Report, 2016, is a report on in-patient and day patient discharges from acute public hospitals participating in the Hospital In-Patient Enquiry (HIPE) scheme in 2016. Discharge activity is examined by type of patient (day patient/in-patient), admission type (elective/emergency/maternity) and hospital group, and by demographic parameters (such as age and sex). Particular issues of relevance to the Irish health care system covered in the report relate to the composition of discharges by medical card and public/private status. Discharges are also analysed by diagnoses, procedures, major diagnostic categories, and diagnosis related groups. The analysis is presented at the national level. In 2016 HIPE discharges were coded using ICD-10-AM/ACHI/ACS 8th Edition and grouped into AR-DRG Version 8.0. See the complete Activity in Acute Public Hospitals in Ireland Annual Report 2016 at http://www.hpo.ie/latest_hipe_nprs_reports/HIPE_2016/HIPE_Report_2016.pdf

aSubsets of specialties visited by a patient at the same health care facility on the same day.bOne-stop visits were defined as more than one ambulatory care visits for different specialties at the same healthcare facility on the same day by a patient.

Number of changes to laboratory test result preferences per specialty.

MDC 4 Diseases and Disorders of the Respiratory System: AR-DRG by Patient Type (day patient and in-patient). The MDC is a category generally based on a single body system or aetiology that is associated with a particular medical specialty. DRGs are clusters of cases with similar clinical attributes and resource requirements. In Ireland, Australian Refined Diagnosis Related Group (AR-DRG) have been in use in Ireland since 2005, in 2014 Version 6.0 was used to group discharges. Activity in Acute Public Hospitals in Ireland Annual Report, 2014, is a report on in-patient and day patient discharges from acute public hospitals participating in the Hospital In-Patient Enquiry (HIPE) scheme in 2014. Discharge activity is examined by type of patient and hospital, and by demographic parameters (such as age and sex). Particular issues of relevance to the Irish health care system covered in the report relate to the composition of discharges by medical card and public/private status. Discharges are also analysed by diagnoses, procedures, major diagnostic categories, and diagnosis related groups. Maternity discharges are examined separately from other discharges. The analysis is presented at the national level. In 2014 HIPE discharges were coded using ICD-10-AM/ACHI/ACS 6th Edition and grouped into AR-DRG Version 6.0. See the complete Activity in Acute Public Hospitals in Ireland Annual Report 2014 at http://www.hpo.ie/latest_hipe_nprs_reports/HIPE_2014/HIPE_Report_2014.pdf

Unassignable to MDC: AR-DRG by Patient Type (day patient and in-patient). The MDC is a category generally based on a single body system or aetiology that is associated with a particular medical specialty. DRGs are clusters of cases with similar clinical attributes and resource requirements. In Ireland, Australian Refined Diagnosis Related Group (AR-DRG) have been in use in Ireland since 2005, in 2014 Version 6.0 was used to group discharges. Activity in Acute Public Hospitals in Ireland Annual Report, 2014, is a report on in-patient and day patient discharges from acute public hospitals participating in the Hospital In-Patient Enquiry (HIPE) scheme in 2014. Discharge activity is examined by type of patient and hospital, and by demographic parameters (such as age and sex). Particular issues of relevance to the Irish health care system covered in the report relate to the composition of discharges by medical card and public/private status. Discharges are also analysed by diagnoses, procedures, major diagnostic categories, and diagnosis related groups. Maternity discharges are examined separately from other discharges. The analysis is presented at the national level. In 2014 HIPE discharges were coded using ICD-10-AM/ACHI/ACS 6th Edition and grouped into AR-DRG Version 6.0. See the complete Activity in Acute Public Hospitals in Ireland Annual Report 2014 at http://www.hpo.ie/latest_hipe_nprs_reports/HIPE_2014/HIPE_Report_2014.pdf

MDC 6 Diseases and Disorders of the Digestive System: AR-DRG by Patient Type (day patient and in-patient). The MDC is a category generally based on a single body system or aetiology that is associated with a particular medical specialty. DRGs are clusters of cases with similar clinical attributes and resource requirements. In Ireland, Australian Refined Diagnosis Related Group (AR-DRG) have been in use in Ireland since 2005, in 2014 Version 6.0 was used to group discharges. Activity in Acute Public Hospitals in Ireland Annual Report, 2014, is a report on in-patient and day patient discharges from acute public hospitals participating in the Hospital In-Patient Enquiry (HIPE) scheme in 2014. Discharge activity is examined by type of patient and hospital, and by demographic parameters (such as age and sex). Particular issues of relevance to the Irish health care system covered in the report relate to the composition of discharges by medical card and public/private status. Discharges are also analysed by diagnoses, procedures, major diagnostic categories, and diagnosis related groups. Maternity discharges are examined separately from other discharges. The analysis is presented at the national level. In 2014 HIPE discharges were coded using ICD-10-AM/ACHI/ACS 6th Edition and grouped into AR-DRG Version 6.0. See the complete Activity in Acute Public Hospitals in Ireland Annual Report 2014 at http://www.hpo.ie/latest_hipe_nprs_reports/HIPE_2014/HIPE_Report_2014.pdf

Pre-MDC: AR-DRG Version 8.0 by Patient Type (day patient and in-patient).The MDC is a category Generally based on a single body system or aetiology that is associated with a particular medical specialty. DRGs are clusters of cases with similar clinical Attributes and resource requirements. In Ireland, Australian Refined Diagnosis Related Group (AR-DRG) have been in use in Ireland since 2005, in 2017 Version 8.0 was used to group Discharges. Activity in Acute Public Hospitals in Ireland Annual Report, 2017, is a report on in-patient and day patient Discharges from acute public hospitals participating in the Hospital In-Patient Enquiry (HIPE) scheme in 2017. Discharge activity is Examined by type of patient (day patient/in-patient), admission type (elective/emergency/maternity) and hospital group, and by demographic parameters (such as age and sex). Certain issues of relevance to the Irish health care system covered in the report relate to the composition of Discharges by medical card and public/private status. Charges are also analysed by diagnoses, procedures, major Diagnostic categories, and Diagnosis related groups. The analysis is presented at the national level. In 2017 HIPE Discharges were coded using ICD-10-AM/Achi/ACS 8th Edition and grouped into AR-DRG Version 8.0. See the complete Activity in Acute Public Hospitals in Ireland Annual Report 2017 at http://www.hpo.ie/latest_hipe_nprs_reports/HIPE_2017/HIPE_Report_2017.pdf

TABLE 4.5: HIPE Report: TABLE 4.5 Total Discharges: MDC 3 Diseases and Disorders of the Ear, Nose, Mouth and Throat: AR-DRG by Patient Type (N, In-Patient Length of Stay) ,2015. Published by Health Service Executive. Available under the license cc-by (CC-BY-4.0).MDC 3 Diseases and Disorders of the Ear, Nose, Mouth and Throat: AR-DRG by Patient Type (day patient and in-patient).The MDC is a category generally based on a single body system or aetiology that is associated with a particular medical specialty. DRGs are clusters of cases with similar clinical attributes and resource requirements. In Ireland, Australian Refined Diagnosis Related Group (AR-DRG) have been in use in Ireland since 2005, in 2015 Version 6.0 was used to group discharges. Activity in Acute Public Hospitals in Ireland Annual Report, 2015, is a report on in-patient and day patient discharges from acute public hospitals participating in the Hospital In-Patient Enquiry (HIPE) scheme in 2015. Discharge activity is examined by type of patient (day patient/in-patient), admission type (elective/emergency/maternity) and hospital group, and by demographic parameters (such as age and sex). Particular issues of relevance to the Irish health care system covered in the report relate to the composition of discharges by medical card and public/private status. Discharges are also analysed by diagnoses, procedures, major diagnostic categories, and diagnosis related groups. The analysis is presented at the national level. In 2015 HIPE discharges were coded using ICD-10-AM/ACHI/ACS 8th Edition and grouped into AR-DRG Version 6.0. See the complete Activity in Acute Public Hospitals in Ireland Annual Report 2015 at http://www.hpo.ie/latest_hipe_nprs_reports/HIPE_2015/HIPE_Report_2015.pdf...