Downloads

WP201521.pdf
PDF | 792.52 KB
Health spending per capita in England has more than doubled since 1997, yet relatively little is known about how that spending is distributed across the population. This paper uses administrative National Health Service (NHS) hospital records to examine key features of public hospital spending in England. We describe how costs vary across the lifecycle, and the concentration of spending among people and over time. We find that costs per person start to increase after age 50 and escalate after age 70. Spending is highly concentrated in a small section of the population: with 32% of all hospital spending accounted for by 1% of the general population, and 18% of spending by 1% of all patients. There is persistence in spending over time with patients with high spending more likely to have spending in subsequent years, and those with zero expenditures more likely to remain out of hospital.
Authors

Research Fellow University College London
Marcos is a Research Fellow at IFS, an Affiliate at the Rural Education Action Program and a Professor of Economics at the University College London.

Senior Research Economist
Elaine works in the Public Finance and Pensions sector and she joined the IFS in 2009 and became a member of the research staff in 2011.

Working Paper details
- DOI
- 10.1920/wp.ifs.2015.1521
- Publisher
- Institute for Fiscal Studies
Suggested citation
E, Kelly and G, Stoye and M, Vera-Hernandez. (2015). Public hospital spending in England: evidence from National Health Service administrative records. London: Institute for Fiscal Studies. Available at: https://ifs.org.uk/publications/public-hospital-spending-england-evidence-national-health-service-administrative (accessed: 10 February 2025).
More from IFS
Understand this issue

What is this government’s ‘theory of growth’? Nobody knows
"Shifting the performance of an entire economy requires a long-term, consistent and persistent direction." Paul Johnson writes for the Times.
20 January 2025

Social care is the nightmare that won’t go away
A government with a big majority should have had the political will to do more than just set up another review.
6 January 2025

Why did the French Budget fail to pass?
France’s failed budget highlights fundamental challenges with public debt, slow growth, and the need for significant reforms.
12 December 2024
Policy analysis

The UK’s near-record government revenues are not uncommon internationally
How do changes in UK government revenues over time compare with what has been seen in other advanced countries?
27 January 2025

Projecting options for 16–18 education spending per student after 2025, 2009–10 = 1
To maintain spending per student at 2025–26 levels, total funding would need to rise by almost £200 million in today's prices by the end of 2027–28.
16 January 2025

Public spending on adult education and skills (actual and projected for 2024–25)
Public funding for adult skills has declined significantly since its peak in the early 2000s.
16 January 2025
Academic research

Public insurance and marital outcomes: Evidence from the Affordable Care Act's Medicaid expansions
We find that an increased likelihood of Medicaid eligibility reduces marriage rates, particularly among people with higher education levels.
8 November 2024

Call for papers: IFS-ADBI-GHE Workshop on Health Economics in LMICs 2025
Submissions are open until 15th February for the IFS-GHE Workshop on Health Economics in LMIC 2025

Firm quality and health maintenance
We estimate the impact of firm quality – primarily measured by firm productivity – on the health maintenance of employees.
18 December 2024