The role of private hospitals in South Africa. Part I. Current trends.

This paper is the first of two that examine the present and the future role of private hospitals in South Africa. Part I describes the current structure and size of the private hospital sector, and analyses recent trends in the number and distribution of beds and hospitals, expenditure patterns, and utilisation of care. These observations are used as the basis for an analysis of the present role of the private hospital sector. It is argued that this sector is an important potential national resource for health care. However, the present contribution of private hospitals to national health care is limited by several factors. Access to a large proportion of these hospitals is restricted to those who can afford to pay, while the economic inefficiency and geographical maldistribution of fee-for-service and charity hospitals compound the negative effect private hospitals have on the public health sector. The gap between the potential contribution of private hospitals and current reality provides a strong argument for the development of a national policy that will improve the situation.