Plans are to be drawn up to try and reduce the number of patients travelling to Dublin hospitals for treatments they can have in their own areas.
The chief executive officer of the Eastern Regional Health Authority, Mr Michael Lyons, said about 40 per cent of elective bed days in hospitals in his region were taken up by patients from outside the area.
He told the Irish Medical News that in many cases equally good services were available in the health board areas from which patients were being referred.
"This raises the question for us of balancing the right of patients to look for the sort of assistance they need with the finite resources available," he said.
He said protocols for referrals would have to be agreed with health boards, hospitals and GPs.
The move, if implemented, should take pressure off the major Dublin Hospitals including Beaumont, the Mater, St James's, Tallaght and St Vincent's, which between them face a €100 million funding deficit this year.
However, even if new referral protocols are drawn up, many patients will still have to be transferred from the regions to Dublin hospitals for specialist treatment such as radiotherapy, cardiac surgery and neurosurgery.
In a similar move earlier, the master of the National Maternity Hospital in Holles Street, Dr Declan Keane, said his hospital would have to consider refusing to accept expectant mothers from counties adjoining Dublin as a result of a shortfall in its funding.
Dr Keane said the hospital had stopped taking routine bookings for its maternity services from counties outside Dublin, Wicklow, Meath and Kildare two years ago because of pressure on its services. Now it was considering further "geographic restrictions".
At this stage, however, it has booked in patients up to next September and it cannot turn these expectant mothers away. Any decision it makes to curtail numbers will therefore not come into effect until next year.