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Current Health Expenditure in Ireland, 2011 to 2016 | ||||||
2011 | 2012 | 2013 | 2014 | 2015 | 2016 | |
Current Health Expenditure (€ bn) | 18.4 | 18.9 | 18.6 | 18.8 | 19.5 | 20.3 |
Current Health Expenditure % GDP | 10.7 | 10.8 | 10.3 | 9.7 | 7.4 | 7.4 |
Current Health Expenditure % GNI* | 14.0 | 14.2 | 13.0 | 12.2 | 11.3 | 10.7 |
Ireland’s current health expenditure was €20.3 billion in 2016, representing 7.4% of GDP. In 2011 current health expenditure was €18.4bn or 10.7% of GDP. Overall there was a 10% increase in health expenditure in Ireland between 2011 and 2016.
The majority of health expenditure (72%) was funded by government, with the balance funded by private sources including health insurance and out-of-pocket expenditure.
This release provides the first estimates of Irish health care expenditure for 2011, 2012 and 2016 according to the System of Health Accounts standard. See Background Notes for further details on the System of Health Accounts. While total values are given for all years 2011 – 2016, detailed cross tabulations are only provided for 2016, further detail on the years 2011 – 2015 can be found in Statbank. The GDP figures used in this publication are consistent with those published in the National Income and Expenditure 2016. There was a significant increase in GDP in 2015 which is why current health expenditure is also shown as a percentage of GNI*. Further details are here: GDP Explanatory Note (PDF 276KB) |
The majority of health expenditure in 2016 (€14,653 million or 72%) was financed by government (HF.1).
The remainder was mainly funded by household out-of-pocket payments (13%) and health insurance (15%).
Table 1: Current Health Care Expenditure by Financing Scheme, 2011 to 2016 | €million | ||||||||
2011 | 2012 | 2013 | 2014 | 2015 | 2016 | ||||
ICHA-HF Code | |||||||||
HF.1 | Govt Financing Schemes and Compulsory Contributory Health Care Financing Schemes | 13,168 | 13,425 | 13,096 | 13,264 | 13,891 | 14,653 | ||
HF.1.1 | Government Schemes | 13,118 | 13,380 | 13,040 | 13,211 | 13,831 | 14,590 | ||
HF.1.2 | Compulsory Contributory Health Insurance Schemes | 50 | 45 | 56 | 53 | 60 | 64 | ||
HF.2 | Voluntary Health Care Payment Schemes | 2,753 | 2,908 | 2,850 | 2,909 | 2,971 | 3,038 | ||
HF.2.1 | Voluntary Health Insurance Schemes | 2,261 | 2,419 | 2,361 | 2,406 | 2,454 | 2,503 | ||
HF.2.x | Other Voluntary Care Payment Schemes | 492 | 489 | 489 | 503 | 517 | 535 | ||
HF.3 | Household Out-of-Pocket Payments | 2,494 | 2,579 | 2,626 | 2,671 | 2,650 | 2,641 | ||
HF.1-HF.3 | Total Current Health Care Expenditure | 18,415 | 18,912 | 18,571 | 18,844 | 19,511 | 20,332 |
Just over one-third of health expenditure happened in hospitals (HP.1) in 2016, with a further 18% in long-term residential facilities (HP.2) such as nursing homes and residential disability services (see Table 2). Ambulatory health care providers (HP.3), predominantly GPs and dentists, accounted for 20% of expenditure.
Retailers of Medical Goods (mainly pharmacies) accounted for a further €2,821 million or 14% of all health care expenditure in 2016.
Table 2: Current Health Care Expenditure by Provider, 2011 to 2016 | €million | ||||||
2011 | 2012 | 2013 | 2014 | 2015 | 2016 | ||
ICHA-HP Code | |||||||
HP.1 | Hospitals | 6,637 | 6,672 | 6,536 | 6,663 | 6,976 | 7,377 |
HP.2 | Long-Term Residential Facilities | 3,407 | 3,627 | 3,453 | 3,529 | 3,627 | 3,760 |
HP.3 | Ambulatory Health Care Providers | 3,612 | 3,667 | 3,742 | 3,780 | 3,985 | 4,113 |
HP.4 | Ancillary Health Care Providers | 308 | 283 | 284 | 278 | 303 | 308 |
HP.5 | Retailers of Medical Goods | 2,828 | 2,948 | 2,738 | 2,677 | 2,703 | 2,821 |
HP.6 | Providers of Preventative Care | 246 | 238 | 230 | 228 | 228 | 233 |
HP.7 | Providers of Health Care Administration and Financing | 413 | 485 | 563 | 625 | 558 | 513 |
HP.8 | Rest of the Economy | 940 | 953 | 988 | 1,032 | 1,092 | 1,162 |
HP.9 | Rest of the World | 24 | 26 | 26 | 28 | 36 | 42 |
HP.0 | Providers N.E.C. | 1 | 13 | 12 | 3 | 4 | 4 |
HP.1 to HP.0 | Total Current Health Care Expenditure | 18,415 | 18,912 | 18,571 | 18,844 | 19,511 | 20,332 |
Current Health Care Expenditure by Provider, 2016 | |
Hospitals | 36.2842018382036 |
Ambulatory Health Care Provider | 20.2285055631719 |
Long-Term Residential Facilities | 18.4941612608109 |
Retailer of Medical Goods | 13.8757654791047 |
Ancillary Health Care Provider | 1.51432928878971 |
Other Providers | 9.6039182533416 |
Current Health Care Expenditure by Provider, 2016 | |
Hospitals | 36.2842018382036 |
Ambulatory Health Care Provider | 20.2285055631719 |
Long-Term Residential Facilities | 18.4941612608109 |
Retailer of Medical Goods | 13.8757654791047 |
Ancillary Health Care Provider | 1.51432928878971 |
Other Providers | 9.6039182533416 |
The functional classification, i.e. the type of health services provided, is the key classification for defining the boundary of health care (see Table 3).
In previous releases dental care had been classified to outpatient curative and rehabilitative care (HC.1.3+HC.2.3), further information has enabled the splitting of dental care between outpatient curative and rehabilitative care (HC.1.3+HC.2.3) and healthy conditioning monitoring programmes (HC.6.4).
The majority of health expenditure related to curative and rehabilitative care (€11,126 million) and nearly half of this was for inpatient care (€5,028 million). The next largest category was long-term care which amounted to 22% of expenditure, again with inpatient services the largest component of this (€2,729 million).
Pharmaceuticals and other medical non-durables (HC.5.1) made up the next largest category (13%). Administration of the health care system (public and private) amounted to €519 million in 2016, which was 3% of total current health expenditure.
Table 3: Current Health Care Expenditure by Health Care Function, 2011 to 2016 | €million | ||||||||
2011 | 2012 | 2013 | 2014 | 2015 | 2016 | ||||
ICHA-HC Code | |||||||||
HC.1+HC.2 | Curative and Rehabilitative Care | 9,945 | 10,068 | 10,008 | 10,142 | 10,626 | 11,126 | ||
HC.1.1+HC.2.1 | Inpatient Curative & Rehabilitative Care | 4,571 | 4,640 | 4,409 | 4,592 | 4,805 | 5,028 | ||
HC.1.2+HC.2.2 | Day Curative and Rehabilitative Care | 1,277 | 1,299 | 1,252 | 1,267 | 1,323 | 1,397 | ||
HC.1.3+HC.2.3 | Outpatient Curative & Rehabilitative Care | 3,517 | 3,514 | 3,702 | 3,606 | 3,797 | 4,041 | ||
HC.1.4+HC.2.4 | Home-Based Curative & Rehabilitative Care | 579 | 616 | 644 | 678 | 701 | 659 | ||
HC.3 | Long-Term Care (Health) | 3,974 | 4,188 | 3,994 | 4,153 | 4,301 | 4,499 | ||
HC.3.1 | Inpatient Long-Term Care (Health) | 2,476 | 2,665 | 2,487 | 2,597 | 2,645 | 2,729 | ||
HC.3.2 | Day Long-Term Care (Health) | 176 | 170 | 167 | 170 | 178 | 189 | ||
HC.3.4 | Home-Based Long-Term Care (Health) | 1,322 | 1,353 | 1,340 | 1,386 | 1,479 | 1,582 | ||
HC.4 | Ancillary Services | 535 | 514 | 569 | 545 | 581 | 603 | ||
HC.4.1 | Laboratory Services | 173 | 172 | 199 | 193 | 197 | 202 | ||
HC.4.2 | Imaging Services | 37 | 36 | 50 | 38 | 40 | 42 | ||
HC.4.3 | Patient Transportation | 190 | 179 | 179 | 190 | 204 | 208 | ||
Ancillary Services N.E.C | 135 | 127 | 141 | 125 | 140 | 152 | |||
HC.5 | Medical Goods (Non-Specified by Function) | 2,908 | 3,029 | 2,804 | 2,745 | 2,790 | 2,912 | ||
HC.5.1 | Pharmaceuticals and Other Medical Non-Durables | 2702 | 2824 | 2583 | 2,522 | 2,557 | 2,680 | ||
HC.5.2 | Therapeutic Appliances and Other Medical Goods | 206 | 206 | 222 | 223 | 233 | 232 | ||
HC.6 | Preventive Care | 633 | 616 | 622 | 624 | 642 | 666 | ||
HC.6.1 | Information, Education and Counceling Programmes | 74 | 72 | 67 | 66 | 73 | 74 | ||
HC.6.2 | Immunisation Programmes | 51 | 50 | 44 | 43 | 47 | 42 | ||
HC.6.3 | Early Disease Detection Programmes | 66 | 63 | 60 | 60 | 59 | 60 | ||
HC.6.4 | Healthy Condition Monitoring Programmes | 290 | 282 | 290 | 293 | 303 | 326 | ||
HC.6.5 | Epidemiological Surveillance, Disease Control Programmes | 83 | 80 | 82 | 76 | 75 | 79 | ||
HC.6.6 | Preparing for Disaster and Emergency Response Programmes | 2 | 2 | 2 | 2 | 2 | |||
Preventative Care N.E.C | 66 | 67 | 77 | 84 | 83 | 86 | |||
HC.7 | Governance and Health System Administration and Financing | 418 | 490 | 568 | 629 | 564 | 519 | ||
HC.7.1 | Govt Health Administration Agencies | 143 | 145 | 174 | 182 | 179 | 184 | ||
HC.7.2 | Administration of Health Financing | 275 | 345 | 394 | 447 | 385 | 335 | ||
HC.9 | Health Care Services N.E.C | 4 | 6 | 6 | 6 | 6 | 7 | ||
HC.1 to HC.9 | Total Current Health Care Expenditure | 18,415 | 18,912 | 18,571 | 18,844 | 19,511 | 20,332 |
Current Health Care Expenditure By Function, 2016 | |
Curative and Rehabilitative Care | 54.719353655722 |
Long-Term Care (Health) | 22.1297828076516 |
Medical Goods (Non-Specified by Function) | 14.3225866975015 |
Ancillary Services | 2.96796292715175 |
Other Health Care Functions | 5.86267951996852 |
Table 4 presents a breakdown of health care expenditure by function (HC) and provider (HP) for 2016.
Services provided by hospitals accounted for over one-third of health care expenditure in Ireland in 2016 (€6,958 million), 64% of this was on in-patient services (€4,474 million).
Long term residential facilities and ambulatory health care providers each accounted for approximately one fifth of the total current health care expenditure. Long term facilities, which include nursing homes and residential facilities for people with a disability, predominantly provided long-term care inpatient services (€2,631 million).
Ambulatory health care providers accounted for 20% of health care expenditure in Ireland in 2016. These providers, which include GPs, dentists and other services such as home care providers and health care centres mainly delivered outpatient services. In 2016, €4,113 million was spent on health care in these settings with 69% of this spent on outpatient curative and rehabilitative care.
Expenditure on pharmaceuticals (€2,680 million) accounted for 13% of health care expenditure with the vast majority being provided by pharmacies (which are included in retail sellers of medical goods, HP.5).
Other sectors (HP.8, HP.9 and HP.0) also provided health care services amounting to €1,208 million in 2016. Two-thirds of this expenditure (€828 million) was for the provision of long-term health care services in the home (HC.3.4) by persons in receipt of transfer payments (e.g. Carers’ Allowance and Domiciliary Care Allowance).
Table 4: Current Health Care Expenditure by Health Care Function and Health Care Provider, 2016 | €million | |||||||||||||
ICHA Code | HP.1 - Hospitals | HP.2 - Long- Term Residential Facilities | HP.3 - Ambulatory Health Care Providers | HP.4 - Ancillary Health Care Providers | HP.5 - Retailers of Medical Goods | HP.6 - Providers of Preventative Care | HP.7 - Providers of Health Care Administration and Financing | HP.8 - Rest of the Economy | HP.9 - Rest of the World | HP.0 - Providers N.E.C. | HP.1 to HP.0 - Total | |||
HC.1+HC.2 | Curative and Rehabilitative Care | 6,958 | 653 | 3,446 | 0 | 8 | 2 | 19 | 39 | 0 | 11,126 | |||
HC.1.1+HC.2.1 | Inpatient Curative & Rehabilitative Care | 4,474 | 517 | 1 | 0 | 36 | 5,028 | |||||||
HC.1.2+HC.2.2 | Day Curative and Rehabilitative Care | 1,258 | 0 | 138 | 0 | 1 | 1,397 | |||||||
HC.1.3+HC.2.3 | Outpatient Curative & Rehabilitative Care | 1,189 | 3 | 2,820 | 8 | 18 | 3 | 0 | 4,041 | |||||
HC.1.4+HC.2.4 | Home-Based Curative & Rehabilitative Care | 36 | 132 | 487 | 2 | 1 | 659 | |||||||
HC.3 | Long-Term Care (Health) | 97 | 3,107 | 466 | 828 | 0 | 4,499 | |||||||
HC.3.1 | Inpatient Long-Term Care (Health) | 97 | 2,631 | 0 | 2,729 | |||||||||
HC.3.2 | Day Long-Term Care (Health) | 2 | 187 | 189 | ||||||||||
HC.3.4 | Home-Based Long-Term Care (Health) | 474 | 279 | 828 | 1,582 | |||||||||
HC.4 | Ancillary Services | 289 | 0 | 4 | 308 | 0 | 2 | 603 | ||||||
HC.4.1 | Laboratory Services | 129 | 73 | 0 | 202 | |||||||||
HC.4.2 | Imaging Services | 42 | 0 | 42 | ||||||||||
HC.4.3 | Patient Transportation | 23 | 185 | 0 | 208 | |||||||||
Ancillary Services N.E.C | 96 | 0 | 4 | 50 | 2 | 0 | 152 | |||||||
HC.5 | Medical Goods (Non-Specified by Function) | 31 | 1 | 2,814 | 67 | 0 | 0 | 2,912 | ||||||
HC.5.1 | Pharmaceuticals and Other Medical Non-Durables | 31 | 1 | 2,582 | 67 | 2,680 | ||||||||
HC.5.2 | Therapeutic Appliances and Other Medical Goods | 0 | 0 | 231 | 1 | 0 | 0 | 232 | ||||||
HC.6 | Preventative Care | 0 | 195 | 0 | 224 | 246 | 666 | |||||||
HC.6.1 | Information, Education and Counceling Programmes | 13 | 42 | 19 | 74 | |||||||||
HC.6.2 | Immunisation Programmes | 7 | 34 | 42 | ||||||||||
HC.6.3 | Early Disease Detection Programmes | 60 | 60 | |||||||||||
HC.6.4 | Healthy Condition Monitoring Programmes | 99 | 227 | 326 | ||||||||||
HC.6.5 | Epidemiological Surveillance, Disease Control Programmes | 79 | 79 | |||||||||||
HC.6.6 | Preparing for Disaster and Emergency Response Programmes | |||||||||||||
Preventative Care N.E.C | 0 | 76 | 0 | 9 | 86 | |||||||||
HC.7 | Governance and Health System Administration and Financing | 7 | 513 | 519 | ||||||||||
HC.7.1 | Govt Health Administration Agencies | 7 | 177 | 184 | ||||||||||
HC.7.2 | Administration of Health Financing | 335 | 335 | |||||||||||
HC.9 | Health Care Services N.E.C | 2 | 0 | 0 | 0 | 4 | 7 | |||||||
HC.1 to HC.9 | Total Current Health Care Expenditure | 7,377 | 3,760 | 4,113 | 308 | 2,821 | 233 | 513 | 1,162 | 42 | 4 | 20,332 |
Table 5 presents a breakdown of health care expenditure by function (HC) and financing scheme (HF) for 2016.
Inpatient curative and rehabilitative care accounted for 24% (€3,463 million) of the total government spend on healthcare. Over 36% of the total spend of household out-of-pocket payments was for outpatient curative and rehabilitative care (€960 million).
Of the €11,126 million spent on curative and rehabilitative care services in 2016, over two-thirds (€7,816 million) was funded by government and 18% (€2,010 million) was funded by voluntary health insurance payments.
A total of €4,499 million was spent on long-term care. Government financed 84% (€3,757 million) of long term care services in 2016. Almost all of the remainder was paid for by household out-of-pocket payments (14% or €636 million).
Almost a quarter (€664 million) of the expenditure on pharmaceuticals was funded by out-of-pocket payments with the remainder funded by government (€2,016 million). Preventive care (HC.6) such as immunisation and health promotion activities was funded by government (49%) and voluntary payments other than health insurance (36%) the remainder being funded by out of pocket payments which would relate mainly to preventative dental care.
Tax refunds for health expenditure amounted to €147 million in 2016. As there is no information on what services were received, the expenditure is classified to health services not elsewhere classified.
Table 5: Current Health Care Expenditure by Health Care Function and Health Care Financing Scheme, 2016 | €million | ||||||||||
ICHA Code | HF.1 - Govt and Compulsory | HF.1.1 - Government Financing Schemes | HF.1.2 - Compulsory Contributory Schemes | HF.2 - Voluntary Health Care Payment Schemes | HF.2.1 - Voluntary Health Insurance Schemes | HF.2.x - Other Voluntary Health Care Payment Schemes | HF.3 - Household Out-of-Pocket Payments | HF.1 to HF.3 - Total | |||
HC.1+HC.2 | Curative and Rehabilitative Care | 7,816 | 7,799 | 17 | 2,174 | 2,010 | 164 | 1,136 | 11,126 | ||
HC.1.1+HC.2.1 | Inpatient Curative & Rehabilitative Care | 3,463 | 3,463 | 1,476 | 1,414 | 62 | 89 | 5,028 | |||
HC.1.2+HC.2.2 | Day Curative and Rehabilitative Care | 876 | 876 | 501 | 481 | 20 | 21 | 1,397 | |||
HC.1.3+HC.2.3 | Outpatient Curative & Rehabilitative Care | 2,911 | 2,895 | 17 | 170 | 104 | 66 | 960 | 4,041 | ||
HC.1.4+HC.2.4 | Home-Based Curative & Rehabilitative Care | 565 | 565 | 27 | 11 | 16 | 66 | 659 | |||
HC.3 | Long-Term Care (Health) | 3,757 | 3,724 | 33 | 107 | 107 | 636 | 4,499 | |||
HC.3.1 | Inpatient Long-Term Care (Health) | 2,029 | 2,029 | 82 | 82 | 617 | 2,729 | ||||
HC.3.2 | Day Long-Term Care (Health) | 181 | 181 | 3 | 3 | 5 | 189 | ||||
HC.3.4 | Home-Based Long-Term Care (Health) | 1,547 | 1,514 | 33 | 22 | 22 | 13 | 1,582 | |||
HC.4 | Ancillary Services | 382 | 382 | 153 | 150 | 3 | 68 | 603 | |||
HC.4.1 | Laboratory Services | 153 | 153 | 1 | 1 | 47 | 202 | ||||
HC.4.2 | Imaging Services | 41 | 41 | 1 | 1 | 0 | 42 | ||||
HC.4.3 | Patient Transportation | 188 | 188 | 1 | 1 | 19 | 208 | ||||
Ancillary Services N.E.C | 150 | 150 | 2 | 152 | |||||||
HC.5 | Medical Goods (Non-Specified by Function) | 2,063 | 2,048 | 14 | * | * | * | 849 | 2,912 | ||
HC.5.1 | Pharmaceuticals and Other Medical Non-Durables | 2,016 | 2,016 | 664 | 2,680 | ||||||
HC.5.2 | Therapeutic Appliances and Other Medical Goods | 47 | 33 | 14 | * | * | * | 185 | 232 | ||
HC.6 | Preventative Care | 324 | 324 | 242 | 4 | 238 | 99 | 666 | |||
HC.6.1 | Information, Education and Counceling Programmes | 74 | 74 | 0 | 0 | 74 | |||||
HC.6.2 | Immunisation Programmes | 42 | 42 | 0 | 0 | 42 | |||||
HC.6.3 | Early Disease Detection Programmes | 59 | 59 | 1 | 1 | 60 | |||||
HC.6.4 | Healthy Condition Monitoring Programmes | 4 | 4 | 223 | 223 | 99 | 326 | ||||
HC.6.5 | Epidemiological Surveillance, Disease Control Programmes | 74 | 74 | 5 | 5 | 79 | |||||
HC.6.6 | Preparing for Disaster and Emergency Response Programmes | ||||||||||
Preventative Care N.E.C | 73 | 73 | 13 | 4 | 9 | 86 | |||||
HC.7 | Governance and Health System Administration and Financing | 163 | 163 | 356 | 335 | 21 | 519 | ||||
HC.7.1 | Govt Health Administration Agencies | 163 | 163 | 21 | 21 | 184 | |||||
HC.7.2 | Administration of Health Financing | 335 | 335 | 335 | |||||||
HC.9 | Health Care Services N.E.C | 148 | 148 | 6 | 4 | 2 | -147 | 7 | |||
HC.1 to HC.9 | Total Current Health Care Expenditure | 14,653 | 14,590 | 64 | 3,037 | 2,503 | 535 | 2,641 | 20,332 | ||
* Confidential |
Table 6 presents a breakdown of health care expenditure by health care provider (HP) and financing source (HF) for 2016.
Government was the majority funder of healthcare providers in Ireland in 2016 (72%). Over three-quarters of expenditure in long-term care facilities were government funded as was 71% of hospital expenditure. Three-quarters of pharmaceutical expenditure was also funded by government.
78% of voluntary health insurance payments (€1,956 million) were spent on hospital services.
After tax refunds of €147 million were taken into account, out-of-pocket expenditure amounted to €2,641 million in 2016. 41% of this (€1,079 million) was spent on ambulatory health care providers and 25% (€672 million) was on long-term care facilities. Over 23% of out-of-pocket payments (€627 million) was spent in pharmacies.
Table 6: Current Health Care Expenditure by Health Care Provider and Health Care Financing Scheme, 2016 | €million | ||||||||||
ICHA Code | HF.1 - Government and Compulsory | HF.1.1 - Government Financing Schemes | HF.1.2 - Compulsory Contributory Schemes | HF.2 - Voluntary Health Care Payment Schemes | HF.2.1 - Voluntary Health Insurance Schemes | HF.2.x - Other Voluntary Health Care Payment Schemes | HF.3 - Household Out-of-Pocket Payments | HF.1 to HF.3 - Total | |||
HP.1 | Hospitals | 5,204 | 5,204 | 0 | 2,050 | 1,956 | 94 | 123 | 7,377 | ||
HP.1.1 | General Hospitals | 4,371 | 4,371 | 1,805 | 1,723 | 81 | 107 | 6,282 | |||
HP.1.x | Specialised Hospitals (including Mental Health Hospitals) | 833 | 833 | 0 | 245 | 233 | 13 | 16 | 1,095 | ||
HP.2 | Long-Term Residential Facilities | 2,957 | 2,957 | 131 | 22 | 109 | 672 | 3,760 | |||
HP.3 | Ambulatory Health Care Providers | 2,848 | 2,832 | 17 | 185 | 115 | 70 | 1,079 | 4,113 | ||
HP.3.1 | Medical Practices | 586 | 586 | 57 | 57 | 351 | 994 | ||||
HP.3.2 | Dental Practices | 82 | 66 | 17 | 16 | 12 | 4 | 473 | 572 | ||
HP.3.3 | Other Health Care Practitioners | 74 | 74 | 29 | 28 | 1 | 155 | 258 | |||
HP.3.4 | Ambulatory Health Care Centres | 1,636 | 1,636 | 63 | 7 | 56 | 35 | 1,734 | |||
HP.3.5 | Providers of Home Health Care Services | 470 | 470 | 20 | 11 | 9 | 64 | 554 | |||
HP.4 | Ancillary Health Care Providers | 193 | 193 | 51 | 50 | 1 | 64 | 308 | |||
HP.4.1 | Providers of Patient Transportation and Emergency Rescue | 165 | 165 | 2 | 1 | 1 | 19 | 186 | |||
HP.4.2 | Medical and Diagnostic Laboratories | 28 | 28 | 49 | 49 | 46 | 122 | ||||
HP.5 | Retailers of Medical Goods | 2,034 | 2,020 | 14 | * | * | * | 787 | 2,821 | ||
HP.5.1 | Pharmacies | 1,987 | 1,987 | 627 | 2,614 | ||||||
HP.5.2 | Retail Sellers of Durable Medical Goods and Appliances | 47 | 32 | 14 | * | * | * | 160 | 207 | ||
HP.6 | Providers of Preventive Care | 209 | 209 | 23 | 0 | 23 | 233 | ||||
HP.7 | Providers of Health Care System Administration and Financing | 162 | 162 | 350 | 335 | 15 | 513 | ||||
HP.7.1 | Govt Health Administration Agencies | 162 | 162 | 15 | 15 | 177 | |||||
HP.7.3 | Private Health Insurance Administration Agencies | 335 | 335 | 335 | |||||||
HP.8 | Rest of the Economy | 876 | 843 | 33 | 223 | 0 | 223 | 62 | 1,162 | ||
HP.8.1 | Households as Providers of Home Health Care | 828 | 795 | 33 | 828 | ||||||
HP.8.2 | All Other Industries as Secondary Providers of Health Care | 48 | 48 | 223 | 0 | 223 | 62 | 333 | |||
HP.9 | Rest of the World | 22 | 22 | 20 | 20 | 0 | 42 | ||||
HP.0 | Providers N.E.C. | 147 | 147 | 4 | 4 | -147 | 4 | ||||
HP.1 to HP.0 | Total Current Health Care Expenditure | 14,653 | 14,590 | 64 | 3,037 | 2,503 | 535 | 2,641 | 20,332 | ||
* Confidential |
Health expenditure in Ireland expressed as a percentage of GDP exceeded the OECD average in 2008 and has remained consistently above the average until 2015. The large increase in 2015 has seen a drop in this ratio.
Table 7: Revised Health Care Expenditure in Ireland, 2000 to 2016 | €million | |||||||||||||||||
2000 | 2001 | 2002 | 2003 | 2004 | 2005 | 2006 | 2007 | 2008 | 2009 | 2010 | 2011b | 2012 | 2013 | 2014 | 2015 | 2016 | ||
Total Health Care Expenditure (€m) | 6,922 | 8,532 | 9,896 | 10,950 | 12,200 | 13,681 | 14,438 | 16,263 | 17,898 | 18,509 | 18,199 | 19,146 | 19,436 | 19,485 | 19,742 | 20,575 | 21,502 | |
Capital Expenditure (€m)1 | 522 | 727 | 822 | 749 | 918 | 665 | 539 | 877 | 807 | 671 | 583 | 731 | 524 | 914 | 899 | 1,064 | 1,169 | |
Current Expenditure (€m) | 6,400 | 7,805 | 9,075 | 10,201 | 11,282 | 13,016 | 13,899 | 15,387 | 17,091 | 17,838 | 17,616 | 18,415 | 18,912 | 18,571 | 18,844 | 19,511 | 20,332 | |
Current Public Expenditure (€m) | 4,961 | 6,122 | 7,168 | 8,035 | 8,903 | 10,265 | 10,817 | 12,191 | 13,557 | 13,748 | 13,420 | 13,168 | 13,425 | 13,096 | 13,264 | 13,891 | 14,653 | |
Current Private Expenditure (€m) | 1,439 | 1,683 | 1,906 | 2,166 | 2,379 | 2,750 | 3,082 | 3,195 | 3,534 | 4,090 | 4,197 | 5,247 | 5,487 | 5,475 | 5,580 | 5,620 | 5,679 | |
Current Expenditure % GDP, Ireland | 5.9% | 6.4% | 6.7% | 7.0% | 7.2% | 7.7% | 7.5% | 7.8% | 9.1% | 10.5% | 10.6% | 10.7% | 10.8% | 10.3% | 9.7% | 7.4% | 7.4% | |
Current Expenditure % GNI*, Ireland | 6.8% | 7.5% | 8.0% | 8.2% | 8.4% | 8.9% | 8.7% | 9.1% | 10.7% | 12.9% | 13.3% | 14.0% | 14.2% | 13.0% | 12.2% | 11.3% | 10.7% | |
Current Expenditure % GDP, OECD Average (adjusted)2 | 7.2% | 7.4% | 7.7% | 7.9% | 8.0% | 8.0% | 8.0% | 7.9% | 8.2% | 8.9% | 8.8% | 8.7% | 8.8% | 8.9% | 8.9% | 8.9% | 8.7% | |
b Break in series | ||||||||||||||||||
1 Sourced from CSO National Accounts data | ||||||||||||||||||
2 OECD Average recalculated with revised Irish data and latest GDP estimates |
Total Health Care Expenditure | Capital Expenditure | Current Expenditure | |
2000 | 6.92175232686613 | 0.521585032507154 | 6.40016729435898 |
2001 | 8.53180886877449 | 0.727265464877989 | 7.8045434038965 |
2002 | 9.8962979284674 | 0.821661173997352 | 9.07463675447005 |
2003 | 10.9502528018978 | 0.748789008511227 | 10.2014637933866 |
2004 | 12.1998044899761 | 0.918258199367311 | 11.2815462906088 |
2005 | 13.6808559891815 | 0.665283652984776 | 13.0155723361967 |
2006 | 14.4378262794809 | 0.538652991834767 | 13.8991732876462 |
2007 | 16.2632608595315 | 0.876599739853958 | 15.3866611196776 |
2008 | 17.8979569498856 | 0.807171633577503 | 17.0907853163081 |
2009 | 18.508938227549 | 0.670789731730698 | 17.8381484958183 |
2010 | 18.1989739479447 | 0.582628664268421 | 17.6163452836763 |
2011b | 19.1464010725859 | 0.7314510582849 | 18.414950014301 |
2012 | 19.4361454089611 | 0.5242820322751 | 18.911863376686 |
2013 | 19.4852866317829 | 0.9138903881389 | 18.571396243644 |
2014 | 19.7422027822814 | 0.898514323361 | 18.8436884589204 |
2015 | 20.5754177152331 | 1.0640011605661 | 19.511416554667 |
2016 | 21.5016713148477 | 1.1694920509742 | 20.3321792638735 |
Current Expenditure % GDP, Ireland | Current Expenditure % GNI*, Ireland | Current Expenditure % GDP, OECD Average (adjusted) | |
2000 | 5.90639285193704 | 6.77854571623947 | 7.1772418357236 |
2001 | 6.40278227945534 | 7.502637279759 | 7.42241326696107 |
2002 | 6.67517746345612 | 7.98261501976606 | 7.67946696646899 |
2003 | 6.99784867155068 | 8.16352212908244 | 7.9098182534568 |
2004 | 7.22361072803041 | 8.41755677386794 | 7.96247932711462 |
2005 | 7.65720995434511 | 8.91099145307933 | 8.02092215222475 |
2006 | 7.51619500421591 | 8.66510391738746 | 7.95067586611625 |
2007 | 7.80834751879056 | 9.12705380713213 | 7.93220991948231 |
2008 | 9.11280122652353 | 10.6570962875276 | 8.195784779444 |
2009 | 10.5282051181703 | 12.8812036913233 | 8.85218903840623 |
2010 | 10.6022287858329 | 13.2824233641785 | 8.76826897026848 |
2011b | 10.7101646597346 | 14.0233863461429 | 8.73864779925838 |
2012 | 10.7722463284477 | 14.2130342527326 | 8.82646043203175 |
2013 | 10.3003894905346 | 12.9865363054746 | 8.89053069872952 |
2014 | 9.68642903865095 | 12.1999575667794 | 8.87566483540152 |
2015 | 7.44605401323743 | 11.2862345438211 | 8.88856976977359 |
2016 | 7.37830700478413 | 10.7484969385522 | 8.68698955192782 |
Table 8 presents a reconciliation of HSE gross expenditure for 2016 (as reported in their Annual Financial Statement) to the HF.1 Government Financing Schemes total reported under the SHA methodology. The purpose of the table is to illustrate the components of Government funded health care expenditure under the SHA methodology and to relate these to national expenditure data.
Table 8: Reconciliation of HSE Gross Expenditure to Government (HF.1) Funded Current Health Expenditure, 2016 | €million | ||
2016 | |||
1 | HSE AFS - Expenditure - Pay and Pensions | 5,111 | |
2 | HSE AFS - Expenditure - Non-Pay | 9,467 | |
3=1+2 | Total HSE Annual Financial Statement Gross Expenditure | 14,578 | |
4 | Exclude Non-Health Care Services | -1,122 | |
5 | Include Non-AFS Gross Expenditure (Mainly Related to Voluntary Agencies) | 955 | |
6=4+5 | Total Adjustments to AFS Gross Expenditure | -167 | |
7=3+6 | Gross Expenditure of HSE included in SHA Expenditure | 14,411 | |
8 | Non-Government Funding of HSE | -1,077 | |
9=7+8 | Total HSE HF.1 Funded Health Care Expenditure | 13,334 | |
Additional Government Health Care Expenditure: | |||
10 | DSP Transfer payments | 787 | |
11 | Treatment Benefits from Social Insurance Fund | 64 | |
12 | Department of Health | 91 | |
13 | Tax Relief on Medical Expenses | 147 | |
14 | Expenditure of Other Government Departments and Agencies | 230 | |
15=10+11+12+13+14 | Total Additional Government HF.1 Funded Expenditure | 1,319 | |
16=9+15 | Government (HF.1) Funded Current Health Care Expenditure | 14,653 |
This release is the official publication by CSO of health care expenditure estimates for Ireland according to the international standard of the System of Health Accounts, 2011. The release provides a detailed profile of Irish current health expenditure according to the classifications of the functions of health care (ICHA-HC), health care provision (ICHA-HP), and financing schemes (ICHA-HF). This level of detail is available only from reference year 2011.
International comparisons for this data can be found in the Eurostat data explorer http://ec.europa.eu/eurostat/data/database under the theme:
Population and Social Conditions\Health\Health Care\Health Care Expenditure
and in the OECD statistical database at http://stats.oecd.org/index.aspx?DataSetCode=SHA.
A number of revisions have been undertaken since the publication of data in June 2017. They are as follows:
HP.2: A correction in the processing of the household out-of-pocket payments on long-term residential facilities has resulted in a revision for the years 2013-2015. This revision to the data has been made on the CSO’s data portal, Statbank.
HC.1.3 + HC.2.3 and HC.6.4: Previously all dental care had been assigned to the category HC.1.3 + HC.2.3. It has been possible to split dental care to curative (HC.1.3 +HC.2.3) and preventative (HC.6.4), this split has been applied to all years 2011-2016. This revision to the data has been made on the CSO’s data portal, Statbank.
HC.5.1, HP.5.1: There are revisions in this category due to updated data from the Household Budget Survey and the Annual Services Inquiry. The revisions have been applied to all years. This revision to the data has been made on the CSO’s data portal, Statbank.
Refund of Medical Expenses by Revenue: The latest estimates provided by Revenue have been included.
Revisions to GDP : The GDP figures used in the current publication are consistent with those published in the National Income and Expenditure 2016 and the latest Quarterly National Accounts publication.
https://www.cso.ie/en/releasesandpublications/er/nie/niear2016/
What is the System of Health Accounts?
The System of Health Accounts (SHA) was devised by the Organisation for Economic Co-operation and Development (OECD) and has been adopted for joint reporting of health care expenditure by the OECD, Eurostat and the World Health Organisation. It is an extension of the core National Accounts and consists of a family of interrelated tables for reporting expenditure on health and its financing.
The SHA contains common concepts, definitions, classifications and accounting rules to enable comparability over time and across countries. It provides a basis for uniform reporting by countries with a wide range of different models of organising their national health systems. The SHA also draws a commonly defined boundary around what is health care and distinguishes it from related social care services. This is particularly important for international comparisons given the diversity in health and social care services provision and their funding across Europe and the rest of the world.
The provision of health care and its funding is a complex, multi-dimensional process. The set of core tables in the SHA addresses three basic questions:
1. Where does the money to finance the health system come from? (Financing schemes);
2. Who does the money go to? (Provider of health care services and goods);
3. What kind of (functionally defined) services are performed and what type of goods are purchased?
Consequently, the SHA is organised around a tri-axial system for the recording of health expenditure, by means of the International Classification for Health Accounts (ICHA), defining;
Summary details of the categories in each classification are given in the section International Classification of Health Accounts and linked documents. A detailed description of the classifications and their application is set out in the manual on the System of Health Accounts which is available at http://www.who.int/nha/sha_revision/en/.
A detailed review of data sources to allow coding to the SHA classifications has been undertaken over the past two years, and much progress has been made. However this work is ongoing and revisions, especially to the more detailed profile of the data are to be expected.
All HSE hospital expenditure funded by HSE Mental Health Services has been allocated to HP.1.2 Mental Health Hospitals. This is currently under review and coding may be revised in the future.
Expenditure included under the SHA reporting standard should relate to Final Consumption Expenditure (FCE) only. The expenditure included in this publication includes some items that should not be included in FCE e.g. interest payments. This deviation is not material.
Non-Profit Providers: There is ongoing work to improve the coverage of data on expenditure on health care. In particular, further development work on non-profit providers of health care and their non-government funding is ongoing. The funding of health care services from Non-Profit Institutions Serving Households Financing Schemes (HF.2.2) is under represented in the current data and will be revised in future data reporting.
Residents and Non-Residents: Health expenditure should relate only to residents of the Republic of Ireland. Most data sources do not capture information on residence and thus expenditure on non-residents may be included in the data (export of health care services). Expenditure by residents in other countries is also difficult to capture, particularly out-of-pocket expenditure. Some expenditure funded by the HSE and private health insurers has been captured. There is likely to be an underestimate of import of health care services in the Irish SHA data.
Health Care/Social Care Boundary: The project to implement the SHA reporting standard in Ireland reviewed the boundary of health care and social care with the HSE Service Providers. This resulted in a number of services and the associated expenditure, previously categorised as social care, being reclassified to health care. Given that health care and social care are often delivered in the same package of services, it has been hard to separate the two types of services and thus the predominant activity (generally health care) has been used to classify the activity and associated expenditure. This has resulted in the amount of health care being somewhat over-stated in some areas.
This section provides some detail on each classification. Details of the current application of the standard in Ireland area available at http://www.cso.ie/en/surveysandmethodology/nationalaccounts/. The SHA manual provides a full description of the classifications and their categories. The manual is available at http://www.who.int/health-accounts/methodology/sha2011.pdf.
ICHA – HF: Health Care Financing Schemes
Health care financing schemes are structural components of health care financing systems. They are the main types of financing arrangements through which people obtain health services. These include:
For information on mapping of Irish health care financing system to the ICHA-HF classification and data sources used, please see the following methodological http://www.cso.ie/en/surveysandmethodology/nationalaccounts/.
ICHA – HP: Classification of Health Care Providers
The classification of health care providers (ICHA-HP) classifies all organisations that contribute to the provision of health care goods and services, by arranging country-specific provider units into common, internationally applicable categories. The “principal activity” undertaken is the basic criterion for classifying health care providers. These include:
For information on mapping of Irish health care providers to the ICHA-HP classification please and data sources used, see the following methodological http://www.cso.ie/en/surveysandmethodology/nationalaccounts/.
ICHA – HC: Classification of Health Care Functions Explained
The functional classification under the SHA is the key classification for defining the boundary of health care. It groups health care services by purpose. The first five categories relate to goods and services consumed by individuals. These categories comprise
Two other categories relate to the collective consumption of health care, namely:
For information on mapping of Irish health care services to the ICHA-HC classification please and data sources used, see the following methodological http://www.cso.ie/en/surveysandmethodology/nationalaccounts/.
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