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System of Health Accounts 2019

Expenditure by Functions of Health Care

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What is the purpose of the health care being consumed?

More than half (56%) of all health expenditure related to curative and rehabilitative care, this mainly covers in-patient and out-patient care. The next largest category, 21% of all health expenditure, was long-term care, (see Figure 5.1). Table 5.1 includes more details and shows that in-patient services were the largest component of both long-term care and curative/rehabilitative care.

Health expenditure increased by 24% between 2015 and 2019. The growth in spending in curative and rehabilitative care was higher at 28%. There was a lower rate of growth in medical goods and pharmaceuticals (14%) (see figure 5.2).

	Current Health Care Expenditure By Function, (% Current Health Care Expenditure)
Curative and Rehabilitative Care	56.4145831732128
Long-Term Care (Health)	21.6286838211965
Medical Goods (Non-Specified by Function)	13.1618882635222
Ancillary Services	2.83592580001532
Other Health Care Functions	5.95891894205321

	Current Health Care Expenditure By Function, (% change 2015 to 2019)
Curative and Rehabilitative Care	27.6924155534909
Long-Term Care (Health)	23.3060495007229
Medical Goods (Non-Specified by Function)	13.7764418186072
Ancillary Services	23.1825838812554
Other Health Care Functions	13.0491498657303

Table 5.1: Current Health Care Expenditure by Health Care function, 2015 to 2019

Table 5.1: Current Health Care Expenditure by Health Care Function, 2015 to 2019
								€million	% of Total	% of change
ICHA-HC Code				2015	2016	2017	2018	2019	2019	2015-2019
HC.1+HC.2		Curative and Rehabilitative Care		10,507	11,009	11,758	12,543	13,416	56	28
	HC.1.1+HC.2.1		Inpatient Care	4,805	5,035	5,358	5,768	6,002	25	25
	HC.1.2+HC.2.2		Day Care	1,324	1,390	1,547	1,637	1,874	8	42
	HC.1.3+HC.2.3		Outpatient Care	3,668	3,928	4,151	4,419	4,761	20	30
	HC.1.4+HC.2.4		Home-Based Care	710	656	703	719	780	3	10

HC.3		Long-Term Care (Health)		4,171	4,408	4,538	4,825	5,144	22	23
	HC.3.1		Inpatient Care	2,533	2,654	2,628	2,756	2,909	12	15
	HC.3.2		Day Care	178	189	195	210	224	1	26
	HC.3.4		Home-Based Care	1,460	1,565	1,715	1,859	2,010	8	38

HC.4		Ancillary Services		548	577	598	620	674	3	23
	HC.4.1		Laboratory Services	208	222	237	244	259	1	25
	HC.4.2		Imaging Services	137	146	134	139	170	1	24
	HC.4.3		Patient Transportation	201	206	224	234	242	1	20
	HC.4.9		Ancillary Services N.E.C	2	3	3	3	3	0	50

HC.5		Medical Goods (Non-Specified by Function)		2,751	2,866	2,992	3,084	3,130	13	14
	HC.5.1		Pharmaceuticals and Other Medical Non-Durables	2,509	2,621	2,729	2,790	2,829	12	13
	HC.5.2		Therapeutic Appliances and Other Medical Goods	242	246	263	294	301	1	24

HC.6		Preventive Care		517	527	563	584	634	3	23
	HC.6.1		Information, Education and Counselling	73	74	80	85	90	0	23
	HC.6.2		Immunisation Programmes	47	42	53	45	52	0	11
	HC.6.3		Early Disease Detection	61	62	68	77	87	0	43
	HC.6.4		Healthy Condition Monitoring	178	188	195	203	220	1	24
	HC.6.5		Epidemiological Surveillance, Disease Control	75	79	82	80	89	0	19
	HC.6.6		Disaster and Emergency Response	2	0	0	2	2	0	0
	HC.6.9		Preventative Care N.E.C	81	82	85	92	94	0	16

HC.7		Governance and Health System Administration and Financing		575	549	567	567	556	2	-3
	HC.7.1		Govt Health Administration Agencies	178	185	177	192	238	1	34
	HC.7.2		Administration of Health Financing	396	364	390	375	318	1	-20

HC.9		Health Care Services N.E.C		161	171	202	209	227	1	41

		Total		19,230	20,107	21,219	22,432	23,782	100	24

Open in Excel: System of Health Accounts 2019, Table 5.1 (XLS 13KB)

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How are health care services funded?

Figure 5.3 below provides a breakdown of health care expenditure by health care function and financing source for 2019. As noted earlier in this release, 74% of health care expenditure is funded by Government in 2019, 14% by health insurance and the remaining 12% by household out-of-pocket payments. The differences from the total financing scheme split show that there is no spending on medical goods by voluntary health schemes. As expected, there is no spending on administration by households.

	HF.1 - Government and Compulsory	HF.2 - Voluntary Health Care Payment Schemes	HF.3 - Household Out-of-Pocket Payments
Curative and Rehabilitive Care	72	19	9
Long-Term Care (Health)	85	2	13
Ancillary Services	69	23	8
medical goods (Non-Specified by Function)	74	0	26
Preventative Care	62	25	13
Governance and Health System administration and financing	36	64	0
Health Care Services N.E.C	90	10	0
Total Current Health Care Expenditure	74	14	12

Table 5.2: Current Health Care Expenditure by Health Care Function and Health Care Financing Scheme, 2019

Table 5.2: Current Health Care Expenditure by Health Care Function and Health Care Financing Scheme, 2019
											€ million
ICHA Code				Govt and Compulsory	Government Financing	Compulsory Contributory	Voluntary Health Care Payment	Voluntary Health Insurance	Other Voluntary Health Care Payment	Household Out-of-Pocket Payments	Total
				HF.1	HF.1.1	HF.1.2	HF.2	HF.2.1	HF.2.x	HF.3
HC.1+HC.2		Curative and Rehabilitative Care		9,809	9,758	52	2,447	2,270	177	1,160	13,416
	HC.1.1+HC.2.1		Inpatient Care	4,321	4,321		1,574	1,516	58	106	6,002
	HC.1.2+HC.2.2		Day Care	1,253	1,253		594	571	23	27	1,874
	HC.1.3+HC.2.3		Outpatient Care	3,553	3,502	52	253	182	71	954	4,761
	HC.1.4+HC.2.4		Home-Based Care	682	682		26	1	25	72	780

HC.3		Long-Term Care (Health)		4,366	4,323	43	105		105	673	5,144
	HC.3.1		Inpatient Care	2,174	2,174		79		79	657	2,909
	HC.3.2		Day Care	215	215		3		3	5	224
	HC.3.4		Home-Based Care	1,977	1,934	43	22		22	11	2,010

HC.4		Ancillary Services		454	454		174	171	2	47	674
	HC.4.1		Laboratory Services	179	179		47	46	1	33	259
	HC.4.2		Imaging Services	50	50		119	118	0	1	170
	HC.4.3		Patient Transportation	225	225		7	6	1	11	242
	HC.4.9		Ancillary Services N.E.C				1	1		2	3

HC.5		Medical Goods (Non-Specified by Function)		2,307	2,258	50	1	1		822	3,130
	HC.5.1		Pharmaceuticals and Other Medical Non-Durables	2,227	2,227		1	1		601	2,829
	HC.5.2		Therapeutic Appliances and Other Medical Goods	80	30	50	0	0		221	301

HC.6		Preventative Care		395	395		154	6	148	85	634
	HC.6.1		Information, Education and Counselling	87	87		3	1	2		90
	HC.6.2		Immunisation Programmes	51	51		1	1	-0		52
	HC.6.3		Early Disease Detection	83	83		5	4	1		87
	HC.6.4		Healthy Condition Monitoring	4	4		131	1	130	85	220
	HC.6.5		Epidemiological Surveillance, Disease Control	86	86		4		4		89
	HC.6.6		Disaster and Emergency Response	2	2						2
	HC.6.9		Preventative Care N.E.C	83	83		11		11		94

HC.7		Governance and Health System Administration and Financing		213	213		344	318	25		556
	HC.7.1		Govt Health Administration Agencies	213	213		25		25		238
	HC.7.2		Administration of Health Financing				318	318			318

HC.9		Health Care Services N.E.C		191	191		35	33	2		227

		Total		17,736	17,591	145	3,259	2,799	460	2,786	23,782
* Confidential

Open in Excel: System of Health Accounts 2019, Table 5.2 (XLS 14KB)

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How are the health care services distributed across provider type?

There is a large amount of detail in Figure 5.4, which looks at the health care services by health care providers. Most of the information is as expected: most medical goods are provided by pharmacies and retailers, nearly all administration functions are provided by the providers of the service. About one-third of curative/rehabilitative care is provided by providers of out-patient care. Two-thirds (66%) of long-term care is provided within long-term residential facilities. The rest is provided by out-patient care (11%) or the rest of the economy or home based care (21%).

	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 Economy	HP.9 - Rest of World	HP.0 - Providers N.E.C
Curative and Rehabilitive Care	62.8138552480162	6.43826961868987	29.8473455900133	0	0.0631512683297031	0.0316964887704772	3.41145660415358E-06	0.179341119997093	0.624765282370537	0.00123423815230002
Long-Term Care (Health)	2.00989678107803	65.6915683735616	11.3318937670958	0	0	0	0	20.9624027145094	0.00423836375511775	0
Ancillary Services	50.3392086274654	0.00409059297057216	0.694794456751011	48.448322849119	0	0	0	0	0.513583473693974	0
medical goods (Non-Specified by Function)	1.58082950165826	0	0.0139788362282175	0	96.1138941921725	0	0	2.29129746994105	0	0
Preventative Care	0.013124888750498	0	30.1653991448779	0	0	44.6074122095476	0	25.214063756824	0	0
Governance and Health System administration and financing	0	0	0	0	0	0.8847260249095	99.1152739750905	0	0	0
Health Care Services N.E.C	7.12896665060848	0	0.187172819776847	0.334898163409044	0	0	0	0.260761548636316	0.00142017087554067	92.0867806466938
Total Current Health Care Expenditure	37.1823711797749	17.6901743722386	19.9048927249744	1.35217833406977	13.1695697559404	1.20411855286094	2.77041253601867	5.56999190632169	0.364056681033253	0.792233956767459

Table 5.3: Current Health Care Expenditure by Health Care Function and Health Care Provider, 2019

Table 5.3: Current Health Care Expenditure by Health Care Function and Health Care Provider, 2019
											€ million
ICHA Code			Hospitals	Long-Term Residential Facilities	Ambulatory Health Care Providers	Ancillary Health Care Providers	Retailers of Medical Goods	Providers of Preventative Care	Rest of the Economy	Other⁴	Total
			HP.1	HP.2	HP.3	HP.4	HP.5	HP.6	HP.8	HP.7¹HP.9²HP.0³
HC.1+HC.2		Curative and Rehabilitative Care	8,521	823	3,969		8	4	23	67 ²	13,416
	HC.1.1+HC.2.1	Inpatient Care	5,255	677	13					57 ²	6,002
	HC.1.2+HC.2.2	Day Care	1,701	1	168					3 ²	1,874
	HC.1.3+HC.2.3	Outpatient Care	1,524	4	3,195		8		22	7 ²	4,761
	HC.1.4+HC.2.4	Home-Based Care	41	142	592			4	1	0 ²	780

HC.3		Long-Term Care (Health)	121	3,334	593				1,096	0 ²	5,144
	HC.3.1	Inpatient Care	121	2,788						0 ²	2,909
	HC.3.2	Day Care		2	222						224
	HC.3.4	Home-Based Care		543	371				1,096		2,010

HC.4		Ancillary Services	354	0	5	312				3 ²	674
	HC.4.1	Laboratory Services	194	0	1	64				0 ²	259
	HC.4.2	Imaging Services	125	0	2	43				0 ²	170
	HC.4.3	Patient Transportation	32	0	2	205				3 ²	242
	HC.4.9	Ancillary Services N.E.C	2	0		1				0	3

HC.5		Medical Goods (Non-Specified by Function)	55		0		3,004		71		3,130
	HC.5.1	Pharmaceuticals and Other Medical Non-Durables	55		0		2,704		70		2,829
	HC.5.2	Therapeutic Appliances and Other Medical Goods	0		0		300		1		301

HC.6		Preventative Care	0		189			289	156	0	634
	HC.6.1	Information, Education and Counselling			17			51	22	0 ³	90
	HC.6.2	Immunisation Programmes			1			51		0 ³	52
	HC.6.3	Early Disease Detection	0		4			83		0 ²	87
	HC.6.4	Healthy Condition Monitoring	0		85				134		220
	HC.6.5	Epidemiological Surveillance, Disease Control			0			89			89
	HC.6.6	Disaster and Emergency Response						2			2
	HC.6.9	Preventative Care N.E.C			83			12			94

HC.7		Governance and Health System Administration and Financing						6		551 ¹	556
	HC.7.1	Govt Health Administration Agencies						6		232 ¹	238
	HC.7.2	Administration of Health Financing								318 ¹	318

HC.9		Health Care Services N.E.C	29	0	1				0	196 ³	227

		Total	9,081	4,157	4,756	312	3,012	299	1,347	818	23,782
¹HP.7 Providers of Health Care Administration and Financing
² HP.9 Rest of World
³HP.0 Providers N.E.C
⁴ For presentation purposes some smaller categories have been combined. A superscript identifies the provider for each service function and full data is available in PxStat.