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System of Health Accounts 2020

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, 22% 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 32% between 2016 and 2020. The growth in spending in Preventative care was higher at 64%, this growth is due to the increased spendng to combat the COVID-19 pandemic. There was increases across all areas of preventive care, in particular Early Disease Detection There was a lower rate of growth in medical goods and pharmaceuticals (15%) (see figure 5.2).

	Current Health Care Expenditure By Function, (% Current Health Care Expenditure)
Curative and Rehabilitative Care	56.1563221810342
Long-Term Care (Health)	22.2337390474539
Medical Goods (Non-Specified by Function)	12.465518036768
Ancillary Services	2.68864322064999
Other Health Care Functions	6.45577751409398

	Current Health Care Expenditure By Function, (% change 2016 to 2020)
Curative and Rehabilitative Care	34.9049600354508
Long-Term Care (Health)	33.4053122963866
Medical Goods (Non-Specified by Function)	15.0257465159189
Ancillary Services	23.2936461421119
Other Health Care Functions	36.9161999795707

Table 5.1: Current Health Care Expenditure by Health Care function, 2016 to 2020

Table 5.1: Current Health Care Expenditure by Health Care Function, 2016 to 2020
								€ million	% of Total	% change
ICHA-HC Code				2016	2017	2018	2019	2020	2020	2016-2020
HC.1+HC.2		Curative and Rehabilitative Care		11,009	11,758	12,543	13,434	14,852	56	35
	HC.1.1+HC.2.1		Inpatient Care	5,035	5,358	5,768	6,012	6,762	26	34
	HC.1.2+HC.2.2		Day Care	1,390	1,547	1,637	1,869	1,944	7	40
	HC.1.3+HC.2.3		Outpatient Care	3,928	4,151	4,419	4,772	5,282	20	34
	HC.1.4+HC.2.4		Home-Based Care	656	703	719	781	864	3	32

HC.3		Long-Term Care (Health)		4,408	4,538	4,825	5,167	5,880	22	33
	HC.3.1		Inpatient Care	2,654	2,628	2,756	2,928	3,215	12	21
	HC.3.2		Day Care	189	195	210	224	253	1	34
	HC.3.4		Home-Based Care	1,565	1,715	1,859	2,015	2,413	9	54

HC.4		Ancillary Services		577	598	620	680	711	3	23
	HC.4.1		Laboratory Services	222	237	244	260	274	1	23
	HC.4.2		Imaging Services	146	134	139	169	150	1	3
	HC.4.3		Patient Transportation	206	224	234	242	277	1	34
	HC.4.9		Ancillary Services N.E.C	3	3	3	9	10	0	250

HC.5		Medical Goods (Non-Specified by Function)		2,866	2,992	3,084	3,099	3,329	12	15
	HC.5.1		Pharmaceuticals and Other Medical Non-Durables	2,621	2,729	2,790	2,800	3,049	12	16
	HC.5.2		Therapeutic Appliances and Other Medical Goods	246	263	294	299	280	1	14

HC.6		Preventive Care		527	563	584	634	864	3	64
	HC.6.1		Information, Education and Counselling	74	80	85	90	106	0	43
	HC.6.2		Immunisation Programmes	42	53	45	52	70	0	66
	HC.6.3		Early Disease Detection	62	68	77	87	245	1	295
	HC.6.4		Healthy Condition Monitoring	188	195	203	220	221	1	18
	HC.6.5		Epidemiological Surveillance, Disease Control	79	82	80	89	120	0	52
	HC.6.6		Disaster and Emergency Response	0	0	2	2	0	0	0
	HC.6.9		Preventative Care N.E.C	82	85	92	94	102	0	25

HC.7		Governance and Health System Administration and Financing		549	567	567	554	631	2	15
	HC.7.1		Govt Health Administration Agencies	185	177	192	237	254	1	38
	HC.7.2		Administration of Health Financing	364	390	375	317	377	1	3

HC.9		Health Care Services N.E.C		171	202	209	225	212	1	24

		Total		20,107	21,219	22,432	23,792	26,479	100	32

Open in Excel: System of Health Accounts 2020, 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 2020. As noted earlier in this release, 79% of health care expenditure is funded by Government in 2020, 11% by health insurance and the remaining 10% by household out-of-pocket payments. The differences from the total financing scheme split show that there is very little spending on long term care by private health insurance companies. 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	79	14	8
Long-Term Care (Health)	86	2	12
Ancillary Services	72	19	9
medical goods (Non-Specified by Function)	77	0	23
Preventative Care	73	18	9
Governance and Health System administration and financing	37	63	0
Health Care Services N.E.C	85	15	0
Total Current Health Care Expenditure	77	11	10

Table 5.2: Current Health Care Expenditure by Health Care Function and Health Care Financing Scheme, 2020

Table 5.2: Current Health Care Expenditure by Health Care Function and Health Care Financing Scheme, 2020
											€ 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		11,702	11,658	44	2,006	1,841	165	1,144	14,852
	HC.1.1+HC.2.1		Inpatient Care	5,369	5,369		1,255	1,209	47	138	6,762
	HC.1.2+HC.2.2		Day Care	1,439	1,439		474	461	13	30	1,944
	HC.1.3+HC.2.3		Outpatient Care	4,128	4,084	44	249	170	79	905	5,282
	HC.1.4+HC.2.4		Home-Based Care	766	766		27	1	26	71	864

HC.3		Long-Term Care (Health)		5,086	5,036	50	95		95	700	5,880
	HC.3.1		Inpatient Care	2,469	2,469		71		71	675	3,215
	HC.3.2		Day Care	243	243		3		3	6	253
	HC.3.4		Home-Based Care	2,373	2,324	50	21		21	19	2,413

HC.4		Ancillary Services		509	509		137	135	2	65	711
	HC.4.1		Laboratory Services	199	199		38	37	1	37	274
	HC.4.2		Imaging Services	54	54		95	95		1	150
	HC.4.3		Patient Transportation	256	256		4	3	1	17	277
	HC.4.9		Ancillary Services N.E.C							10	10

HC.5		Medical Goods (Non-Specified by Function)		2,534	2,487	47				794	3,328
	HC.5.1		Pharmaceuticals and Other Medical Non-Durables	2,462	2,462					586	3,049
	HC.5.2		Therapeutic Appliances and Other Medical Goods	72	25	47				208	280

HC.6		Preventative Care		628	628		157	3	154	79	864
	HC.6.1		Information, Education and Counselling	103	103		2	1	2		106
	HC.6.2		Immunisation Programmes	70	70						70
	HC.6.3		Early Disease Detection	243	243		2	1	1		245
	HC.6.4		Healthy Condition Monitoring	4	4		138	1	138	79	221
	HC.6.5		Epidemiological Surveillance, Disease Control	116	116		3		3		120
	HC.6.6		Disaster and Emergency Response								0
	HC.6.9		Preventative Care N.E.C	92	92		11		11		102

HC.7		Governance and Health System Administration and Financing		233	233		398	377	21		631
	HC.7.1		Govt Health Administration Agencies	233	233		21		21		254
	HC.7.2		Administration of Health Financing				377	377			377

HC.9		Health Care Services N.E.C		180	180		33	33			212

		Total		20,872	20,732	141	2,825	2,389	437	2,781	26,479
* Confidential

Open in Excel: System of Health Accounts 2020, Table 5.2 (XLS 13KB)

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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 (63%) of long-term care is provided within long-term residential facilities. The rest is provided by out-patient care (12%) or the rest of the economy or home based care (23%).

	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, 2020

Table 5.3: Current Health Care Expenditure by Health Care Function and Health Care Provider, 2020
											€ 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	9,357	979	4,417		8	4	25	61 ²	14,852
	HC.1.1+HC.2.1	Inpatient Care	5,878	816	9					59 ²	6,762
	HC.1.2+HC.2.2	Day Care	1,749	1	194						1,944
	HC.1.3+HC.2.3	Outpatient Care	1,677	6	3,564		8		24	2 ²	5,282
	HC.1.4+HC.2.4	Home-Based Care	53	156	650			4	1		864

HC.3		Long-Term Care (Health)	114	3,721	686				1,360		5,880
	HC.3.1	Inpatient Care	114	3,101							3,215
	HC.3.2	Day Care		2	251						253
	HC.3.4	Home-Based Care		618	436				1,360		2,413

HC.4		Ancillary Services	359		6	345				1 ²	711
	HC.4.1	Laboratory Services	201			73					274
	HC.4.2	Imaging Services	111		4	34					150
	HC.4.3	Patient Transportation	36		2	238				1 ²	277
	HC.4.9	Ancillary Services N.E.C	10								10

HC.5		Medical Goods (Non-Specified by Function)	34				3,250		45		3,329
	HC.5.1	Pharmaceuticals and Other Medical Non-Durables	34				2,971		44		3,049
	HC.5.2	Therapeutic Appliances and Other Medical Goods					279		1		280

HC.6		Preventative Care			192			509	163		864
	HC.6.1	Information, Education and Counselling			20			65	21		106
	HC.6.2	Immunisation Programmes						70			70
	HC.6.3	Early Disease Detection			1			244			245
	HC.6.4	Healthy Condition Monitoring			79				142		221
	HC.6.5	Epidemiological Surveillance, Disease Control						120			120
	HC.6.6	Disaster and Emergency Response
	HC.6.9	Preventative Care N.E.C			91			11			102

HC.7		Governance and Health System Administration and Financing						6		625 ¹	631
	HC.7.1	Govt Health Administration Agencies						6		248 ¹	254
	HC.7.2	Administration of Health Financing								377 ¹	377

HC.9		Health Care Services N.E.C	25		1					186 ³	212

		Total	9,888	4,700	5,302	345	3,258	519	1,593	873	26,479
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.