System of Health Accounts 2021

Who is delivering the health care goods and services?

Out of every €100 spent on health care in 2021, €37 was spent in hospitals and €21 in out-patient health care providers, mainly GPs and dentists. A further €17 was spent in long-term residential facilities, such as nursing homes and residential disability services, and €11 in retailers of medical goods (mainly pharmacies). See Figure 5.1.

Health expenditure rose by 35% between 2017 and 2021. Spending on COVID-19 testing and tracing and vaccinations is included in the Providers of Preventative Care category explains the large increases in 2020 and 2021. There has also been a 35% increase in spending in Hospitals and 43% for Ambulatory Health Care Provider. See Table 5.1.

Health care providers include all the organisations and individuals who deliver health care goods and services as their primary activity. Also included are those who deliver health care as one of a number of activities, see the background notes for more details.

How are the health care providers funded?

Figure 5.3 below provides a breakdown of health care expenditure by health care provider and financing source for 2021. As noted earlier in this publication, 77% of health care expenditure is funded by Government, 12% by health insurance and the remaining 11% by household out-of-pocket payments - this profile of total spending is included as the bottom bar of the graph and can be used as a reference point to compare across providers.

Differences from the overall pattern were observed in the expenditure by providers of healthcare system administration and financing - none of which was provided by households. Only 1% of hospital provided care was paid directly by households, however direct payments by households accounted for 23% of the expenditure in pharmacies and retailers of medical goods.  Voluntary payment schemes accounted for a small percentage (2%) of payments to long-term residential care facilities compared to 18% that was funded by households.