The statistics in this chapter relate the Irish Health Survey and to the expenditure on health in Ireland from the System of Health Accounts 2019 publication with provisional health expenditure estimates for 2020. The COVID-19 pandemic had a significant impact on the level of health expenditure in 2020.
The Irish Health Survey provides data and insights on various aspects of health in Ireland. The survey also presents data on the health experience of persons with disabilities. The data collection for the survey was conducted between July 2019 and February 2020 and accordingly relates to the pre-pandemic health and other experiences of respondents.
The survey is based on self-reported data from persons aged 15 years and over, and outlines their view of their health status – from how well they are feeling, to the extent to which they suffer from long-standing health conditions, as well as other factors. People’s engagement with the Irish health system is also outlined – the frequency by which they access health services, to the nature of those services. The publication concludes on the health determinants of the population aged 15 years and over – what are the choices we make as regards smoking, alcohol consumption and exercise? To what extent are we as a nation overweight, as reported by the people themselves? To what extent do we use preventive health services like taking a flu vaccine or getting our blood pressure checked?
Visit tables IH209-IH055 on PxStat and Visit tables IH339-IH320 on PxStat
Link to publications: Irish Health Survey - Main Results, and Irish Health Survey - Persons with Disabilities
Just over a quarter (26%) of persons aged 15 years and over report having a long-lasting condition which requires supervision, observation or care. The prevalence of having such a long-lasting condition increases as people get older, with twice as many persons aged 75 years and over (49%) reporting having a long-lasting condition, compared to those aged 45-54 years (24% of this age cohort).
Slightly more females (26%) than males (25%) report having a long-lasting condition, and non-Irish nationals (16%) report lower levels than Irish nationals (27%). Disadvantaged persons report higher levels of having a long-lasting condition, 29% of Very disadvantaged persons compared to 22% of Very affluent people. At a regional level, persons in the Midlands report the highest levels of having a long-lasting condition at 31% of persons aged over 15 years in this region, compared to the Mid-East region which reports the lowest levels at 22%. Unemployed persons report higher levels of having a long-lasting condition than those In employment at levels of 27% and 17% respectively.
Table 4.2 provides detail on any limitations in everyday activities due to a health problem. At State level, 82% of persons aged 15 years and over report not being limited in everyday activities at all. Males and females report the same levels around any limitations. Very disadvantaged persons report some or severe limitations at levels in excess of more affluent persons, 17% of Very disadvantaged persons report having “limitations but not severely” compared to 10% of Very affluent persons.
As to be expected perhaps, limitations increase with age, 15% of 75 years and over report severe limitations in everyday activities compared to only 2% of 15-24-year olds. Irish nationals report higher levels of Severely limited or Limited but not severely regarding everyday activities (19% combined) as compared to non-Irish nationals (12%). At a regional level, the Midlands report the highest levels of severe limitations at 7% of the 15 years and over population in that region. In contrast, Dublin reports the lowest levels of severe limitations at 3% of the 15 years and over population in that region. While around three-quarters (76%) of Unemployed persons report no limitations in everyday activities due to a health problem, much more Employed persons (92%) report no such limitation.
Levels of Affluence | Severely Limited | Limited but not severely | Not limited at all |
---|---|---|---|
Very disadvantaged | 7 | 17 | 77 |
Disadvantaged | 6 | 14 | 80 |
Average | 6 | 13 | 82 |
Affluent | 3 | 12 | 84 |
Very affluent | 1 | 10 | 89 |
Over a fifth (21%) of Unemployed persons report some form of depression, compared to less than half that (9%) for those In employment. Looking at the more severe forms of depression – Moderately severe or severe depression – Unemployed persons report higher levels than for those In employment, with 5% of Unemployed persons reporting such levels of depression compared to 1% of those In employment.
At State level, 86% of persons aged 15 years and over report having None to minimal depression. More Very affluent persons aged 15 years and over report having None to minimal depression than those in the Very disadvantaged cohorts of persons (89% compared to 82%). Females report lower (84%) levels of None to minimal depression than males (89%). There is little difference in the reported mental health experience of Irish nationals (86% reporting for None to minimal depression) compared to non-Irish nationals (87% reporting for None to minimal depression).
At a regional level, the South-West reports the highest levels of some form of depression (Mild to severe) at 18% of persons aged 15 years and over. The West region reports the lowest levels of some form of depression at 10%, a full 8 percentage points lower than the South-West region.
Interestingly, the youngest (15-24 years) and the oldest (75 years and over) age groups report the lowest levels of None to minimal depression (84% for 15-24 year olds and 83% for 75 years and over), but it should be noted that the differences between the age groups are relatively small.
Levels of Affluence | None to minimal depression | Mild depression | Moderate depression | Moderately severe or severe depression |
---|---|---|---|---|
In employment | 91 | 6 | 1 | 1 |
Unemployed | 79 | 11 | 5 | 5 |
The Irish Health Survey outlines the engagement of people in Ireland aged 15 years and over with the Irish health system. Females, older people and the disadvantaged are more likely than men, younger people and more affluent persons to engage with the health system. Unemployed persons also report higher levels of engagement with the health system than those in employment, and also experience higher levels of not accessing health care due to waiting lists than those in employment. Younger people report higher levels than older people of accessing mental health services.
Across the broad range of visits to health professionals, females are more likely to visit than men. For example, 82% of females reported that they visited a GP in the 12 months prior to survey, compared to 68% of men, and 63% of females visited a dentist compared to 52% of men.
As regards visits to GPs, older people report visiting them more than younger people (94% of 75 years and over compared to 67% of 15-24-year olds). There is little or no difference in terms of relative affluence whether someone reports they have visited a GP in the 12 months prior to survey, 74% of the Very affluent group and 74% of the Very disadvantaged group.
Male | Female | |
GP consultation | 68 | 82 |
Dental or orthodontic consultation | 52 | 63 |
Medical or surgical consultant visit | 28 | 34 |
Physiotherapist, osteopath or chiropractor visit | 19 | 19 |
Psychiatrist, psychologist or psychotherapist | 5 | 5 |
The text in this section, Table 4.5 and Figure 4.4 have been revised on 03/11/21 due to a computational error. |
Affluent persons report higher prevalence levels of alcohol consumption than disadvantaged persons, with 83% of Very affluent persons reporting that they drink alcohol compared to 71% of Very disadvantaged persons.
Alcohol consumption is highest in the 25-34 and 35-44 years age groups (84% of these age groups consuming alcohol), with the age group 75 years and over reporting the lowest levels of alcohol consumption (53%).
Smoking is more prevalent in the non-Irish national community than for Irish nationals, with 19% of non-Irish nationals reporting daily smoking compared to 13% of Irish nationals. The 25-34 years old age group report the highest levels for smoking with over a quarter (27%) reporting they smoke daily or occasionally. The 75 years and over age group report the lowest levels of smoking, with 8% smoking daily or occasionally.
Over half (55%) the State aged 15 years and over report consuming 5 portions of fruit and vegetables a day, with females reporting higher levels than men (58% of females compared to 51% of men). The oldest age group (aged 75 years and over) reports the lowest levels for consuming 5 portions of fruit and vegetables a day at 47% of this age group, compared to 59% of the 55-64 years age group.
Drinks alcohol | |
Very disadvantaged | 71 |
Disadvantaged | 72 |
Average | 76 |
Affluent | 79 |
Very affluent | 83 |
Respondents were asked their weight and height from which a Body Mass Index (BMI) was then calculated. Based on this, respondents reported that over half of them (56%) were overweight or obese (with over a quarter, 26%, registering as obese alone).
Males (61%) are more likely to be overweight or obese than females (49%), and older people are generally more likely to be overweight than younger people. The age group 65-74 years report that two-thirds (66%) of them are overweight or obese, over twice the levels for persons aged 15-24 years (31%).
While all classes of affluence / disadvantage indicate that around 55% of those groups report as being overweight or obese, the Very disadvantaged group report the highest levels of being overweight or obese at 58% of that group.
State | |
Underweight | 4 |
Normal weight | 41 |
Overweight | 30 |
Obese | 26 |
This Irish Health Survey publication relating to “Disabilities” provides data and insights on the self-reported health status of persons with disabilities in Ireland and the extent to which they can rely on informal social supports (assistance from neighbours for example). The publication also outlines, for those aged 55 years and older, the extent to which persons with disabilities experience difficulties with certain personal care and household activities.
The detail in this publication is based on self-reported data from persons aged 15 years and over who experience certain physical and sensory difficulties (which are listed below) and outlines their view of their health status, the informal social supports available to them, and the extent to which they encounter (for persons aged 55 years and over) difficulties in performing personal care (for example, eating, dressing themselves, showering) or household activities (for example, performing housework or shopping). It looks at the list of physical and sensory activities (sight, hearing, walking, etc.) by whether the person has a lot of difficulty with the activity or cannot do the activity at all. Accordingly, the definition of disability in this publication is those persons that have a lot of difficulty with an activity (e.g. seeing) or cannot do the activity at all. The data collection for this publication was conducted between July 2019 and February 2020 and accordingly relates to the pre-pandemic health and other experiences of respondents.
Physical and sensory difficulties
A quarter of persons with any of the disabilities surveyed report that their health status is Bad or Very Bad, which is well in excess of the 4% of persons at State level who also report their health status as Bad or Very Bad.
Very good or good | Fair | Bad or very bad | |
State | 85 | 12 | 4 |
Persons with any type of physical or sensory difficulty | 38 | 37 | 25 |
Three-quarters of those with a disability report they have a long-standing health condition (compared to a State average of a quarter), and 35% of those with any of the physical or sensory difficulties surveyed reported they are Severely limited in carrying out everyday activities due to a health problem (compared to a State average of 5% of persons aged 15 years and over).
Over four in ten (43%) of persons aged 15 years and over with disabilities report some form of depression, well above the State average of 14%. In particular, 9% of persons with a disability report suffering from Moderately severe or severe depression, over four times the average State level of 2%.
Around a quarter (26%) of persons with disabilities report having unmet health care needs in the 12 months prior to interview due to waiting times, compared to a State average of 14% of persons aged 15 years and over. Persons with Difficulties in seeing report the highest levels of unmet health care needs due to waiting times (at 34% of this group), with persons with walking difficulties reporting the lowest levels of persons with disabilities for having unmet health care needs due to waiting times (c.24% of the walking with difficulties groups).
At State level, 2% of persons aged 15 years and over report Transportation or distance problems as reasons for unmet health care needs. However, rates for persons with disabilities are higher, 6% of persons with any disability report Transportation or distance problems as a reason for unmet health care needs, with the disability group Difficulty with remembering or concentrating reporting the highest levels for persons with disabilities, at 8% of persons in this group.
Unmet medical needs due to waiting times | |
State | 14 |
Persons with any type of physical or sensory difficulty | 26 |
Difficulty in seeing | 34 |
Difficulty in hearing what is said in a quiet room | 29 |
Difficulty in hearing what is said in a noisier room | 26 |
Difficulty in walking half a km | 23 |
Difficulty in walking up or down 12 steps | 24 |
Difficulty in remembering or concentrating | 28 |
This survey looks at the extent to which persons aged 55 years and over with disabilities (the definition of disability in this publication is those persons that have a lot of difficulty with an activity (e.g. seeing) or cannot do the activity at all for a range of physical and sensory difficulties) encounter difficulties in personal care and household activities.
The list of personal care activities respondents were asked to consider are:
And the household activities to be considered are:
Over a third (37%) of persons with disabilities aged 55 years and over report they have at least one difficulty with a personal care activity (Feeding, Getting in and out of a bed or chair, Dressing or undressing, Using toilets and Bathing or showering). This is four times higher than the State average (9%) for persons aged 55 years and over.
Persons in the disability group Difficulty in remembering or concentrating report the highest levels of difficulties with personal care activities (at 61% of this group), with persons who report hearing difficulties reporting the lowest levels (ranging from 26-29% of these groups).
Of persons with disabilities who report having a personal care difficulty, 69% of them report receiving help with the activity. Almost eight in ten (77%) persons with Difficulty in hearing what is said in a noisier room report they receive help with personal care activities.
At State level, three-quarters of persons aged 15 years and over report that they find it Easy or very easy to get practical help from neighbours. Persons with disabilities report the same level for getting practical help (75%). At State level, 3% of persons report they find it Very difficult to get practical help from neighbours, 5% of persons with disabilities report likewise. The disability group Difficulty in walking half a km on level ground without the use of any aid reports the highest levels for finding it Very difficult to get practical help from neighbours, at 8% of this group.
Persons with Difficulty in hearing what is said in a conversation with one other person in a quiet room even when using a hearing aid report the highest levels for finding it Easy or very easy to get practical help from neighbours (82% of this group), with persons with Difficulty in remembering or concentrating reporting the relatively lowest (72% of this group).
Very difficult | Difficult | Possible | Easy or very easy | |
State | 3 | 6 | 17 | 75 |
Persons with any type of physical or sensory difficulty | 5 | 6 | 14 | 75 |
The statistics in this section relate to the expenditure on health in Ireland. Additional data is available in the System of Health Accounts 2019 publication.
Table 4.11 Current Health Expenditure in Ireland, 2015 to 2019 | |||
Year | € million | % of GDP | % of GNI* |
2015 | 19,230 | 7.3 | 11.8 |
2016 | 20,107 | 7.4 | 11.5 |
2017 | 21,219 | 7.1 | 11.4 |
2018 | 22,432 | 6.9 | 11.3 |
2019 | 23,782 | 6.7 | 11.1 |
Source: CSO |
(Modified Gross National Income (GNI*) is equal to Gross National Income at current market prices less the factor income of redomiciled companies, less depreciation on research and development related intellectual property imports and less depreciation on aircraft related to aircraft leasing.)
Current expenditure on health care in Ireland was €23.8 billion in 2019
Ireland's health expenditure was €23.8 billion in 2019, which is equivalent to 6.7% of GDP or 11.1% of GNI*. Health expenditure increased by 6% between 2018 and 2019 and by 24% between 2015 and 2019 (Table 4.11).
The majority of health expenditure (74%) was funded by government, with the balance funded by private sources including voluntary health care payments (14%) and household out-of-pocket expenditure (12%). The share of spending between the classification groups has has been stable over time (see Figure 4.9).
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Link to publication: System of Health Accounts
X-axis label | Government | Voluntary Payments | Household Out of Pocket |
---|---|---|---|
2015 | 13847.6715546834 | 2841.82560244328 | 2540.9780519521 |
2016 | 14622.3084753574 | 2912.31762467983 | 2572.6993518234 |
2017 | 15485.6303326378 | 3058.2039959028 | 2675.42543800744 |
2018 | 16627.8149355418 | 3107.10100174578 | 2696.89130218914 |
2019 | 17735.9817901652 | 3259.63051107023 | 2786.17032932532 |
Who is delivering the health care goods and services?
Health care providers include all the organisations and individuals who deliver health care goods and services as their primary activity. Further details on the health care providers can be found in the System of Health Accounts publication.
Out of every €100 spent on health care in 2019, €38 was spent in hospitals and €20 in out-patient health care providers, mainly GPs and dentists. A further €18 was spent in long-term residential facilities, such as nursing homes and residential disability services, and €13 in retailers of medical goods (mainly pharmacies), (see Figure 4.10).
Current Health Care Expenditure By Provider (% Current Health Care Expenditure) | |
Hospitals | 38.1843454385156 |
Ambulatory Health Care Provider | 20.0001463508984 |
Long-Term Residential Facilities | 17.4792606513227 |
Retailer of Medical Goods | 12.6631070877756 |
Ancillary Health Care Provider | 1.31400969069967 |
Other Providers | 10.3591307807881 |
Link to publication: System of Health Accounts
Total Health Expenditure and COVID-19 Related Spending in 2020
The COVID-19 pandemic had a significant impact on the level of health expenditure in 2020. Based on preliminary data, €26.4 billion was spent on healthcare in 2020, an increase of 11% on 2019 figures. The growth in spending is due to a 15% increase in government spending. Preliminary data on spending by private health insurance companies, charitable organisations or direct household expenditure is not available at this time so the estimates provided are based on 2019 expenditure.
The preliminary estimates have identified €2.4 billion of expenditure related to COVID-19. A detailed breakdown of the type of COVID-19 expenditure is shown in Table 4.13. Most of the expenditure was on personal protective equipment, swab kits and ventilators, with significant expenditure on treatment costs and testing costs.
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Link to publication: System of Health Accounts
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