COVID-19 pandemic: This release was compiled during the COVID-19 pandemic. Users should be aware that the quality of the underlying data has been impacted by the crisis and therefore may not be directly comparable with previous periods data. For details regarding how this data has been affected See here.
The CSO understands the severe difficulties now being faced by survey respondents and that filling in the survey forms may not be top of their list at present, however it is by collecting survey information that we will be able to report on the effects of COVID-19 on our economy and society.
Insofar as possible, we are continuing to collect survey information from businesses so that we can provide statistics that show the changing situation from March 2020 onwards. We appreciate the ongoing support of the business community and understand the difficulties faced by all.
No link available
|Current Health Expenditure in Ireland, 2012 to 2017|
|Current Health Expenditure (€ bn)||18.7||18.5||18.9||19.3||20.2||21.1|
|Current Health Expenditure % GDP||10.7%||10.3%||9.7%||7.3%||7.4%||7.2%|
|Current Health Expenditure % GNI*||14.8%||13.5%||12.7%||11.9%||11.5%||11.7%|
Ireland’s current health expenditure was €21.1 billion in 2017, which represents 7.2% of GDP or 11.7% of GNI*. Overall there was a 5% increase in health expenditure in Ireland between 2016 and 2017. Health expenditure has increased by 13% since 2012.
The majority of health expenditure (73%) was funded by government, with the balance funded by private sources including health insurance (14%) and household out-of-pocket expenditure (12%).
This release provides the first estimate of Irish current health care expenditure for 2017 and revised data for years 2012 – 2016. Capital health expenditure is shown in Table 7 of this release. Within this release detailed cross tabulations are provided for 2017, cross tabulations for all years 2011-2017 can be found in Statbank. Please note that the rounding of numbers to the nearest integer results in some subtotals not summing to 100%. See Background Notes for further details on the System of Health Accounts.
The GDP figures used in this publication are consistent with those published in the National Income and Expenditure 2017. Current health expenditure is shown as a percentage of GDP and GNI*. See Background Notes for definitions.
The majority of health expenditure in 2017 (€15,487 million) was financed by government (HF.1). The remainder was mainly funded by household out-of-pocket payments (12%) and health insurance (14%).
Table 1 shows the breakdown of financing schemes from 2012 to 2017. There was a 15% increase in health spending by government (HF.1) between 2012 and 2017. Health expenditure by private health insurance (HF.2.1) increased by 21% in the same period. Household out-of-pocket expenditure has remained fairly stable over this period.
|Table 1: Current Health Care Expenditure by Financing Scheme, 2012 to 2017||€million|
|HF.1||Govt Financing Schemes and Compulsory Contributory Health Care Financing Schemes||13,488||13,173||13,387||13,868||14,621||15,487|
|HF.1.2||Compulsory Contributory Health Insurance Schemes||53||60||64||60||64||78|
|HF.2||Voluntary Health Care Payment Schemes||2,627||2,690||2,818||2,836||2,974||3,048|
|HF.2.1||Voluntary Health Insurance Schemes||2,216||2,285||2,406||2,453||2,600||2,678|
|HF.2.x||Other Voluntary Care Payment Schemes||411||405||413||383||373||370|
|HF.3||Household Out-of-Pocket Payments||2,599||2,642||2,645||2,550||2,577||2,595|
|HF.1-HF.3||Total Current Health Care Expenditure||18,715||18,506||18,850||19,254||20,171||21,130|
Just over one-third of health expenditure was in hospitals (HP.1) in 2017, 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 (HP.5, mainly pharmacies) accounted for a further €2,983 million (14%) of all health care expenditure in 2017.
Expenditure in hospitals (HP.1) increased by 20% between 2012 and 2017.
Spending by providers of preventive care (HP.6) increased by 10% between 2016 and 2017.
|Table 2: Current Health Care Expenditure by Provider, 2012 to 2017||€million|
|HP.2||Long-Term Residential Facilities||3,624||3,449||3,493||3,534||3,646||3,724|
|HP.3||Ambulatory Health Care Providers||3,767||3,760||3,774||3,918||4,098||4,207|
|HP.4||Ancillary Health Care Providers||283||284||263||271||280||277|
|HP.5||Retailers of Medical Goods||2,891||2,738||2,705||2,737||2,851||2,983|
|HP.6||Providers of Preventative Care||238||230||228||228||233||256|
|HP.7||Providers of Health Care Administration and Financing||423||488||625||557||544||618|
|HP.8||Rest of the Economy||917||985||1,070||994||1,045||1,151|
|HP.9||Rest of the World||26||26||28||36||41||51|
|HP.1 to HP.0||Total Current Health Care Expenditure||18,715||18,506||18,850||19,254||20,171||21,130|
|Current Health Care Expenditure by Provider, 2017|
|Ambulatory Health Care Provider||19.9099817289944|
|Long-Term Residential Facilities||17.62478775687|
|Retailer of Medical Goods||14.1163170698798|
|Ancillary Health Care Provider||1.31079485246618|
|Current Health Care Expenditure by Provider, 2017|
|Ambulatory Health Care Provider||19.8991594485444|
|Long-Term Residential Facilities||17.6684625460581|
|Retailer of Medical Goods||14.1086439969292|
|Ancillary Health Care Provider||1.31008235610637|
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).
The majority of health expenditure (€11,808 million) related to curative and rehabilitative care (HC.1+HC.2) with almost half of this for inpatient care (€5,336 million). The next largest category was long-term care (HC.3) which amounted to 21% of expenditure, again with inpatient services(HC.3.1) being the largest component (€2,560 million).
Pharmaceuticals and other medical non-durables (HC.5.1) made up the next largest category (13%). Administration(HC.7) of the health care system (public and private) amounted to €625 million in 2017, which was 3% of total current health expenditure.
There was a 22% increase in expenditure on home-based long-term care (HC.3.4) over the period 2012-2017. Spending on curative and rehabilitative care (HC.1+HC.2) increased by 17% between 2012 and 2017.
There was a 2% increase in spending on long-term care (HC.3) between 2016 and 2017. Within this category there was a 10% increase in expenditure on home-base long-term care (HC.3.4) and a 3% decrease in expenditure on inpatient long term care (HC.3.1).
|Table 3: Current Health Care Expenditure by Health Care Function, 2012 to 2017||€million|
|HC.1+HC.2||Curative and Rehabilitative Care||10,031||10,038||10,156||10,586||11,183||11,808|
|HC.1.1+HC.2.1||Inpatient Curative & Rehabilitative Care||4,500||4,409||4,591||4,805||5,080||5,336|
|HC.1.2+HC.2.2||Day Curative and Rehabilitative Care||1,300||1,252||1,267||1,323||1,404||1,577|
|HC.1.3+HC.2.3||Outpatient Curative & Rehabilitative Care||3,613||3,732||3,618||3,748||4,044||4,193|
|HC.1.4+HC.2.4||Home-Based Curative & Rehabilitative Care||618||644||681||709||655||701|
|HC.3||Long-Term Care (Health)||4,231||4,070||4,243||4,209||4,385||4,469|
|HC.3.1||Inpatient Long-Term Care (Health)||2,662||2,483||2,564||2,565||2,631||2,560|
|HC.3.2||Day Long-Term Care (Health)||170||167||170||178||189||194|
|HC.3.4||Home-Based Long-Term Care (Health)||1,399||1,421||1,510||1,465||1,565||1,714|
|HC.4.9||Ancillary Services N.E.C||127||141||125||140||153||141|
|HC.5||Medical Goods (Non-Specified by Function)||2,972||2,804||2,772||2,824||2,942||3,074|
|HC.5.1||Pharmaceuticals and Other Medical Non-Durables||2755||2569||2,531||2,584||2,698||2,812|
|HC.5.2||Therapeutic Appliances and Other Medical Goods||217||235||242||239||244||261|
|HC.6.1||Information, Education and Counceling Programmes||72||67||66||73||74||80|
|HC.6.3||Early Disease Detection Programmes||63||60||60||59||60||65|
|HC.6.4||Healthy Condition Monitoring Programmes||200||193||183||178||185||187|
|HC.6.5||Epidemiological Surveillance, Disease Control Programmes||80||82||76||75||79||82|
|HC.6.6||Preparing for Disaster and Emergency Response Programmes||2||2||2||2||0||0|
|HC.6.9||Preventative Care N.E.C||67||77||84||83||86||88|
|HC.7||Governance and Health System Administration and Financing||428||492||630||563||551||625|
|HC.7.1||Govt Health Administration Agencies||148||174||182||179||185||201|
|HC.7.2||Administration of Health Financing||280||318||447||384||367||424|
|HC.9||Health Care Services N.E.C||6||7||5||6||7||8|
|HC.1 to HC.9||Total Current Health Care Expenditure||18,715||18,506||18,850||19,254||20,171||21,130|
|Current Health Care Expenditure By Function, 2017|
|Curative and Rehabilitative Care||55.8798993943433|
|Long-Term Care (Health)||21.1475078689308|
|Medical Goods (Non-Specified by Function)||14.5465148041461|
|Other Health Care Functions||5.62112257289459|
|Current Health Care Expenditure By Function, 2017|
|Curative and Rehabilitative Care||55.7714225688844|
|Long-Term Care (Health)||21.136245654753|
|Medical Goods (Non-Specified by Function)||14.5387679828052|
|Other Health Care Functions||5.75010222728808|
Table 4 presents a breakdown of health care expenditure by function (HC) and provider (HP) for 2017.
Curative and rehabilitative care services (HC.1 + HC.2) provided by hospitals (HP.1) accounted for over one-third of health care expenditure in Ireland in 2017 (€7,419 million), of which 63% was on inpatient services (€4,641 million).
Long-term residential facilities (HP.2 accounted for approximately 17% 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 (HC.3.1) (€2,468 million).
Ambulatory health care providers (HP.3) accounted for 20% of health care expenditure in Ireland in 2017. These providers, which include GPs, dentists and other services such as home care providers and health care centres, mainly delivered outpatient services. In 2017, €4,207 million was spent on health care in these settings with 67% of this spent on outpatient curative and rehabilitative care (HC1.3+HC.2.3).
Expenditure on pharmaceuticals (HC.5.1) (€2,812 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 €1,212 million in 2017. Two-thirds of this expenditure (€929 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, 2017||€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||7,419||781||3,522||1||8||2||20||50||5||11,808|
|HC.1.1+HC.2.1||Inpatient Curative & Rehabilitative Care||4,641||637||10||0||43||5||5,336|
|HC.1.2+HC.2.2||Day Curative and Rehabilitative Care||1,423||0||150||1||3||1,577|
|HC.1.3+HC.2.3||Outpatient Curative & Rehabilitative Care||1,314||4||2,844||0||8||19||4||0||4,193|
|HC.1.4+HC.2.4||Home-Based Curative & Rehabilitative Care||41||140||518||2||1||0||701|
|HC.3||Long-Term Care (Health)||92||2,943||505||929||0||4,469|
|HC.3.1||Inpatient Long-Term Care (Health)||92||2,468||0||2,560|
|HC.3.2||Day Long-Term Care (Health)||1||194||194|
|HC.3.4||Home-Based Long-Term Care (Health)||474||311||929||1,714|
|HC.4.9||Ancillary Services N.E.C||105||0||5||31||0||141|
|HC.5||Medical Goods (Non-Specified by Function)||30||2,975||69||3,074|
|HC.5.1||Pharmaceuticals and Other Medical Non-Durables||30||2,714||68||2,812|
|HC.5.2||Therapeutic Appliances and Other Medical Goods||261||1||261|
|HC.6.1||Information, Education and Counceling Programmes||14||46||21||80|
|HC.6.3||Early Disease Detection Programmes||65||65|
|HC.6.4||Healthy Condition Monitoring Programmes||75||113||187|
|HC.6.5||Epidemiological Surveillance, Disease Control Programmes||0||82||82|
|HC.6.6||Preparing for Disaster and Emergency Response Programmes|
|HC.6.9||Preventative Care N.E.C||0||78||0||9||0||88|
|HC.7||Governance and Health System Administration and Financing||0||0||0||7||618||0||625|
|HC.7.1||Govt Health Administration Agencies||7||194||201|
|HC.7.2||Administration of Health Financing||0||0||0||423||0||424|
|HC.9||Health Care Services N.E.C||3||0||0||0||5||8|
|HC.1 to HC.9||Total Current Health Care Expenditure||7,854||3,724||4,207||277||2,983||256||618||1,151||51||10||21,130|
Table 5 presents a breakdown of health care expenditure by function (HC) and financing scheme (HF) for 2017.
Inpatient curative and rehabilitative care (HC.1.1 + HC.2.1) accounted for 24% (€3,720 million) of the total government (HF.1) spend on healthcare. Over 36% of the total spend of household out-of-pocket payments (HF.3) was for outpatient curative and rehabilitative care (€952 million).
Of the €11,808 million spent on curative and rehabilitative care services in 2017, Government (HF.1) funded over 71% (€8,365 million) and 18% (€2,105 million) was funded by voluntary health insurance payments (HF.2.1).
A total of €4,469 million was spent on long-term care services (HC.3). Government (HF.1) financed 86% (€3,844 million) of long term care services in 2017. Almost all of the remainder was paid for by household out-of-pocket payments (13% or €583 million).
Almost a quarter (€688 million) of the expenditure on pharmaceuticals (HC.5.1) was funded by household out-of-pocket payments with the remainder funded by government (€2,124 million).
Preventive care (HC.6), such as immunisation and health promotion activities, was funded by government (63%) and voluntary payments other than health insurance (HF.2.x) (22%). The remainder was funded by household out-of-pocket payments which would relate mainly to preventative dental care.
Tax refunds for health expenditure amounted to €164 million in 2017. 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, 2017||€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||8,365||8,344||21||2,280||2,105||175||1,162||11,808|
|HC.1.1+HC.2.1||Inpatient Curative & Rehabilitative Care||3,720||3,720||1,501||1,439||62||115||5,336|
|HC.1.2+HC.2.2||Day Curative and Rehabilitative Care||989||989||564||543||21||24||1,577|
|HC.1.3+HC.2.3||Outpatient Curative & Rehabilitative Care||3,047||3,026||21||194||122||72||952||4,193|
|HC.1.4+HC.2.4||Home-Based Curative & Rehabilitative Care||609||609||22||1||21||71||701|
|HC.3||Long-Term Care (Health)||3,844||3,807||37||42||42||583||4,469|
|HC.3.1||Inpatient Long-Term Care (Health)||1,967||1,967||30||30||564||2,560|
|HC.3.2||Day Long-Term Care (Health)||188||188||2||2||5||194|
|HC.3.4||Home-Based Long-Term Care (Health)||1,689||1,653||37||10||10||14||1,714|
|HC.4.9||Ancillary Services N.E.C||139||139||2||141|
|HC.5||Medical Goods (Non-Specified by Function)||2,178||2,158||20||*||*||*||896||3,074|
|HC.5.1||Pharmaceuticals and Other Medical Non-Durables||2,124||2,124||688||2,812|
|HC.5.2||Therapeutic Appliances and Other Medical Goods||53||33||20||*||*||*||208||261|
|HC.6.1||Information, Education and Counceling Programmes||80||80||1||1||80|
|HC.6.3||Early Disease Detection Programmes||64||64||1||1||65|
|HC.6.4||Healthy Condition Monitoring Programmes||4||4||109||109||75||187|
|HC.6.5||Epidemiological Surveillance, Disease Control Programmes||78||78||4||0||4||82|
|HC.6.6||Preparing for Disaster and Emergency Response Programmes|
|HC.6.9||Preventative Care N.E.C||74||74||14||5||9||88|
|HC.7||Governance and Health System Administration and Financing||178||178||447||424||23||625|
|HC.7.1||Govt Health Administration Agencies||178||178||23||23||201|
|HC.7.2||Administration of Health Financing||424||424||424|
|HC.9||Health Care Services N.E.C||165||165||7||5||2||-164||8|
|HC.1 to HC.9||Total Current Health Care Expenditure||15,487||15,410||78||3,048||2,678||370||2,595||21,130|
Table 6 presents a breakdown of health care expenditure by health care provider (HP) and financing source (HF) for 2017.
Government (HF.1) was the majority funder of health care providers in Ireland in 2017 (73%). Over 80% of expenditure in long-term care facilities (HP.2) were government funded. Government also funded 71% of hospital (HP.1) expenditure. The majority (79%) of pharmaceutical expenditure was also funded by government.
Over three-quarters (76%) of voluntary health insurance payments (€2,043 million) were spent on hospital services.
After tax refunds of €164 million were taken into account, houshold out-of-pocket expenditure amounted to €2,595 million in 2017. Over 40% of this (€1,043 million) was spent on ambulatory health care providers (HC.3) and 25% (€640 million) was on long-term care facilities (HP.2). Over 25% of household out-of-pocket payments (€649 million) was spent in pharmacies.
|Table 6: Current Health Care Expenditure by Health Care Provider and Health Care Financing Scheme, 2017||€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.x||Specialised Hospitals (including Mental Health Hospitals)||912||912||248||239||9||18||1,178|
|HP.2||Long-Term Residential Facilities||3,016||3,016||68||21||46||640||3,724|
|HP.3||Ambulatory Health Care Providers||2,952||2,931||21||212||133||80||1,043||4,207|
|HP.3.3||Other Health Care Practitioners||78||78||30||30||1||276||384|
|HP.3.4||Ambulatory Health Care Centres||1,662||1,662||70||8||62||47||1,779|
|HP.3.5||Providers of Home Health Care Services||531||531||24||10||13||69||624|
|HP.4||Ancillary Health Care Providers||204||204||34||32||1||39||277|
|HP.4.1||Providers of Patient Transportation and Emergency Rescue||177||177||3||1||1||7||186|
|HP.4.2||Medical and Diagnostic Laboratories||27||27||31||31||32||90|
|HP.4.9||Other providers of ancillary services||1||1||1|
|HP.5||Retailers of Medical Goods||2,151||2,131||20||*||*||*||832||2,983|
|HP.5.2||Retail Sellers of Durable Medical Goods and Appliances||53||33||20||*||*||*||183||236|
|HP.6||Providers of Preventive Care||232||232||24||24||256|
|HP.7||Providers of Health Care System Administration and Financing||177||177||440||423||17||618|
|HP.7.1||Govt Health Administration Agencies||177||177||17||17||194|
|HP.7.3||Private Health Insurance Administration Agencies||423||423||423|
|HP.8||Rest of the Economy||979||942||37||109||0||109||64||1,151|
|HP.8.1||Households as Providers of Home Health Care||929||892||37||929|
|HP.8.2||All Other Industries as Secondary Providers of Health Care||50||50||109||0||109||64||223|
|HP.9||Rest of the World||35||35||15||15||0||51|
|HP.1 to HP.0||Total Current Health Care Expenditure||15,487||15,410||78||3,048||2,678||370||2,595||21,130|
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 GDP in 2015 led to a drop in this ratio. GNI* excludes globalisation effects that are disproportionally impacting the measurement of the size of the Irish economy, and hence may be a more appropriate indicator to use.
|Table 7: Revised Health Care Expenditure in Ireland, 2000 to 2017||€million|
|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||19,024||19,239||19,419||19,749||20,320||21,352||22,181|
|Capital Expenditure (€m)1||522||727||822||749||918||665||539||877||807||671||583||731||524||914||898||1,066||1,180||1,051|
|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||18,293||18,715||18,506||18,850||19,254||20,171||21,130|
|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||13,233||13,488||13,173||13,387||13,868||14,621||15,487|
|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||5,059||5,226||5,332||5,464||5,386||5,551||5,643|
|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%||10.7%||10.3%||9.7%||7.3%||7.4%||7.2%|
|Current Expenditure % GNI*, Ireland||6.8%||7.5%||8.0%||8.1%||8.4%||8.8%||8.5%||9.0%||10.5%||12.5%||12.5%||14.5%||14.8%||13.5%||12.7%||11.9%||11.5%||11.7%|
|Current Expenditure % GDP, OECD Average (adjusted)2||7.2%||7.5%||7.7%||8.0%||8.0%||8.0%||7.9%||7.9%||8.2%||8.8%||8.7%||8.7%||8.8%||8.8%||8.8%||8.8%||8.9%||8.8%|
|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|
|Current Expenditure % GDP, Ireland||Current Expenditure % GNI*, Ireland||Current Expenditure % GDP, OECD Average (adjusted)|
|Current Expenditure % GDP, Ireland||Current Expenditure % GNI*, Ireland||Current Expenditure % GDP, OECD Average (adjusted)|
Table 8 presents a reconciliation of HSE gross expenditure for 2017 (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, 2017||€million|
|1||HSE AFS - Expenditure - Pay and Pensions||5,357|
|2||HSE AFS - Expenditure - Non-Pay||9,872|
|3=1+2||Total HSE Annual Financial Statement Gross Expenditure||15,229|
|4||Exclude Non-Health Care Services||-932|
|5||Include Non-AFS Gross Expenditure (Mainly Related to Voluntary Agencies)||776|
|6=4+5||Total Adjustments to AFS Gross Expenditure||-156|
|7=3+6||Gross Expenditure of HSE included in SHA Expenditure||15,073|
|8||Non-Government Funding of HSE||-1,010|
|9=7+8||Total HSE HF.1 Funded Health Care Expenditure||14,063|
|Additional Government Health Care Expenditure:|
|10||DSP Transfer payments||881|
|11||Treatment Benefits from Social Insurance Fund||78|
|12||Department of Health||104|
|13||Tax Relief on Medical Expenses||164|
|14||Expenditure of Other Government Departments and Agencies||197|
|15=10+11+12+13+14||Total Additional Government HF.1 Funded Expenditure||1,424|
|16=9+15||Government (HF.1) Funded Current Health Care Expenditure||15,487|
This release is the official publication by CSO of health care expenditure 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 from 2011.
International comparisons for this data can be found in Eurostat data explorer here under the theme:
Population and Social Conditions\Health\Health Care\Health Care Expenditure and OECD statistical database here.
Data revisions since previous publication
The following are a number of revisions undertaken since the publication of data in June 2017:
HP.3: A review of the processing of the household out-of-pocket payments on medical and dental practices has resulted in a revision for the years 2013-2016. Revised series is available on the CSO’s data portal statbank.
HP.8: A revision in the methodology of expenditure on other industries as secondary providers of healthcare has resulted in a revision for the years 2013-2016. Revised series is available on the CSO’s data portal statbank.
Refund of Medical Expenses by Revenue: The latest estimates provided by Revenue have been included.
Gross Domestic Product (GDP)
The GDP figures used in the current publication are consistent with those published in the National Income and Expenditure 2017 and the latest Quarterly National Accounts publication. See here.
Modified Gross National Income (GNI*)
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.
Overview of the System of Health Accounts
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 below, 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 here.
National application of the SHA standard
Much progress has been made in the coding of data sources to the SHA classifications. However this work is ongoing and revisions, especially to the more detailed profile of the data are to be expected.
Specific known data issues
All HSE hospital expenditure funded by HSE Mental Health Services has been allocated to HP.1.2 Mental Health Hospitals.
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 (purchasing of healthcare abroad) 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 expenditure been somewhat over-stated in some areas.
International Classification of Health Accounts
This section provides some detail on each classification. Details of the current application of the standard in Ireland area are available here:
The SHA manual available here, provides a full description of the classifications and their categories.
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, see the methodology here.
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:
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:
Scan the QR code below to view this release online or go to