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Ireland's public healthcare expenditure ranks ninth in Europe, ESRI report says

The report author said Ireland’s HCE should not be “interpreted as a measure of hospital service expenditure”.

Image: Shutterstock/Syda Productions

IRELAND’S EXPENDITURE ON public healthcare ranks in ninth place out of 15 EU countries, an ESRI report has said. 

The Economic and Social Research Institute (ESRI) today published a report titled: ‘How does Irish Healthcare Expenditure compare internationally?’

The report compares the expenditure on healthcare in Ireland to that of those in the EU15 (countries that joined the EU before May 2004). 

The research found that Ireland’s Healthcare Expenditure (HCE) on public healthcare ranked in ninth place and spending on private healthcare per capita ranked in second place. 

Differences in ranking

Using data from 2017, the report found that expenditure rankings differ depending on the measure used, the service examined and whether the comparison is adjusted for different approaches to accounting for social care expenditure.

Expenditure considered as a share of national income is a measure often used to compare different countries. 

However, adjusting for population and relative prices can impact this ranking between countries. Moreover, not all countries include the same items in healthcare expenditure. 

Ireland’s healthcare expenditure was found to rank differently depending on the measure used. 

The country’s total expenditure as a share of national income ranks first in Europe. However, adjusted per capita with changes for relative prices, it ranks in ninth place. 

A relative price is the cost of a certain good or service in terms of another, for example the price of renting a film online and the price of going to the cinema. 

Public HCE also ranks in ninth place, while private expenditure per capita ranks in second. 

10 out of the 15 EU countries examined allocated some social care expenditure in their healthcare-related expenditure in 2017. However, this is not counted in regular healthcare expenditure. 

Ireland allocated €4.6 billion in social care expenditure in its HCE. However, it was not one of the EU countries which included it in healthcare-related expenditure.  

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Other differences arise between countries. For example, Ireland included more than €900 million in family carer payments in its HCE, accounting for 4.3% of the total expenditure. 

In the Netherlands, these payments are not included in HCE.  

Ireland also included its expenditure on home care services, group homes for people with disabilities and day services for older people under its HCE. In the UK, much of this is excluded from HCE expenditure. 

Dr Maev-Ann Wren, an ESRI Senior Research Officer and lead author of the report, said that the findings “make clear” that Ireland’s HCE should not be “interpreted as a measure of hospital service expenditure”. 

“Healthcare expenditure is sometimes understood as expenditure on hospital services, leading to a disconnect between Ireland’s apparently high HCE and over-stressed hospital system,” Wren said. 

“We hope that the analysis in this report will contribute to a better understanding of international HCE comparisons to inform the development and strengthening of the Irish healthcare system.”

The report was prepared by the ESRI for a research programme funded by the Department of Health. 

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