System of Health Accounts
in Ireland
Ciara O’Shea, Central Statistics Office
Health Accounts Seminar
Royal College of Physicians
10 November 2016
www.cso.ie
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Overview
• Headline results
• What is the System of Health Accounts?
• Detailed Results 2014
– including international comparison.
• Possible developments.
www.cso.ie
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Headline results
Health expenditure for 2013 and 2014 under
new methodology.
Current Health Expenditure (€ bn)
Current Health Expenditure % GDP
Current Health Expenditure % GNI
www.cso.ie
2013
18.8
10.5
12.3
2014
19.1
10.1
11.7
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Headline results
www.cso.ie
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What is the System of Health Accounts?
• Format for reporting health care expenditure
agreed between OECD, WHO, Eurostat
– Extension of core National Accounts
• Answers 3 main questions
– Where does the money to finance the health
system come from?
– Who does the money go to?
– What kind of (functionally defined) services are
performed and what type of goods are purchased?
www.cso.ie
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What’s new?
• First detailed profile of Irish current health
expenditure in accordance with System of Health
Accounts, 2011 (SHA)
• Previously only high level estimates
– Total
– Public / private
– Current / capital
• Now detailed breakdown of current spending by 3
classifications – financing, provider, function
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Boundary of health care
• Functional classification (ICHA-HC) is key to
defining the boundary of health care
• Excludes social care – difficult in practice
• Review of Irish data has led to inclusion of
wider range of services as health care than
previously reported
• Main changes – more long-term care for
older people and people with a disability
now included
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Detailed Results 2014
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Who finances health care in Ireland?
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Who provides health care in Ireland?
Health Care Expenditure by Provider, 2014 (€m)
Hospitals
6,648
Long-Term Residential Facilities
3,640
Ambulatory Health Care Provider
3,842
Ancillary Health Care Provider
278
Retailer of Medical Goods
2,716
Other Providers
2,024
0
1,000 2,000 3,000 4,000 5,000 6,000 7,000
www.cso.ie
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www.cso.ie
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What kind of health care is funded
in Ireland?
Health Care Expenditure by Function, 2014 (€m)
Curative and Rehabilitative Care
10,291
Long-Term Care (Health)
4,263
Ancillary Services
548
Medical Goods (Non-Specified by
Function)
2,838
Other Health Care Functions
1,208
0
2,000
4,000
www.cso.ie
6,000
8,000
10,000
12,000
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Cross-Classifying
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1.Who provides what kind of care?
Type of Provider by Type of Service, 2014
Curative and Rehabilitative Care
Long-term care (health)
Hospitals
Residential Facilities
94%
17%
Ambulatory Providers
Other Providers
Other Services
4%
83%
87%
Medical Goods Retailers
Medical Goods
10%
99.7%
32%
61%
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2.Who funds which type of care?
Health Care Function by Financing, 2014
Curative and Rehabilitative
68%
Long-term care (health)
79%
Medical Goods
€m
68%
0
Government
19%
13%
19%
32%
2,000
4,000
6,000
Voluntary Payments
www.cso.ie
8,000
10,000
12,000
Out-of-Pocket
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3.Who funds which providers?
Type of Provider by Financing, 2014
Hospitals
70%
Residential Facilities
73%
Ambulatory Provider
30%
71%
Other Providers
€m
23%
66%
Medical Goods Retailers
64%
0
Government
1,000
28%
29%
34%
2,000
3,000
Voluntary Payment
www.cso.ie
4,000
5,000
6,000
7,000
Out-of-Pocket
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Possible Developments
• More granularity – analyse Providers and
Services at 3-digit level.
• Public v Private Providers
• Application of classification to nonexpenditure data
• Quality improvements
– Preventative Care
– Review of Boundary – Health v Social Care
– Non-Profit Sector
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Public and Private Hospital
Provision in Ireland, 2014
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For data and further information
CSO Publication
Ireland’s System of Health Accounts, Annual Results 2013 (Preliminary)
http://www.cso.ie/en/releasesandpublications/er/sha/systemofhealthaccounts2014/
International Data
OECD: - http://stats.oecd.org/ - see health expenditure and financing under Health theme
Eurostat: -http://ec.europa.eu/eurostat/web/health/health-care/data/database
Please refer to the following methodological papers on the CSO’s website
http://www.cso.ie/en/surveysandmethodology/nationalaccounts/
Mapping of Health Care Services in Ireland to the Functions Classification (ICHA – HC) within the System
of Health Accounts
Mapping of the Structure of Health Care Financing in Ireland to the Health Care Financing Scheme
Classification (ICHA – HF) within the System of Health Accounts
Mapping of Health Care Providers in Ireland to the Provider Classification (ICHA – HP) within the System
of Health Accounts
Contact us: [email protected]
www.cso.ie
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