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System of Health Accounts 2021

Expenditure by Functions of Health Care

Online ISSN: 2009-8812

CSO statistical publication, 22 June 2023, 11am

What is the purpose of the health care being consumed?

In 2021 more than half (55%) of all health expenditure related to curative and rehabilitative care; this mainly covers in-patient and out-patient care. The next largest category, 21% of all health expenditure, was long-term care. See Figure 6.1. Table 6.1 includes more details and shows that in-patient services were the largest component of both long-term care and curative/rehabilitative care.

Health expenditure increased by 35% between 2017 and 2021. The growth in spending in preventative care was higher due to the increased spending to combat the COVID-19 pandemic. There were increases across all areas of preventive care, in particular early disease detection and immunisation. There was a lower rate of growth in medical goods and pharmaceuticals (14%). See Figure 6.2.

System of Health Accounts 2021 Figure 6.1 (XLS 1KB)

	Current Health Care Expenditure By Function, (% change 2017 to 2021)
Curative and Rehabilitative Care	33.9326074280204
Long-Term Care (Health)	31.1386043694534
Medical Goods (Non-Specified by Function)	14.3181087507557
Ancillary Services	24.5866762388045
Other Health Care Functions	107.149486133851

Table 6.1: Current Health Care Expenditure by Health Care function, 2017 to 2021

Table 6.1: Current Health Care Expenditure by Health Care Function, 2017 to 2021
				€ million					% of Total	% change
ICHA-HC Code				2017	2018	2019	2020	2021	2021	2017-2021
HC.1+HC.2		Curative and Rehabilitative Care		11,765	12,547	13,513	14,878	15,757	55	34
	HC.1.1+HC.2.1		Inpatient Care	5,358	5,767	6,015	6,766	6,923	24	29
	HC.1.2+HC.2.2		Day Care	1,547	1,637	1,869	1,937	2,282	8	48
	HC.1.3+HC.2.3		Outpatient Care	4,158	4,424	4,849	5,311	5,615	20	35
	HC.1.4+HC.2.4		Home-Based Care	703	719	781	864	937	3	33

HC.3		Long-Term Care (Health)		4,586	4,908	5,213	5,783	6,014	21	31
	HC.3.1		Inpatient Care	2,676	2,839	2,977	3,307	3,661	13	37
	HC.3.2		Day Care	195	210	224	253	245	1	25
	HC.3.4		Home-Based Care	1,715	1,859	2,011	2,224	2,108	7	23

HC.4		Ancillary Services		598	620	681	710	746	3	25
	HC.4.1		Laboratory Services	238	244	260	274	288	1	21
	HC.4.2		Imaging Services	134	139	169	150	157	1	17
	HC.4.3		Patient Transportation	224	234	242	277	291	1	30
	HC.4.9		Ancillary Services N.E.C	2	2	10	9	10		365

HC.5		Medical Goods (Non-Specified by Function)		2,934	3,025	3,051	3,294	3,354	12	14
	HC.5.1		Pharmaceuticals and Other Medical Non-Durables	2,671	2,731	2,752	3,015	3,055	11	14
	HC.5.2		Therapeutic Appliances and Other Medical Goods	263	294	299	279	299	1	14

HC.6		Preventive Care		563	584	635	859	1,687	6	200
	HC.6.1		Information, Education and Counselling	80	85	91	108	114		42
	HC.6.2		Immunisation Programmes	53	45	51	70	366	1	597
	HC.6.3		Early Disease Detection	68	77	85	244	660	2	875
	HC.6.4		Healthy Condition Monitoring	195	203	219	213	230	1	18
	HC.6.5		Epidemiological Surveillance, Disease Control	82	80	89	120	194	1	136
	HC.6.6		Disaster and Emergency Response		2	2
	HC.6.9		Preventative Care N.E.C	85	92	98	105	123		45

HC.7		Governance and Health System Administration and Financing		567	567	597	766	837	3	48
	HC.7.1		Govt Health Administration Agencies	177	192	237	254	260	1	47
	HC.7.2		Administration of Health Financing	390	375	360	511	577	2	48

HC.9		Health Care Services N.E.C		203	210	241	214	238	1	17

		Total		21,216	22,460	23,931	26,505	28,632	100	35

Open in Excel: System of Health Accounts 2021 Table 6.1 (XLS 15KB)

Visit Table SHA04 on PxStat

How are health care services funded?

Figure 6.3 below provides a breakdown of health care expenditure by health care function and financing source for 2021. As noted earlier in this release, 77% of health care expenditure was funded by Government in 2021, with 12% by health insurance and the remaining 11% by household out-of-pocket payments. The differences from the total financing scheme split show that there is very little spending on long term care by private health insurance companies. As expected, there is no spending on administration by households.

	HF.1 - Government and Compulsory	HF.2 - Voluntary Health Care Payment Schemes	HF.3 - Household Out-of-Pocket Payments
Curative and Rehabilitive Care	77.0716562373252	14.8900684870492	8.03827527562559
Long-Term Care (Health)	83.7551034306053	1.53592362411938	14.7089729452753
Ancillary Services	68.5003025890259	23.0685210558818	8.43117635509236
medical goods (Non-Specified by Function)	77.4419255467897	0	22.5580744532103
Preventative Care	85.6590868969718	9.03175786631012	5.30915523671812
Governance and Health System administration and financing	27.7247096869655	72.2752903130345	0
Health Care Services N.E.C	81.5806482007868	18.4193517992132	0
Total Current Health Care Expenditure	77.3971057803243	11.914611282692	10.6882829369837

Table 6.2: Current Health Care Expenditure by Health Care Function and Health Care Financing Scheme, 2021

Table 6.2: Current Health Care Expenditure by Health Care Function and Health Care Financing Scheme, 2021
											€ million
				Govt and Compulsory	Government Financing	Compulsory Contributory	Voluntary Health Care Payment	Voluntary Health Insurance	Other Voluntary Health Care Payment	Household Out-of-Pocket Payments	Total
ICHA Code				HF.1	HF.1.1	HF.1.2	HF.2	HF.2.1	HF.2.x	HF.3
HC.1+HC.2		Curative and Rehabilitative Care		12,145	12,092	53	2,346	2,196	151	1,267	15,757
	HC.1.1+HC.2.1		Inpatient Care	5,465	5,465		1,373	1,335	38	85	6,923
	HC.1.2+HC.2.2		Day Care	1,577	1,577		671	658	12	34	2,282
	HC.1.3+HC.2.3		Outpatient Care	4,266	4,214	53	274	201	73	1,075	5,615
	HC.1.4+HC.2.4		Home-Based Care	836	836		29	1	27	73	937

HC.3		Long-Term Care (Health)		5,037	4,989	48	92		92	885	6,014
	HC.3.1		Inpatient Care	2,734	2,734		69		69	858	3,661
	HC.3.2		Day Care	233	233		4		4	8	245
	HC.3.4		Home-Based Care	2,070	2,022	48	19		19	18	2,108

HC.4		Ancillary Services		511	511		172	171	1	63	746
	HC.4.1		Laboratory Services	193	193		59	58	1	36	288
	HC.4.2		Imaging Services	48	48		108	108		1	157
	HC.4.3		Patient Transportation	270	270		3	3		16	291
	HC.4.9		Ancillary Services N.E.C							10	10

HC.5		Medical Goods (Non-Specified by Function)		2,598	2,536	62	0			757	3,354
	HC.5.1		Pharmaceuticals and Other Medical Non-Durables	2,509	2,509					546	3,055
	HC.5.2		Therapeutic Appliances and Other Medical Goods	88	26					211	299

HC.6		Preventative Care		1,445	1,445		152	3	149	90	1,687
	HC.6.1		Information, Education and Counselling	113	113		1		1		114
	HC.6.2		Immunisation Programmes	366	366						366
	HC.6.3		Early Disease Detection	660	660						660
	HC.6.4		Healthy Condition Monitoring	4	4		136		136		230
	HC.6.5		Epidemiological Surveillance, Disease Control	194	194						194
	HC.6.6		Disaster and Emergency Response
	HC.6.9		Preventative Care N.E.C	108	108		15	3	12		123

HC.7		Governance and Health System Administration and Financing		232	232		605	577	28		837
	HC.7.1		Govt Health Administration Agencies	232	232		28		28		260
	HC.7.2		Administration of Health Financing	0			577	577			577

HC.9		Health Care Services N.E.C		194	194		44	43	1		238

		Total		22,160	21,998	162	3,411	2,989	422	3,060	28,632
* Confidential

Open in Excel: System of Health Accounts 2021 Table 6.2 (XLS 13KB)

Visit Table SHA05 on PxStat

How are the health care services distributed across provider type?

Figure 6.4 contains details of health care services by health care providers. Most of the information is as expected: the majority of medical goods are provided by pharmacies and retailers; and nearly all administration functions are provided by the providers of the service. About one-third of curative/rehabilitative care is provided by providers of out-patient care. Almost two-thirds (63%) of long-term care is provided within long-term residential facilities. The rest is provided by out-patient care (12%) or the rest of the economy or home based care (23%).

	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 Economy	HP.9 - Rest of World	HP.0 - Providers N.E.C
Curative and Rehabilitive Care	63.4800667442361	5.1188575751455	30.7141907980507	0	0.080064176288163	0.0296415569544022	0	0.166610790711994	0.410194552162135	0.000373806451047294
Long-Term Care (Health)	2.10226267299272	65.4999025027514	12.6410742000636	0	0	0	0	19.7567606241923	0	0
Ancillary Services	50.0394774608909	0.00352772253541098	0.601066720115293	49.2070160332359	0	0	0	0	0.148912063222485	0
medical goods (Non-Specified by Function)	1.6250658448539	0	0	0	98.0053974181324	0	0	0.369536737013724	0	0
Preventative Care	0.00697448086112027	0	20.670095473516	0.0395526733722803	0.0391992844612798	69.4426060231437	0	9.80150629969022	6.57649554054813E-05	0
Governance and Health System administration and financing	0	0	0	0	0	0.794699244364727	99.2053007556353	0	0	0
Health Care Services N.E.C	14.2643793675295	0	0.697905666980168	0.00478806398361079	0	0	0	0.467806132690524	0.00874115289593343	84.5563796159203
Total Current Health Care Expenditure	36.9897105757046	16.5742688186988	20.7977230008721	1.28367079128861	11.5280789423802	4.13079689660959	2.89856335511559	4.86586791972274	0.229703301879237	0.701616397728626

Table 6.3: Current Health Care Expenditure by Health Care Function and Health Care Provider, 2021

Table 6.3: Current Health Care Expenditure by Health Care Function and Health Care Provider, 2021
											€ million
			Hospitals	Long-Term Residential Facilities	Ambulatory Health Care Providers	Ancillary Health Care Providers	Retailers of Medical Goods	Providers of Preventative Care	Rest of the Economy	Other⁴	Total
ICHA Code			HP.1	HP.2	HP.3	HP.4	HP.5	HP.6	HP.8	HP.7¹HP.9²HP.0³
HC.1+HC.2		Curative and Rehabilitative Care	10,003	807	4,840		13	5	26	65	15,757
	HC.1.1+HC.2.1	Inpatient Care	6,214	635	12					62	6,923
	HC.1.2+HC.2.2	Day Care	1,998	2	282					0	2,282
	HC.1.3+HC.2.3	Outpatient Care	1,747	11	3,818		13		25	2	5,615
	HC.1.4+HC.2.4	Home-Based Care	45	159	728			5	1		937

HC.3		Long-Term Care (Health)	126	3,939	760				1,188		6,014
	HC.3.1	Inpatient Care	126	3,535							3,661
	HC.3.2	Day Care		3	242						245
	HC.3.4	Home-Based Care		402	518				1,188		2,108

HC.4		Ancillary Services	373	0	4	367				1	746
	HC.4.1	Laboratory Services	210		0	78					288
	HC.4.2	Imaging Services	115		4	36				1	157
	HC.4.3	Patient Transportation	38		0	253					291
	HC.4.9	Ancillary Services N.E.C	10	0		0					10

HC.5		Medical Goods (Non-Specified by Function)	55				3,287		12		3,354
	HC.5.1	Pharmaceuticals and Other Medical Non-Durables	55				2,989		12		3,055
	HC.5.2	Therapeutic Appliances and Other Medical Goods					299		1		299

HC.6		Preventative Care	0		349	1	1	1,171	165	0	1,687
	HC.6.1	Information, Education and Counselling	0		20			68	25		114
	HC.6.2	Immunisation Programmes			129			237			366
	HC.6.3	Early Disease Detection	0		0			660			660
	HC.6.4	Healthy Condition Monitoring	0		90				140		230
	HC.6.5	Epidemiological Surveillance, Disease Control			0			194			194
	HC.6.6	Disaster and Emergency Response									0
	HC.6.9	Preventative Care N.E.C	0		109	1	1	12		0	123

HC.7		Governance and Health System Administration and Financing						7		830	837
	HC.7.1	Govt Health Administration Agencies						7		253	260
	HC.7.2	Administration of Health Financing								577	577

HC.9		Health Care Services N.E.C	34		2	0			1	201	238

		Total	10,591	4,746	5,955	368	3,301	1,183	1,393	1,097	28,632
¹HP.7 Providers of Health Care Administration and Financing
² HP.9 Rest of World
³HP.0 Providers N.E.C
⁴ For presentation purposes some smaller categories have been combined. A superscript identifies the provider for each service function and full data is available in PxStat.