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Situation
- Mortality has fallen sharply over the last thirty years
- Healthcare expenditure has made a modest contribution to this, substantially less than one third of the total, and possibly only a few percentage points.
- Development of primary care, and the more effective delivery of prevention measures will likely lead to the greatest declines in mortality.
There have been major improvement in the health of the Irish population over the last 20 years, (e.g. McDaid, 2009 p228), with a rise in life expectancy overall of 5 years from 1990 to 2006. The rate of increase seems to have risen in about 1999, and while Irish life expectancy is still a little low by EU standards, there has been substantial improvement, especially for men. The health care system has many weaknesses, notably very poorly developed primary care, giving us, for example, strikingly low immunization rates (McDaid, 2009, p156). However public health care expenditure has risen substantially as the economy grew from 1995 onwards, form about €3 billion to about €15 billion in 2009. Overall health care expenditure has risen from 8.8% of GNP in 1995 to approximately 10.7% in 2007. What has been the impact of this substantial change, and how much of the improved health outcomes are attributable to the increased expenditure?
Conclusions
The existing evidence strongly suggests that :-