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The Irish health system: developments in strategy, structure, funding and delivery since 1980

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  • Miriam M. Wiley

    (The Economic and Social Research Institute, Dublin, Ireland)

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    Abstract

    As the Irish health system embarks upon its first major structural reorganisation in over 30 years, developments within this system over the past two decades are assessed. Real cuts in health expenditure achieved in the 1980s contrast sharply with the unprecedented increase in resources devoted to the health system in the 1990s. While successive statements of health strategy have prioritised the objectives of equity, efficiency and quality of care, questions arise regarding the return achieved with the increased investment. With higher levels of economic growth, more people have been buying private health insurance such that almost half the population are now privately insured. At the same time, the numbers with eligibility for health services without charge have decreased while those from lower socio-economic groups continue to have higher levels of utilisation. Equity issues arise, however, with regard to access to public hospitals as the rate of growth in admissions for private patients outstrips that for public patients. The establishment of a National Treatment Purchase Fund to purchase treatment in private facilities for public patients on waiting lists raises efficiency and equity questions as the treatment of private patients in public hospitals is heavily subsidised while the State pays full cost for the treatment of public patients in private facilities. Copyright © 2005 John Wiley & Sons, Ltd.

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    Bibliographic Info

    Article provided by John Wiley & Sons, Ltd. in its journal Health Economics.

    Volume (Year): 14 (2005)
    Issue (Month): S1 ()
    Pages: S169-S186

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    Handle: RePEc:wly:hlthec:v:14:y:2005:i:s1:p:s169-s186

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    Web page: http://www3.interscience.wiley.com/cgi-bin/jhome/5749

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    1. David Madden & Anne Nolan & Brian Nolan, 2005. "GP reimbursement and visiting behaviour in Ireland," Health Economics, John Wiley & Sons, Ltd., vol. 14(10), pages 1047-1060.
    2. van Doorslaer, Eddy & Wagstaff, Adam & van der Burg, Hattem & Christiansen, Terkel & De Graeve, Diana & Duchesne, Inge & Gerdtham, Ulf-G & Gerfin, Michael & Geurts, Jose & Gross, Lorna, 2000. "Equity in the delivery of health care in Europe and the US," Journal of Health Economics, Elsevier, vol. 19(5), pages 553-583, September.
    3. Wiley, Miriam M., 2001. "Reform and Renewal of the Irish Health Care System: Policy and Practice," Papers BP2002/4, Economic and Social Research Institute (ESRI).
    4. Nolan, Brian, 1991. "The Utilisation and Financing of Health Services in Ireland," Research Series, Economic and Social Research Institute (ESRI), number GRS155.
    5. Fadden, Lillian, 2003. "The Impact of the Extension of the General Medical Services Scheme to Cover All Persons Aged 70 Years and Over: A Case Study," Papers HRBWP06, Economic and Social Research Institute (ESRI).
    6. Layte, Richard & Nolan, Brian, 2003. "Equity in the Utilization of Health Care in Ireland," Papers HRBWP02, Economic and Social Research Institute (ESRI).
    7. Watson, Dorothy & Williams, James & Kinsella, Ray, 2001. "Perceptions of the Quality of Health Care in the Public and Private Sectors in Ireland: Report to the Centre for Insurance Studies Graduate Business School, UCD," Research Series, Economic and Social Research Institute (ESRI), number BMI163.
    8. Nolan, Brian, 1993. "Economic incentives, health status and health services utilisation," Journal of Health Economics, Elsevier, vol. 12(2), pages 151-169, July.
    9. repec:esr:chaptr:jacb200116 is not listed on IDEAS
    10. Brian Nolan & Hugh Magee, 1992. "Perinatal Mortality and Low Birthweight by Age, Parity and Socio-Economic Background: Evidence for Ireland," Papers WP037, Economic and Social Research Institute (ESRI).
    11. Wagstaff, Adam & van Doorslaer, Eddy & van der Burg, Hattem & Calonge, Samuel & Christiansen, Terkel & Citoni, Guido & Gerdtham, Ulf-G & Gerfin, Mike & Gross, Lorna & Hakinnen, Unto, 1999. "Equity in the finance of health care: some further international comparisons1," Journal of Health Economics, Elsevier, vol. 18(3), pages 263-290, June.
    12. Brian Nolan, 1989. "Socio-Economic Mortality Differentials in Ireland," Papers WP013, Economic and Social Research Institute (ESRI).
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    Cited by:
    1. Paula González & Inés Macho-Stadler, 2011. "A Theoretical Approach to Dual Practice Regulations in the Health Sector," Working Papers 11.01, Universidad Pablo de Olavide, Department of Economics.
    2. Briggs, Adam D.M., 2013. "How changes to Irish healthcare financing are affecting universal health coverage," Health Policy, Elsevier, vol. 113(1), pages 45-49.
    3. Jacqueline O'Reilly & Miriam M. Wiley, 2007. "The Public/Private Mix in Irish Acute Public Hospitals: Trends and Implications," Papers WP218, Economic and Social Research Institute (ESRI).
    4. Jacqueline O'Reilly & Miriam M. Wiley, 2008. "How Local is Hospital Treatment? An Exploratory Analysis of Public/Private Variation in Location of Treatment in Irish Acute Public Hospitals," Papers WP237, Economic and Social Research Institute (ESRI).
    5. Socha, Karolina Z. & Bech, Mickael, 2011. "Physician dual practice: A review of literature," Health Policy, Elsevier, vol. 102(1), pages 1-7, September.

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