New ESRI report projects that public acute hospitals will need to increase inpatient bed capacity by at least 40 per cent by 2040

May 28, 2025

Health and Quality of Life
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A new Economic and Social Research Institute (ESRI) report released today (28 May, 2025), projects that the number of inpatient beds in public acute hospitals will need to increase by at least 40 per cent by 2040, reflecting continued increases in the population, particularly at older ages. The research, funded by the Department of Health, also produced projections of demand for emergency department, outpatient department, day patient and inpatient services, as well as inpatient bed days. The report considers a range of scenarios based on varying assumptions about population growth and ageing, the pace of healthy ageing, and policy choices (e.g., reducing inpatient length of stay).

Key findings:

Population change

The rising demand for hospital services is largely driven by population growth and ageing. Ireland’s population is projected to increase from 5.3 million in 2023 to between 5.9 and 6.3 million by 2040, with the range reflecting differing assumptions on future migration trends. Importantly, the number of people aged 65 years and over will increase from 1 in 7 of the population in 2023 to 1 in 5 by 2040. This age group are particularly high users of hospital services, accounting for over 60 per cent of inpatient bed days in 2023.

Demand for services

  • Emergency Department attendances are projected to grow from 1.6 million in 2023, to between 2.0 and 2.1 million by 2040, growth of between 20 and 27 per cent.
  • Outpatient Department attendances are projected to grow from 4.6 million in 2023, to between 5.5 and 5.9 million by 2040, growth of between 21 and 28 per cent.
  • Day patient discharges are projected to grow from 1.2 million in 2023, to between 1.5 and 1.6 million by 2040, growth of between 25 and 37 per cent.
  • Inpatient discharges are projected to grow from 650k in 2023, to between 800k and 900k by 2040, growth of between 22 and 39 per cent.
  • Inpatient bed days are projected to increase from 3.9 million in 2023, to between 5.1 and 6.0 million in 2040, growth of between 32 and 55 per cent.

Bed requirements

  • Requirements for an additional 650 to 950 day patient beds by 2040 are projected, growth of between 25 and 37 per cent.
  • Requirements for an additional 4,400 to 6,800 inpatient beds by 2040 are projected, growth of between 40 and 60 per cent.

Policy implications

Even at the lower end of the projections, the report highlights the need for substantial additional capacity to meet increases in demand for hospital services by 2040. The analysis shows how different policy choices (e.g., reducing inpatient length of stay, waiting list management, etc.) can alter the projections, providing guidance to policymakers on appropriate policies. However, most of the projected growth arises from continued increases in the size and age of the population.

Dr Aoife Brick, Senior Research Officer at the ESRI and lead author of the report, said: "Our findings highlight significant future growth in demand for public acute hospital services, driven primarily by population growth and ageing. The report offers policymakers evidence on the scale of service expansion needed to meet future demand.”

Minister Jennifer Carroll MacNeill, TD, said: "This resource from the ESRI allows us to better anticipate future healthcare demand and capacity, ensuring our health system evolves to meet the needs of our changing population. I look forward to ongoing engagement with the ESRI and our colleagues in the HSE as we continue to develop and strengthen our future capacity plans.”