New study shows large inequalities in the supply of health and social care across counties in Ireland

Download an infographic highlighting key findings from the research. 

There is an unequal supply of community health and social care across counties, with the greater Dublin Commuter Belt and the South East having the lowest supply of primary and community care in Ireland.

This is according to new research entitled Geographic Profile of Healthcare Needs and Non-Acute Healthcare Supply in Ireland published today by the Economic and Social Research Institute (ESRI) as part of a Health Research Board funded project. Findings suggest that areas with low supply of care should be targeted to increase supply provision.

Project Overview

The objective of this project is to provide evidence on the supply of care available in the community. This evidence could inform policies, such as Sláintecare, that aim to move care from acute hospitals to the community. This report examines the supply of 10 key non-acute services in Ireland in 2014: GPs, Community Nurses, Physiotherapists, Occupational Therapists, Speech & Language Therapists, Podiatrists, Counsellors and Psychologists, Social Workers, Nursing Home Beds, and Home Care Hours. The report compares supply across counties to the national average to identify counties where care supply is particularly scarce. The study adjusts results for healthcare need factors such as age, mortality, disability, and Medical Card holders.

Key Findings

Large inequalities existed for supply of all services examined in 2014, the year for which detailed data analysis was undertaken. In general, healthcare supply was not allocated according to population need. Given that Ireland has not introduced a system of resource allocation based on population need in the years since 2014, such inequalities are likely to persist.

Counties with the highest number of services with supply 10 per cent below the national average:

  • Kildare: 9 services;
  • Meath, Wicklow, and Wexford: 8 services;
  • Kilkenny, Waterford, Clare: 7 services;

Generally, counties in the West and South were less likely to have lower relative supply, though this was not consistent for all services. Supply inequalities remained after adjusting for a broad range of need measures.

Policy Implications

The findings suggest that without suitable resource allocation mechanisms, inequalities in healthcare supply could impede progress in implementing Sláintecare proposals, such as meeting more healthcare needs in the community and thereby reducing pressures on acute hospitals.

This report also shows the importance of accurate and timely collection of health and social care data. Establishing a consistent and systematic data infrastructure would improve the evidence base to inform the efficient and equitable allocation of health and social care resources in Ireland. As the population will grow and age at different rates across counties, policies are required to allocate supply according to need.

One of the authors of the report, Brendan Walsh stated:

“Quantifying supply at the local level is vital to inform policymakers about those areas where greater provision of care is required. The findings demonstrate that in the absence of a national resource allocation system that relates supply to population need, inequalities in the supply of health and social care could impede progress towards proposed Sláintecare policies.”