An analysis of the effects on Irish hospital care of the supply of care inside and outside the hospital

Abstract

The mission of the Economic and Social Research Institute is to advance evidencebased policymaking that supports economic sustainability and social progress in Ireland. ESRI researchers apply the highest standards of academic excellence to challenges facing policymakers, focusing on 12 areas of critical importance to 21st Century Ireland.The Institute was founded in 1960 by a group of senior civil servants led by Dr T.K. Whitaker, who identified the need for independent and in-depth research analysis to provide a robust evidence base for policymaking in Ireland.Since then, the Institute has remained committed to independent research and its work is free of any expressed ideology or political position. The Institute publishes all research reaching the appropriate academic standard, irrespective of its findings or who funds the research.The quality of its research output is guaranteed by a rigorous peer review process. ESRI researchers are experts in their fields and are committed to producing work that meets the highest academic standards and practices.The work of the Institute is disseminated widely in books, journal articles and reports. ESRI publications are available to download, free of charge, from its website. Additionally, ESRI staff communicates research findings at regular conferences and seminars.The ESRI is a company limited by guarantee, answerable to its members and governed by a Council, comprising 14 members who represent a cross-section of ESRI members from academia, civil services, state agencies, businesses and civil society. The Institute receives an annual grant-in-aid from the Department of Public Expenditure and Reform to support the scientific and public interest elements of the Institute's activities; the grant accounted for an average of 30 per cent of the Institute's income over the lifetime of the last Research Strategy. The remaining funding comes from research programmes supported by government departments and agencies, public bodies and competitive research programmes.

Projections of expenditure for public hospitals in Ireland, 2018–2035, based on the Hippocrates Model

“…An improved integration with post-acute hospital care could also reduce delayed discharges, allowing more hospital patients to be seen. Recent ESRI research has shown that hospital stays for older people are shorter in areas with better supply of home care and residential care services (Walsh et al, 2020b;Walsh et al, 2019). The flexibility of Hippocrates also allowed for analysis of the sensitivity of projected expenditures to assumed changes in public-sector pay policy.…”

Geographic profile of healthcare needs and non-acute healthcare supply in Ireland

“…First, there is a surprising lack of empirical analysis of the substitutability of acute and non-acute care and this needs to be addressed in order to inform policymakers tasked with implementing the goals set out in the current reform programme for Irish healthcare. Thus, this project seeks to contribute to the evidence base on the substitutability between acute and non-acute care (in Report 2 (Walsh et al, 2019b)). To further inform the debate on the transfer of care, there is need for information on what non-acute services are currently available, and how they are dispersed around the country, hence the focus of this report.…”

“…Acute care utilisation is a key part of the analyses in this project, so a more detailed description of acute public hospital services in Ireland is provided in the next report (Walsh et al, 2019b).…”

“…This report contributes to the evidence base on the supply of non-acute services around the country. A further report will analyse the interaction between acute and non-acute care in the Irish healthcare system and examine substitution effects between acute inpatient activity in public hospitals using the large administrative Hospital In-Patient Enquiry (HIPE) database, and non-acute supply indicators for long-term care (home care and long-term residential care) using administrative data from the Health Service Executive (HSE) and other sources (Walsh et al, 2019b). This second report will also reflect on the findings from both reports to make recommendations about how resource allocation could be improved within Irish health care services (Walsh et al, 2019b).…”

Developments in healthcare information systems in Ireland and internationally

“…To provide context in which to frame a discussion of the healthcare system data infrastructure in Ireland, we provide a brief overview of the healthcare system itself. A number of recent ESRI publications discuss some of the specific parts of the system in greater detail (Keane et al, 2021;Nolan et al, 2014;Smith et al, 2019;Walsh et al, 2019a;Walsh et al, 2019b;Wren and Fitzpatrick, 2020;.…”