Geographic inequalities in non-acute healthcare supply: evidence from Ireland [version 1; peer review: 1 approved, 2 approved with reservations]
Background: Recent reforms in Ireland, as outlined in Sláintecare, the report of the cross-party parliamentary committee on health, are focused on shifting from a hospital-centric system to one where non-acute care plays a more central role. However, these reforms were embarked on in the absence of...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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F1000 Research Ltd
2021-10-01
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| Series: | HRB Open Research |
| Subjects: | |
| Online Access: | https://hrbopenresearch.org/articles/4-111/v1 |
| _version_ | 1811249775486435328 |
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| author | Samantha Smith Brendan Walsh Edgar Morgenroth Maev-Ann Wren Steve Barron Seán Lyons James Eighan |
| author_facet | Samantha Smith Brendan Walsh Edgar Morgenroth Maev-Ann Wren Steve Barron Seán Lyons James Eighan |
| author_sort | Samantha Smith |
| collection | DOAJ |
| description | Background: Recent reforms in Ireland, as outlined in Sláintecare, the report of the cross-party parliamentary committee on health, are focused on shifting from a hospital-centric system to one where non-acute care plays a more central role. However, these reforms were embarked on in the absence of timely and accurate information about the capacity of non-acute care to take on a more central role in the system. To help address this gap, this paper outlines the most comprehensive analysis to date of geographic inequalities in non-acute care supply in Ireland. Methods: Data on the supply of 10 non-acute services including primary care, allied health, and care for older people, were collated. Per capita supply for each service is described for 28 counties in Ireland (Tipperary and Dublin divided into North and South), using 2014 supply and population data. To examine inequity in the geographic distribution of services, raw population in each county was adjusted for a range of needs indicators. Results: The findings show considerable geographic inequalities across counties in the supply of non-acute care. Some counties had low levels of supply of several types of non-acute care. The findings remain largely unchanged after adjusting for need, suggesting that the unequal patterns of supply are also inequitable. Conclusions: In the context of population changes and the influence of non-need factors, the persistence of historical budgeting in Ireland has led to considerable geographic inequities in non-acute supply, with important lessons for Ireland and for other countries. Such inequities come into sharp relief in the context of COVID-19, where non-acute supply plays a crucial role in ensuring that acute services are preserved for treating acutely ill patients. |
| first_indexed | 2024-04-12T15:52:28Z |
| format | Article |
| id | doaj.art-01a03e7c6f8c4b70baddcb6afc3022cc |
| institution | Directory Open Access Journal |
| issn | 2515-4826 |
| language | English |
| last_indexed | 2024-04-12T15:52:28Z |
| publishDate | 2021-10-01 |
| publisher | F1000 Research Ltd |
| record_format | Article |
| series | HRB Open Research |
| spelling | doaj.art-01a03e7c6f8c4b70baddcb6afc3022cc2022-12-22T03:26:27ZengF1000 Research LtdHRB Open Research2515-48262021-10-01414612Geographic inequalities in non-acute healthcare supply: evidence from Ireland [version 1; peer review: 1 approved, 2 approved with reservations]Samantha Smith0https://orcid.org/0000-0002-4513-5916Brendan Walsh1Edgar Morgenroth2https://orcid.org/0000-0002-9442-0561Maev-Ann Wren3Steve Barron4Seán Lyons5https://orcid.org/0000-0002-3526-6947James Eighan6Centre for Health Policy and Management, Trinity College Dublin, Dublin 2, IrelandEconomic and Social Research Institute, Sir John Rogerson's Quary, Whitaker Square, Dublin 2, IrelandDCU Business School, Dublin City University, Dublin 9, IrelandEconomic and Social Research Institute, Sir John Rogerson's Quary, Whitaker Square, Dublin 2, IrelandUniversity College Dublin, Dublin 4, IrelandEconomic and Social Research Institute, Sir John Rogerson's Quary, Whitaker Square, Dublin 2, IrelandIndecon, Indecon House, Dublin 4, IrelandBackground: Recent reforms in Ireland, as outlined in Sláintecare, the report of the cross-party parliamentary committee on health, are focused on shifting from a hospital-centric system to one where non-acute care plays a more central role. However, these reforms were embarked on in the absence of timely and accurate information about the capacity of non-acute care to take on a more central role in the system. To help address this gap, this paper outlines the most comprehensive analysis to date of geographic inequalities in non-acute care supply in Ireland. Methods: Data on the supply of 10 non-acute services including primary care, allied health, and care for older people, were collated. Per capita supply for each service is described for 28 counties in Ireland (Tipperary and Dublin divided into North and South), using 2014 supply and population data. To examine inequity in the geographic distribution of services, raw population in each county was adjusted for a range of needs indicators. Results: The findings show considerable geographic inequalities across counties in the supply of non-acute care. Some counties had low levels of supply of several types of non-acute care. The findings remain largely unchanged after adjusting for need, suggesting that the unequal patterns of supply are also inequitable. Conclusions: In the context of population changes and the influence of non-need factors, the persistence of historical budgeting in Ireland has led to considerable geographic inequities in non-acute supply, with important lessons for Ireland and for other countries. Such inequities come into sharp relief in the context of COVID-19, where non-acute supply plays a crucial role in ensuring that acute services are preserved for treating acutely ill patients.https://hrbopenresearch.org/articles/4-111/v1geographic inequalities geographic inequity non-acute care primary & community care historical budgeting Irelandeng |
| spellingShingle | Samantha Smith Brendan Walsh Edgar Morgenroth Maev-Ann Wren Steve Barron Seán Lyons James Eighan Geographic inequalities in non-acute healthcare supply: evidence from Ireland [version 1; peer review: 1 approved, 2 approved with reservations] HRB Open Research geographic inequalities geographic inequity non-acute care primary & community care historical budgeting Ireland eng |
| title | Geographic inequalities in non-acute healthcare supply: evidence from Ireland [version 1; peer review: 1 approved, 2 approved with reservations] |
| title_full | Geographic inequalities in non-acute healthcare supply: evidence from Ireland [version 1; peer review: 1 approved, 2 approved with reservations] |
| title_fullStr | Geographic inequalities in non-acute healthcare supply: evidence from Ireland [version 1; peer review: 1 approved, 2 approved with reservations] |
| title_full_unstemmed | Geographic inequalities in non-acute healthcare supply: evidence from Ireland [version 1; peer review: 1 approved, 2 approved with reservations] |
| title_short | Geographic inequalities in non-acute healthcare supply: evidence from Ireland [version 1; peer review: 1 approved, 2 approved with reservations] |
| title_sort | geographic inequalities in non acute healthcare supply evidence from ireland version 1 peer review 1 approved 2 approved with reservations |
| topic | geographic inequalities geographic inequity non-acute care primary & community care historical budgeting Ireland eng |
| url | https://hrbopenresearch.org/articles/4-111/v1 |
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