A Critical Evaluation Of Irelands Healthcare System Sample

Introduction : A Critical Evaluation Of Ireland’s Healthcare System

The effectiveness and efficiency of a nation's healthcare system can have a significant influence on a number of factors including life expectancy economic development, and overall standard of living. Using economic principles as a framework the objective of this essay is to critically evaluate Ireland's healthcare system. Understanding its operation the existing payment system the workings of the market and the ways in which these factors impact Irish health outcomes are the main objectives. Ireland's healthcare system has been praised and criticized over the years often being contrasted with other European models. Modern medical technology and highly qualified medical workers may be found in Ireland a developed country in the West. However, an analysis of the system's architecture has uncovered several intrinsic challenges that may compromise its effectiveness. In the sections that follow this essay will look at the basic economic components of the Irish healthcare model, highlighting both its benefits and drawbacks.

Health status of Ireland

Population and Demographics

When compared to other European nations Ireland's population is very youthful. Recent research indicates that over 40% of the population is less than 30 years old which presents both opportunities and challenges (Ivankovi? et al., 2022). Younger populations can result in a more dynamic labour force but they also call for investments in family support career options and education.

Disease Burden

Although the death rates from a number of major diseases have decreased in Ireland the nation still has to contend with diseases linked to a poor lifestyle such as diabetes heart disease and obesity (World Health Organization, 2020).

• Cardiovascular diseases
• Cancers
• Respiratory diseases
• Diabetes
• Mental health disorders
• Musculoskeletal conditions
• Chronic respiratory conditions
• Neurological disorders
• Infectious diseases
• Injuries

In addition to the rising prevalence of non-communicable diseases Ireland has problems with public health such as:

• Alcohol intake and the related health effects
• Mental health issues, particularly in the younger demographic
• Health issues associated with ageing brought on by an ageing population (Biswas et al., 2022)

Figure 1: Annual expenditure on healthcare in Ireland in 2011 to 2021

(Source: Statista, 2022)

Considering the status and challenges of the global economy, the nation's 5.6% unemployment rate is suitably low, indicating its positive aspects. It appears that most individuals of working age are employed, which is essential to the stability and growth of the economy. Ireland's health spending grew dramatically between 2011 and 2022, from 18.3 billion euros to 30.5 billion euros (Larkin et al., 2022). This ten-year rise in aspect shows how committed the country is on improving healthcare infrastructure, services, and accessibility.

 According to OECD (2022), the country's continued appropriateness for healthcare is demonstrated by the about 6.6% growth in spending on healthcare from 2021 to 2022. This growth may be attributed to rising demand, advancing technology, and inflationary pressures. Additionally, present spending has been shown to account for a sufficient percentage of healthcare spending in 2021—roughly 95%—and the nation must concentrate on meeting its medical demands and providing services. Moreover, it has been determined that there was a tripling of capital spending from 2012 to 2021. This increase in capital expenditures indicates large costs for new medical facilities, technology, and equipment as well as long-term healthcare infrastructure.

Healthcare structure of the Ireland

Ireland offers both public and private medical care to its inhabitants through a dual healthcare system.

Public Healthcare System

Regulation and Establishment:

Established under the Health Act of 2004, Ireland's public healthcare system is overseen by the Health Service Executive (HSE). The public healthcare system provides a variety of services, including inpatient and outpatient hospital treatment (International Trade Administration, 2022). Primary and acute care treatments are provided free of charge to holders of Category 1 medical cards. Diagnostic tests such as X-rays and lab work are provided at no cost to public patients. Spending and Budget: It is estimated that Ireland will spend €21 billion on health care in 2022 (Charlesworth et al., 2021). A large amount-roughly 78% is provided by the federal government, demonstrating its commitment to and importance for healthcare.

Private Healthcare System

Healthcare organizations and individual medical experts make up the private healthcare sector. In contrast to the public system patients typically pay the whole cost of services offered. Many Irish people choose private health insurance which can pay for a sizable amount of private medical bills to help with the costs of private healthcare (Irishlifehealth.ie, 2022). The private healthcare system is a valuable addition to the public one frequently enabling quicker access to specialists and specific procedures as well as services and luxuries that may not always be easily available in the public sector.

Implications

Approximately one million individuals are served by each area in Ireland. The provision of services extends beyond official bodies and encompasses a combination of public volunteer and private suppliers (Health.ec.europa.eu, 2021). The inclusion of a diversified assortment of professionals guarantees the availability of a broad spectrum of services and areas of expertise throughout the nation. The implementation of a dual system guarantees the provision of healthcare services to individuals of all backgrounds hence promoting accessibility (Ivankovi? et al., 2022). While the public system gives vital services at a reduced or free cost, the private system provides expedited and occasionally more specialised healthcare for individuals with the financial means to access it.

The coexistence of both systems has the potential to enhance the quality of healthcare, since each sector contributes its unique characteristics. The healthcare sector has a wide range of economic effects. On the other hand, the public system is essential to ensuring broad coverage. However the private sector also significantly boosts the economy with its array of services (Riordan et al., 2021). One of the challenges is striking a careful balance between the two systems to prevent public healthcare's accessibility and quality from suffering in contrast to private healthcare (Kentikelenis and Stubbs, 2021).

Ireland's healthcare system is unique in that it has two distinct components: public and private healthcare services. The public healthcare system is administered by the Health Service Executive (HSE). In 2022, the nation allotted €21 billion for health, with the primary objectives being to decrease acute hospital waiting list backlogs and improve the assistance provided to those with disabilities (Thomas, Poku-Amanfo and Patel, 2022). Furthermore, one of the administration's top priorities for women's healthcare services is the provision of free contraception.

Despite Ireland's sizable population, behavioural risk factors such as obesity and smoking should nevertheless be taken seriously (Hruby and Hu, 2015). The capacity to receive treatment may be hampered by financial limitations and protracted waiting times even though healthcare quality is normally high. Acute care, primary care, continuing care, and community care services are some of the components that make up the healthcare system. Numerous health-related issues, including mental health, disabilities, and family welfare, are addressed by these services (World Health Organization (WHO), 2022). In order to provide healthcare services, both public and private healthcare providers are essential.

The healthcare infrastructure in Ireland comprises a combination of publicly and privately owned hospitals whereas public hospitals cater to patients from both the public and private sectors. Upon admittance to public hospitals patients are presented with the choice to pick for either public or private treatment alternatives (Colombo and Tapay, 2021). There are 48 publicly supported hospitals in the country, divided into seven different hospital groups. Furthermore, the Private Hospital Association (PHA) has affiliations with twenty-one privately operated hospitals. In Ireland, there will be three hospital beds for every 1,000 people in 2021 (HMI, 2023). As cited by Stepovic et al., (2020), in 2020, the GDP share of overall health spending was 7.2%, little less than the 9.9% average for the EU.

The aim of the Sláintecare Implementation Strategy and Action Plan 2021-2023 was to replace Ireland's current two-tier healthcare system with a universal healthcare model akin to the National Health Service (NHS) in the United Kingdom. It was revealed in May 2021. The plan aims to improve overall results reduce healthcare costs and maximise the experiences of both patients and clinicians. Based on information provided by Collins and Homeniuk (2021) on the Irish College of General Practitioners (ICGP) there are an estimated 3,496 general practitioners now practicing in Ireland and there are strong connections between the Irish and American healthcare systems.

Health market of Ireland

Figure 2: Revenue in the Health Care market

(Source: Statista, 2022)

The projected estimation of the healthcare industry in Ireland is observed to be 14.85% between the years 2023 and 2027. Furthermore government has been focusing in to attain a market value of US$115.40m by the end of 2027 (Statista, 2022). According to forecasts of Ibisworld (2023) it is observed that the healthcare ecommerce sector in Ireland will generate revenues of US$66.3m by the year 2023. This projection has been indicating a growth rate of 9% compared to the previous year.

According to the 2022 World Index of Healthcare Innovation, Ireland has its ascending from its previous rankings of 4th in 2021 and 5th in 2020 and it has to secure the 2nd spot. The score of the nation under consideration was recorded as 60.04 and with Switzerland being the only country to get a higher score of 66.56 (Kelly and Young, 2017).

The principal source of financial support for the healthcare system in Ireland is derived from the government. Furthermore the company has been deriving from voluntary healthcare contributions and household expenditures with a substantial proportion going towards hospitals and ambulatory healthcare services. The adequate use of health insurance in Ireland has been rising (Cawley et al., 2021). In the year of 2021, the number of individuals receiving health insurance reached 2.4 million and it has been representing approximately 47.1% of the total population. It is to be noted that a significant proportion approximately 40% of the population in Ireland has been getting medical services without incurring any direct expenses through the utilisation of the Category 1 or "Irish Medical Card" aspect.

Healthcare funding provided by Ireland government

Ireland's healthcare spending was impacted by the global financial crisis in 2008. Proactive steps have been taken by the government and administration to attain economic stability and lessen the complexity of the problem. All of the healthcare industry's sectors have received the same amount of budget reduction. However, an imbalance in the proportion of nurses to doctors and other healthcare professionals has been identified by the government (Nolan et al., 2020). As a result, the funding cuts had a greater negative impact on nurses and midwives.

There was a significant decrease in the allocation of capital expenditure towards the healthcare sector and it has resulted in a direct impact on the infrastructure and developmental capacities of the healthcare system. The observed decline aligns with the prevailing governmental tendency to curtail diverse functions after a disaster.

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The recurring pattern of healthcare expenditure has been declining during periods of economic recession has prompted concerns over the availability of healthcare services particularly for socioeconomically disadvantaged populations (Teja et al., 2020). Concerns over the potential loss of economic disparities and the potential detriment to the welfare of less affluent households due to these expenditure trends.

The increase in private health insurance contributions towards healthcare finance has observed as the government faced the challenges of the financial crisis and explored strategies to restrict public expenditure. As cited by Sánchez Recio et al., (2022), the increase in demand can also be attributed to the implementation of prescription charges for those with medical cards which has been decreasing in dental care benefits for this population and the imposition of elevated user fees for various outpatient services.

The amount of money contributed by the private sector to the healthcare industry peaked in 2013 and has since accounted for about 30% of all costs (Smith et al., 2021). Additionally by 2019 the previously mentioned share had decreased by 4 percentage points as the economy has been doing better.

In the five years prior to the start of the pandemic the stability of household out-of-pocket expenditures in relation to healthcare costs has shown nominal yearly rise of less than 1%. The Pandemic's Effect on "Private Health Financing" In comparison to a number of other nations in the Organization for Economic Co-operation and Development (OECD) the financial burden on individuals in this setting is relatively smaller indicating a reduced degree of financial strain (Gori and Luppi, 2022). The COVID-19 epidemic has brought forth a number of challenges that have made the state's engagement in health funding more necessary. In addition, the percentage of private contributions decreased even further (Filip et al., 2022).

Models for healthcare funding in Ireland

The healthcare finance system in Ireland is intricate and integrates both public and private funding sources. These methods are designed to ensure that people have access to essential medical care while also taking their budget into account. The Irish government largely uses general taxes to fund the majority of healthcare services delivered by the Health Service Executive (HSE), providing a tax-based financial foundation for this system (Connolly and Wren, 2019). This approach guarantees a comprehensive and diverse revenue stream to meet different healthcare requirements.

Although the public healthcare system's primary objective is to provide comprehensive coverage co-payments such as outpatient prescription costs are not usually required. Ireland's commitment to guaranteeing equitable access to healthcare services is demonstrated by the introduction of the medical card system in that country (Connolly, 2023). It guarantees that those who qualify can receive a range of healthcare services at no cost preventing financial constraints from preventing them from receiving the essential medical care.

As an adjunct to the public healthcare system, voluntary health insurance enables individuals to access private healthcare providers' expedited medical care and specialised consultations in both public and private settings. Levies on health insurance have been put in place to try and provide equity and consistent premium costs for all policyholders (Domapielle, Akurugu and Derbile, 2021). However, the implementation of these procedures there continues to be a prevalence of out-of-pocket expenditures for diverse healthcare services including consultations with primary care physician’s dental treatments and certain pharmaceuticals. The approach aims to achieve a harmonious equilibrium between cost-sharing and the prevention of financial deterrents that may dissuade individuals from seeking essential medical care. Alongside public and private funding charitable contributions and individual gifts have a significant impact. These contributions play a crucial role in providing essential support for certain medical programmers and research endeavors.

The government continues to priorities capital investment as seen by its inclusion of healthcare infrastructure development plans in the National Development Plan (Adshead et al., 2019). The investments encompass the establishment of novel healthcare facilities improvements to pre-existing ones and the procurement of cutting-edge medical technology with the aim of augmenting the caliber of healthcare services. In addition, it is worth noting that Ireland's healthcare initiatives might potentially secure financial support from the European Union thereby emphasizing the nation's dedication to enhancing its healthcare sector through international cooperation and financial resources.

The central focus of healthcare financing in Ireland is around the Sláintecare plan a comprehensive initiative aimed at transitioning the country towards a universal healthcare system (Burke et al., 2021). This plan envisions a healthcare model wherein the funding for access to care is predominantly derived from general taxes. The primary objective is to guarantee the equal distribution of healthcare services prioritizing need over an individual's financial means. This objective aligns with the larger purpose of providing accessible healthcare to all members of society.

Systems for procuring healthcare services

The cornerstone of healthcare procurement in Ireland is the Health Service Executive (HSE) which is in charge of the careful acquisition of supplies and services that support the provision of social and health care services (Sheerin, 2019). Privacyshield.gov, (2022) depicted that since the HSE is the nation's largest buyer with an annual procurement budget of almost €4 billion procurement practices must be strict and heavily regulated within the parameters of intricate EU and national laws.

The HSE's procurement goals are centered on its steadfast dedication to ensuring the continuous provision of healthcare services (World Health Organization. Regional Office for Europe et al., 2019). This entails making certain that premium products and services are available exactly when and where they are required. In order to uphold the highest levels of ethics and openness the HSE carefully complies with all legal requirements legislative directives circulars and procurement directives. Compliance and governance are of utmost importance (Jeebhay et al., 2023).

A major component of the HSE's procurement strategy is value for money. Making every euro spent on healthcare procurement matter is the aim in order to reduce costs and reallocate funds to better patient care and services. Strategic and coordinated purchasing practices that increase compliance and efficiency are required under this approach. In addition, the HSE is aware of how procurement may advance social economic and environmental goals (Manutan, 2022). This involves encouraging social inclusion supporting innovation adhering to environmentally conscious practices and encouraging small and medium-sized businesses (SMEs) to actively participate in the procurement process.

The HSE manages a suite of shared services capabilities that control the whole procurement lifecycle in order to expedite these crucial procurement endeavors. These functions which range from sourcing and contracting to corporate procurement planning, logistics and inventory management, compliance enhancement and business systems support altogether guarantee that Ireland's healthcare procurement process is not only effective but also in line with the larger objectives of social cohesion economic expansion and environmental sustainability (Swords, 2021). In the end this contributes to the ongoing improvement of healthcare services throughout the country. Planning for Corporate Procurement and Enhancing Compliance. In addition to managing procurement relationships improving compliance and building capabilities and capacities across a range of healthcare entities including Hospital Groups Community Healthcare Organizations (CHOs) Section 38 and 39 Agencies and Corporate Services this unit also coordinates multi-annual procurement planning (Stepovic et al., 2020).

Economic evaluation of certain interventions including mental health in Ireland

Economic analyses of mental health therapies should be available to decision-makers since they provide important insights into the relative costs of various treatment alternatives. These evaluations are particularly crucial in Ireland, where mental health problems have a significant financial impact and cost the nation €11 billion annually. This financial burden is mostly the result of decreased labour market productivity, which emphasises the importance of good and efficient mental health therapy.

An important study in this area indicates that there is a 0.77 probability that an early intervention would be cost-effective which means that it will most likely have a favourable cost-benefit ratio (Jeebhay et al., 2023). This means that if a treatment programmer costs less than €45,000 for every QALY attained it is considered cost-effective. Non-pharmacological therapies are subject to a different cost-effectiveness threshold. Various psychological therapies and other forms of mental health care are examples of non-drug interventions. In this case, the barrier typically ranges from €20,000 to €45,000 per QALY. These are the spectrum of non-drug interventions that are most cost-effective (McGrath et al., 2022).

These thresholds are crucial for determining which healthcare interventions to use and when. They assist legislators and healthcare professionals in assessing the financial viability of various mental health programmed and help choose the most efficient method to allocate resources (Funk et al., 2008). Economic evaluations and consideration of these criteria can help Ireland effectively manage healthcare spending enhance the well-being of its citizens and solve the social and economic issues brought on by mental health disorders (Thomas and Chalkidou, 2016).

The scope of health interventions covered by Ireland's Health Technology Assessment (HTA) framework-based economic evaluation guidelines for medical technology has grown over time. These guidelines provide a comprehensive and empirically based approach to assess the advantages and disadvantages of various healthcare technology such as public health campaigns, diagnostic tools, and prescription medications.

Healthcare distribution and equity in Ireland

Public health and social justice intersect with healthcare equity and distribution. Fundamentally the distribution of medical resources services and benefits among a population is the focus of healthcare distribution. This entails assessing the infrastructure such as clinics and hospitals that is available and making sure that medical professionals such as nurses and doctors are distributed appropriately. Assessments are guaranteed to be in accordance with the Irish healthcare environment by the Health Service Executive (HSE), speaking on behalf of the publicly financed health and social care system. Moreover, taking into account both the length and standard of living The suggested outcome metric that captures the overall effect of treatments is quality-adjusted life years (QALY). Both deterministic and probabilistic sensitivity studies are performed in order to reduce evaluation uncertainty. Furthermore, the commitment to justice and fairness in outcome measures ensures that medical interventions benefit all populations. Ireland's dedication to comprehensive and inclusive economic studies is reflected in these proposals which will eventually assist the healthcare sector in making well-informed decisions. 

Figure 3: Status of the health information system in Ireland

(Source: Statista, 2022)

Distribution on its own is inadequate; distribution quality is vital. (Carroll et al., 2021). At that time equity becomes important. The specific needs of each patient should dictate access to medical care, not irrelevant factors like gender, color, income, or area of residence.

For example, the requirements of the residents in rural areas are just as important as those in urban areas, despite the fact that there may be fewer healthcare services there. Historically marginalised people may have comparable institutional impediments to healthcare it is morally and practically imperative to remove these obstacles (Carroll et al., 2021). The system faces the risk of worsening health outcomes for the general public and escalating health inequities if these gaps are not filled. Illnesses or disorders that go untreated can also result in increased long-term healthcare costs and decreased economic productivity. Thus in addition to being a question of justice tackling healthcare equity also makes sense from an economic and policy perspective. Achieving this aim will require a variety of tactics, such as community involvement programmed universal health care, and continual data collection to monitor disparities (Biswas et al., 2022).

Health outcomes and performance

Life Expectancy: Women's life expectancy in Ireland is 84.4 years while men's life expectancy is 80.8 years (Statista, 2023). This demonstrates how healthcare services have improved and how the burden of sickness has decreased in many locations.

Morbidity and Mortality Rates: Notably lower death rates from diseases such as cancer heart disease stroke and respiratory disorders point to successful medical treatments. But as said compared to other European peers the death rate from disorders of the respiratory system including various malignancies is noticeably greater.

Years of Life Lost (YLL): YLL is a statistic used to calculate early death. It can be assumed that the YLL has decreased in Ireland given the dropping rates of early mortality from major diseases. Even said conditions with greater death rates such as respiratory system disorders, may still play a major role in YLL (Vít?zslav Ji?ík et al., 2023).

Quality of Life: 82.1% of Irish people consider their health to be good or very good reflecting the majority's favourable perception of their health (Colwell, 2021). A good quality of life in terms of health is reflected in this high self-perceived health status. The disparity in health perception according to income however suggests that health-related quality of life may differ among various socioeconomic groups (Wallander et al., 2019).

Figure 4: Causes of death in ireland

(Source: Cso.ie, 2022)

2,343 deaths and 1.8 per 1,000 were attributed to circulatory system diseases which include heart and blood vessel disorders (WHO, 2021). The majority of these deaths 1,065 were caused by ischemic heart disease (IHD) that is characterised by a reduced blood supply to the heart muscle and is frequently the result of coronary artery diseases. 373 deaths were attributed to cerebrovascular diseases that are mainly conditions like strokes that result from problems with blood supply to the brain.

Ireland has adequately small and highly educated and competent labour force and it has its population of 5.0 million (Wright, 2022). The population size has been allowing the country for more flexible and focused policy actions in the economic and public health domains. An adequate economy has been indicating by a GDP that is Purchasing Power Parity of $566.7 billion (Imf.org, 2019). It has been suggesting high degree of economic output and a rich economy especially considering Ireland's small population.

Performance and health outcomes are important measures of how effective a healthcare system. Numerous factors, including lifestyle decisions and structural investments, impact health outcomes in Ireland. Ireland has one of the greatest life expectancies in the EU. The life expectancy at birth was approximately 82 years, which was longer than the EU average in the early 2020s (Ceeol, 2021). This indicates better living standards better healthcare and a decline in the number of mortality from serious illnesses.

Syndromes related to the heart: Although cardiovascular disorders including ischemic heart disease continue to be the primary cause of death the mortality rates from these conditions have declined over time due to advancements in treatment and preventive measures (Jansen et al., 2022). The death rates from the disease have shown a variety of trends, with improvements in detection and treatment being associated with higher survival rates for some types of the disease, such as breast cancer.

Drinking Alcohol: Ireland has one of the highest rates of alcohol consumption in the EU, which has an impact on chronic illnesses and public health issues (HMI, 2023). Treatment for diseases like diabetes and heart disease may become more challenging if obesity rates rise. Access issues have arisen despite the generally good service provided by Ireland's healthcare system. The length of wait times in the public healthcare system has drawn criticism, especially for some procedures and treatments (Connolly and Wren, 2019).

Programmed such as Sláintecare have been implemented to tackle these issues by giving priority to prompt access to high-quality healthcare services, regardless of financial capacity. Increased funding and awareness have led to a greater focus on mental health. However, issues persist, particularly with regard to prompt access to care and assistance. Ireland still spends less on health care per GDP than the EU average, despite historical fluctuations.

Ireland has put a lot of effort into improving the quality and safety of medical care in recent years (Colombo and Tapay, 2021). This includes taking steps to improve patient satisfaction decrease the occurrence of hospital-acquired infections, and raise the bar for care in both community and hospital settings.

While most patients are satisfied with the quality of care they receive surveys often indicate that concerns about wait times and accessibility persist (Collins and Homeniuk, 2021).

Recommendations

Coordinated Care:

Enhancing integrated care routes between primary secondary and community health facilities is recommended. This can guarantee more seamless patient transfers and lessen the need for emergency hospital services (Irishlifehealth.ie, 2022). Prompt interventions reduced duplication of services and increased patient satisfaction are all ensured by a well-organized care route.

Digital Conversion:

It is recommended to give telemedicine and e-health solutions top priority. These online therapies might work well in Ireland's rural locations and in circumstances where in-person sessions present difficulties. Since the COVID-19 pandemic digital health technology has been widely accepted and well-prepared (Connolly and Wren, 2019).

Health Promotion Initiatives:

It is advised to put into place and grow programmes that forbid smoking and binge drinking and encourage a balanced diet and frequent exercise (Privacyshield.gov, 2022). Take strong action to address behavioural risk factors in order to save the expense of chronic illnesses and achieve major long-term health benefits.

Putting Money into Mental Health:

More funding for mental health services is recommended with an emphasis on community-based resources and early intervention (McGrath et al., 2022). In Ireland, the public's understanding of mental health concerns is rising. Better outcomes and lower long-term healthcare costs can result from early intervention.

Conclusion

Ireland is a relatively young country, with almost 40% of its population under 30. Being youthful provides benefits for a dynamic workforce, but it also entails investing in things like family support education and employment possibilities. The country faces challenges in treating diseases including obesity diabetes and heart disease that are linked to certain lifestyle choices. Numerous medical service such as community care acute care primary care, and continuing care, are provided by Ireland's healthcare system. This all-encompassing strategy targets a range of health issues including mental health and family welfare and includes both public and private healthcare providers. The industry supports the government system.

The coexistence of the two systems boosts the economy by creating jobs luring medical tourists and improving the standard and accessibility of healthcare in general. The healthcare system in Ireland is renowned for its high capital expenditures and recent sharp increases in healthcare expenses. The government's commitment to improving accessibility and care quality is reflected in its emphasis on developing the healthcare infrastructure.

References

• Adshead, D., Thacker, S., Fuldauer, L.I. & Hall, J.W. (2019). Delivering on the Sustainable Development Goals through long-term infrastructure planning. Global Environmental Change, 59(16), p.101975. doi:https://doi.org/10.1016/j.gloenvcha.2019.101975.
• Biswas, T., Townsend, N., Huda, M.M., Maravilla, J., Begum, T., Pervin, S., Ghosh, A., Mahumud, R.A., Islam, S., Anwar, N., Rifhat, R., Munir, K., Gupta, R.D., Renzaho, A.M.N., Khusun, H., Wiradnyani, L.A.A., Radel, T., Baxter, J., Rawal, L.B. & McIntyre, D. (2022). Prevalence of multiple non-communicable diseases risk factors among adolescents in 140 countries: A population-based study. eClinicalMedicine, 52(5), p.101591. doi:https://doi.org/10.1016/j.eclinm.2022.101591.
• Burke, S., Parker, S., Fleming, P., Barry, S. & Thomas, S. (2021). Building health system resilience through policy development in response to COVID-19 in Ireland: From shock to reform. The Lancet Regional Health - Europe, 9(15), p.100223. doi:https://doi.org/10.1016/j.lanepe.2021.100223.
• Carroll, C., Evans, K., Elmusharaf, K., O’Donnell, P., Dee, A., O’Donovan, D. & Casey, M. (2021). A review of the inclusion of equity stratifiers for the measurement of health inequalities within health & social care data collections in Ireland. BMC Public Health, 21(1). doi:https://doi.org/10.1186/s12889-021-11717-5.
• Cawley, J., Biener, A., Meyerhoefer, C., Ding, Y., Zvenyach, T., Smolarz, B.G. & Ramasamy, A. (2021). Direct medical costs of obesity in the United States & the most populous states. Journal of Managed Care & Specialty Pharmacy, 27(3), pp.354–366. doi:https://doi.org/10.18553/jmcp.2021.20410.
• Ceeol (2021). Sustainable Development: Trends in Ukraine & the World. Journal of Environmental Management & Tourism (JEMT), [online] XII(05(53)), pp.1179–1187. Available at: https://www.ceeol.com/search/article-detail?id=1015720 [Accessed 27 Oct. 2023].
• Charlesworth, A., Anderson, M., Donaldson, C., Johnson, P., Knapp, M., McGuire, A., McKee, M., Mossialos, E., Smith, P., Street, A. & Woods, M. (2021). What is the right level of spending needed for health & care in the UK? The Lancet, 397(10288), pp.2012–2022. doi:https://doi.org/10.1016/s0140-6736(21)00230-0.
• Collins, C. & Homeniuk, R. (2021). How many general practice consultations occur in Ireland annually? Cross-sectional data from a survey of general practices. BMC Family Practice, 22(1). doi:https://doi.org/10.1186/s12875-021-01377-0.
• Colombo, F. & Tapay, N. (2021). Private Health Insurance in Ireland: A Case Study Francesca Colombo & Nicole Tapay . [online] Available at: https://www.oecd.org/health/health-systems/29157620.pdf.
• Colwell, R. (2021). World Health Survey: Over half of all young adults in Ireland feeling regularly stressed. [online] RedC Research & Marketing. Available at: https://www.redcresearch.com/world-health-survey-over-half-of-all-young-adults-in-ireland-feeling-regularly-stressed/ [Accessed 27 Oct. 2023].
• Connolly, S. & Wren, M.-A. (2019). Universal Health Care in Ireland—What Are the Prospects for Reform? Health Systems & Reform, [online] 5(2), pp.94–99. doi:https://doi.org/10.1080/23288604.2018.1551700.
• Connolly, S. (2023). Improving access to healthcare in Ireland: an implementation failure. Health Economics, Policy, & Law, [online] 11(9), pp.1–11. doi:https://doi.org/10.1017/S1744133123000130.
• Domapielle, M.K., Akurugu, C.A. & Derbile, E.K. (2021). Vertical equity in access to health insurance services: An exploration of perceptions & enrolment in the Jirapa Municipality, north-western Ghana. Journal of Planning & Land Management, 2(1), pp.1–12. doi:https://doi.org/10.36005/jplm.v2i1.28.
• Filip, R., Gheorghita Puscaselu, R., Anchidin-Norocel, L., Dimian, M. & Savage, W.K. (2022). Global Challenges to Public Health Care Systems during the COVID-19 Pandemic: a Review of Pandemic Measures & Problems. Journal of Personalized Medicine, 12(8), p.1295. doi:https://doi.org/10.3390/jpm12081295.
• Funk, M., Saraceno, B., Drew, N. & Faydi, E. (2008). Integrating mental health into primary healthcare. Mental health in family medicine, [online] 5(1), pp.5–8. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2777555/.
• Gori, C. & Luppi, M. (2022). Cost-containment long-term care policies for older people across the Organisation for Economic Co-operation & Development (OECD): a scoping review. Ageing & Society, pp.1–24. doi:https://doi.org/10.1017/s0144686x22001076.
• Health.ec.europa.eu (2021). State of Health in the EU. [online] Available at: https://health.ec.europa.eu/system/files/2021-12/2021_chp_ir_english.pdf.
• HMI (2023). Ireland may have 1,000 bed capacity deficit in public hospitals. [online] Health Manager. Available at: https://healthmanager.ie/2023/06/ireland-may-have-1000-bed-capacity-deficit-in-public-hospitals/ [Accessed 27 Oct. 2023].