The latest OECD comparison of health across much of the globe confirms healthier lifestyles, higher incomes and better education have all contributed to boost life expectancy in recent decades, with Ireland faring better than most on key headings.
Ireland’s progress is in spite of low levels of investment in health services compared to other developed countries and most EU members states, and having very low hospital bed numbers on a per capita basis.
The findings feature in the OECD’s evaluation of health care resources – Irish waiting list data was not included in the study which mostly relates to 2015.
Ireland is close to the bottom of the OECD table with 3.0 hospital beds per 1,000 population, compared to an OECD average of 4.7.
Ireland has 2.9 doctors per 1,000 population, which is below the average of 3.4, but fares better on the number of nurses at 11.9 per 1,000, compared to the average of 11.
Health spending per capita has grown at around 1.4 per cent annually since 2009, compared to 3.6 per cent in the six years up to 2009.
Average spending per capita has now reached about $4,000 per year. In Ireland, it has reached $5,528 per capita, ranking 70th in the world after countries including Greece, Costa Rica and Chile. Spending is highest in the US at $9,892 per person – 17.2 per cent of GDP though Canada has better “health status” from spending less money.
Health at a Glance 2017 concludes all OECD countries have seen life expectancy at birth increase by more than 10 years since 1970 to reach an average of 80.6 years.
Life expectancy at birth is highest in Japan (83.9 years), and Spain and Switzerland (83 years each), and lowest in Latvia (74.6) and Mexico (75). Ireland is close to the top of table with female life expectancy at 83.4 years, and male life expectancy at 79.6 years.
Under “quality of care,” Ireland has close to the highest rates of hospital admission due to asthma and chronic obstructive pulmonary disease, and is among the best performing states on deaths due to acute myocardial infarction and cases of obstetric trauma.
Its rate of prescribing antibiotics is higher than the OECD average, and below the average on recovery rates from colon cancer.
Low dementia rates
Under “health status” Ireland is close to the best performing countries in terms of low dementia rates (though this may be linked to having a younger population compared to other countries) and has low levels of deaths of due to ischemic heart disease.
On risk factors, Ireland has continued to make progress on daily smoking, alcohol consumption and obesity rates, though alcohol consumption at 10.9 litres a year per capita remains high and close to bottom of the OECD table.
While smoking rates continue to decline, there has been little success overall in tackling obesity and harmful alcohol use, and air pollution is often neglected, the report concludes.
Trinity College professor of population health medicine Joe Barry said the report was “a mixed bag” as far as Ireland was concerned; progress was being made on lifestyle risk factors, but health expenditure, notably on hospital beds, was low compared to other countries.
Comparisons between different health systems, and in particular hospital structures, were difficult to make in some instances, and this had to be taken into account in interpreting the findings, Prof Barry added.
Given the high cost of medicines and strong pharmaceutical sector in Ireland, he was surprised that the use of generics was so low.
He also noted low vaccination and cancer survival rates compared to other countries. On hospital care, he said there was moves to reduce hospital beds in many countries, but he added in Ireland the main problem was having “too many hospitals trying to do everything” with services concentrated on the east coast.
OECD analysis in the report suggests that if smoking rates and alcohol consumption were halved, life expectancies would rise by 13 months.
A 10 per cent increase in health spending per capita in real terms would, on average, boost life expectancy by 3.5 months, according to the OECD.
How resources are used makes the most difference in life expectancy, it concludes.
There is a large variation in the link between changes in health spending and in life expectancy: in the US, for example, health spending has increased much more than in other countries since 1995, yet life expectancy gains have been smaller.
