Sheelah Connolly

The Perceived Benefits of Participating in Voluntary Activities Among Older People: Do They Differ by Volunteer Characteristics?

Previous research has linked volunteering with a catalog of well-being indicators; however, it is unclear whether all volunteers derive the same benefit. The aim of this article is to examine the perceived benefits of volunteering among older people and to determine whether the benefits differ by volunteer characteristics. The study found that volunteers reported a wide range of benefits emerging from their volunteering, including increased socialization and self-worth. There was some evidence to suggest that benefits vary by volunteer characteristics with the older-old, the less educated, and the retired reporting the greatest benefit. In addition, different subgroups may benefit in different ways. Recognizing and responding to the potential benefits of volunteering to different groups is important in the recruitment and retention of volunteers.

The 2011 proposal for Universal Health Insurance in Ireland: potential implications for healthcare expenditure

The Irish healthcare system has long been criticised for a number of perceived weaknesses, including access to healthcare based on ability-to-pay rather than need. Consequently, in 2011, a newly elected government committed to the development of a universal, single-tier system based on need and financed through Universal Health Insurance (UHI). This article draws on the national and international evidence to identify the potential impact of the proposed model on healthcare expenditure in Ireland. Despite a pledge that health spending under UHI would be no greater than in the current predominantly tax-funded model, the available evidence is suggestive that the proposed model involving competing insurers would increase healthcare expenditure, in part due to an increase in administrative costs and profits. As a result the proposed model of UHI appears to be no longer on the political agenda. Although the Government has been criticised for abandoning its model of UHI, it has done so based on national and international evidence about the relatively high additional costs associated with this particular model.

Unmet healthcare needs in Ireland: Analysis using the EU-SILC survey

The analysis used the 2013 Survey of Income and Living Conditions to examine the extent and causes of unmet need for healthcare services in Ireland. The analysis found that almost four per cent of participants reported an unmet need for medical care. Overall, lower income groups, those with poorer health status and those without free primary care and/or private insurance were more likely to report an unmet healthcare need. The impact of income on the likelihood of reporting an unmet need was particularly strong for those without free primary care and/or private insurance, suggesting a role for the health system in eradicating income based inequalities in unmet need. Factors associated with the healthcare system - cost and waiting lists - accounted for the majority of unmet needs. Those with largely free public healthcare entitlement were more likely than all other eligibility categories to report that their unmet need was due to waiting lists (rather than cost). While not possible to explicitly examine in this analysis, it is probable that unmet need due to cost is picking up on the relatively high out-of-pocket payments for primary care for those who must pay for GP visits; while unmet need due to waiting is identifying the relatively long waiting times within the acute hospital sector for those within the public system.

A European late starter: lessons from the history of reform in Irish health care

The Irish health care system is unusual within Europe in not providing universal, equitable access to either primary or acute hospital care. The majority of the population pays out-of-pocket fees to access primary health care. Due to long waits for public hospital care, many purchase private health insurance, which facilitates faster access to public and private hospital services. The system has been the subject of much criticism and repeated reform attempts. Proposals in 2011 to develop a universal health care system, funded by Universal Health Insurance, were abandoned in 2015 largely due to cost concerns. Despite this experience, there remains strong political support for developing a universal health care system. By applying an historical institutionalist approach, the paper develops an understanding of why Ireland has been a European outlier. The aim of the paper is to identify and discuss issues that may arise in introducing a universal healthcare system to Ireland informed by an understanding of previous unsuccessful reform proposals. Challenges in system design faced by a late-starter country like Ireland, including overcoming stakeholder resistance, achieving clarity in the definition of universality and avoiding barriers to access, may be shared by countries whose universal systems have been compromised in the period of austerity.

Measuring healthcare expenditure: different methods, different results

BackgroundAccurate information on healthcare expenditure is essential; however, a number of issues arise when healthcare expenditure is being measured. Traditionally healthcare expenditure data in Ireland have been limited, especially data that facilitate comparable analysis through time and across particular programmes or services. Recently however, a major development in Irish healthcare expenditure estimates was the publication of Irish healthcare current expenditure estimates for 2013 according to the international standard of the OECD System of Health Accounts (SHA).AimsThe aim of the analysis presented in this paper is to examine how alternative methodologies for measuring healthcare can influence the estimate(s) of healthcare expenditure.MethodsThe methods and results (in terms of healthcare expenditure) of the Central Statistics Office (CSO) application of SHA methodology will be compared and contrasted with an alternative methodology for measuring healthcare expenditure developed by Wren et al. [1].ResultsThe two approaches to measuring healthcare expenditure in Ireland reached a very similar figure for total current healthcare expenditure in 2013. However, there were considerable disparities in the components of expenditure.ConclusionsThere is no one absolute definition or estimate of healthcare expenditure, and different methodological approaches to estimating expenditure will likely yield different results. Therefore, care is required when assessing healthcare expenditure to ensure that there is a clear understanding about what is and is not included in the estimate.

Economics of dementia: A review of methods

Given the expected increase in the number of people with dementia in the coming years, it is anticipated that the resources necessary to support those with dementia will significantly increase. There will therefore likely be increased emphasis on how best to use limited resources across a number of domains including prevention, diagnosis, treatment and supporting informal caregivers. There has been increasing use of economic methods in dementia in the past number of years, in particular, cost-of-illness analysis and economic evaluation. This paper reviews the aforementioned methods and identities a number of methodological issues that require development. Addressing these methodological issues will enhance the quality of economic analysis in dementia and provide some useful insights about the best use of limited resources for dementia.