There are a range of additional direct healthcare costs associated with VI and blindness that have not been identified above. These include the costs of outpatient expenditure, residential care, and community care.
Health care expenditure data for these services and people with eye conditions could not be identified for the ROI. The best proxy data were identified within ROI health care expenditure statistics for 2004, which report non-capital expenditure on the Disability Programme; specifically for ‘assessment and care of the visually impaired’, non-capital expenditure was €12.22 million (DOHC, 2005). Since the reorganisation of the Irish health care system in 2004, expenditure for the previous Department of Health and Children budget categories (including the Disability Programme) have not been reported, and the 2004 data therefore represent the most recent estimates.
It is assumed that non-capital Disability Programme expenditure on the vision impaired includes a large proportion of health care expenditure remaining after accounting for hospital, prescription drug, and general ophthalmic service expenditure above. Unfortunately, the Disability Programme data are not reported by condition associated with VI and therefore no breakdown by condition could be estimated.
Population growth from 2004 onwards (CSO, 2008; 2010b) was applied to non-capital expenditure on the ‘assessment and care of the visually impaired’ (DOHC, 2005) to estimate non-capital expenditure in 2010, 2015 and 2020 (Table 3.9).
Non-capital expenditure was scaled up to account for capital expenditure. In 2003, non-capital expenditure on the Disability Programme (including ‘assessment and care of the visually impaired’ and all other patient categories) was €1.16 billion, and capital expenditure on the Disability Programme was €40.26 million (DOHC, 2005). The ratio of capital to non-capital expenditure on the Disability Programme in 2003 (0.03) was applied to estimated non-capital expenditure on ‘assessment and care of the visually impaired’ in 2010, 2015 and 2020, assuming that (1) the ratio is similar for the ‘assessment and care of the visually impaired’ and the overall Disability Programme, and (2) the ratio would remain constant in the future.
Estimates of capital and non-capital expenditure on ‘assessment and care of the visually impaired’ in 2010, 2015 and 2020 are presented in Table 3.9. Total expenditure on ‘assessment and care of the visually impaired’ was estimated to be nearly €14.4 million in 2010, and is projected to rise to €16.8 million by 2020.
Table 3.9: Estimated expenditure on ‘assessment and care of the visually impaired’
| 2010 | 2015 | 2020 | |
|---|---|---|---|
| Population growth 2004 | 13.5% | 23.9% | 33.0% |
| Non-capital expenditure (a) | €13,874,561 | €15,141,971 | €16,256,617 |
| Capital expenditure (b) | €483,220 | €527,361 | €566,181 |
| Total expenditure | €14,357,781 | €15,669,332 | €16,822,798 |
Source: Deloitte Access Economics calculations using DOHC (2005) and CSO (2008). (a) Estimated by applying growth rate of the ROI population from 2004 onwards to total non-capital expenditure on ‘assessment and care of the visually impaired’ in 2004, €12.22 million (DOHC, 2005). (b) Estimated by applying the ratio of capital to non-capital expenditure on the Disability Programme in 2003 to estimated non-capital expenditure in each year. This ratio was 0.03 (DOHC, 2005).
Unfortunately, no publicly available data were identified to estimate residential and community care services directly paid by patients and not funded by the government.