- Population based resource allocation (PBRA) is a funding model that seeks to distribute available healthcare resources according to population need to promote efficiency and equity in both health outcomes and distribution of resources.
- A new PBRA model is a core component of Regional Health Area (RHA) implementation. RHAs will be regional divisions within the HSE with the objective of aligning hospital and community care services and promoting innovation, integrated care, efficiency, and clinical and corporate governance and accountability.
The Minister for Health Stephen Donnelly TD and the Minister for Public Expenditure and Reform, Michael McGrath TD, published ‘Towards Population Based Funding for Health: Evidence Review & Regional Profiles’ as part of the 2022 Spending Review process.
This Spending Review contributes to the evidence required to support decision making on the most appropriate population-based funding model to implement. A new population-based resource allocation (PBRA) model is a core component of Regional Health Area (RHA) implementation. This reform will help deliver greater efficiency and equity in our health service.
This paper provides a practical overview of PBRAs, focusing on the different ways that PBRAs have been implemented in six countries. Consideration is then given to the potential data sources and the foundation of a PBRA approach in Ireland. For the first time, this paper presents a profile of the new Regional Health Areas (RHAs), outlining their demographic structure, socioeconomic characteristics, and population density. This will be an important tool for planning the delivery of services in these areas over time.
The paper finds that while no two countries use the same PBRA model, some common features are identified. Primarily these models are population-based, where funding is per capita, adjusted for certain characteristics that influence health need – such as demographic features like age and sex, and socioeconomic status.
The paper examines the building blocks of the PBRA in an Irish context, identifying the necessary data to support its application. It finds the CSO Population Census and the Department of Health’s ‘Healthy Ireland’ surveys to be particularly useful and reliable data sources. Further work will be published by Irish Government Economic and Evaluation Service (IGEES) Department of Health staff in Q4 2022 which will consider current expenditure and staffing by RHA and recommend potential PBRA models for decision.
Minister for Health, Stephen Donnelly TD, welcomed the publication saying:
“I’m happy to announce the publication of ‘‘Towards Population Based Funding for Health: Evidence Review & Regional Profiles’. Population-based funding is an important component of the reform of our health system. It is the mechanism through which funding will be allocated to the new Regional Health Areas. Properly designed, it can support better corporate governance and clinical responsibility, while empowering local decision making and innovation. The international evidence shows that population-based funding can play a role in improving the equity and efficiency of healthcare. I welcome this IGEES paper as part of the expanding evidence base to support decision making in health.”