Morrow Elizabeth, Lynch Mary
Faculty of Nursing and Midwifery, Royal College of Surgeons Ireland, Dublin, Ireland.
Front Public Health. 2025 Jun 2;13:1602617. doi: 10.3389/fpubh.2025.1602617. eCollection 2025.
Home support is a critical yet under-recognized component of public health and aging policy, with economic perspectives often overlooked in workforce and system planning. This paper explores the economics of home support services in Ireland, against a backdrop of increasing demand for home care driven by aging populations and workforce supply challenges.
To provide a comprehensive overview of the economic challenges faced by the home support sector in Ireland, particularly in relation to workforce sustainability, population health, and quality service delivery. To explore international best practices and case studies that can further inform the development of home support models.
Utilizing both qualitative and quantitative population, labor force, and health service data, the analysis of the Irish context investigates three critical areas: (1) the rising demand and funding of home support, (2) cost comparisons with institutional care, and (3) the economic implications of workforce expansion. Systematic literature review of the international evidence used a structured search of electronic databases (Web of Science, MEDLINE, CINHAL) using key terms ("home support," "workforce development," and "economic or cost") to identify a range of recent (published 2015-2025) and relevant case studies to inform policy development.
Findings indicate that Ireland's market-driven approach, heavily reliant on approved private providers, exacerbates issues like low wages, job insecurity, and high staff turnover, which negatively impact service quality. Implications for healthcare workforce policy include improving wages and working conditions, establishing career pathways and professional development, and increased government investment. Recommendations for policy include making strategic investments in workforce stability and better integration of home support with informal care systems to enhance service delivery.
Policymakers can inform themselves about the economic considerations for developing a robust home support system in the context of aging populations. Further research is needed into the assumptions and validity of financial decisions to ensure services are sustainable.
家庭支持是公共卫生和老龄政策的一个关键但未得到充分认识的组成部分，在劳动力和系统规划中，经济层面往往被忽视。本文在老龄化人口推动家庭护理需求增加以及劳动力供应面临挑战的背景下，探讨爱尔兰家庭支持服务的经济学情况。
全面概述爱尔兰家庭支持部门面临的经济挑战，特别是在劳动力可持续性、人口健康和优质服务提供方面。探索可进一步为家庭支持模式发展提供参考的国际最佳实践和案例研究。
利用定性和定量的人口、劳动力及卫生服务数据，对爱尔兰的情况进行分析，研究三个关键领域：（1）家庭支持需求和资金的增长；（2）与机构护理的成本比较；（3）劳动力扩张的经济影响。对国际证据进行系统文献综述，通过使用关键术语（“家庭支持”“劳动力发展”和“经济或成本”）对电子数据库（科学网、医学期刊数据库、护理学与健康领域数据库）进行结构化搜索，以识别一系列近期（2015 - 2025年发表）且相关的案例研究，为政策制定提供参考。
研究结果表明，爱尔兰严重依赖获批私人供应商的市场驱动方法加剧了低工资、工作不安全和员工高流动率等问题，这些问题对服务质量产生负面影响。对医疗劳动力政策的影响包括提高工资和改善工作条件、建立职业发展路径和专业发展机会以及增加政府投资。政策建议包括对劳动力稳定性进行战略投资，以及更好地将家庭支持与非正式护理系统整合，以提高服务提供水平。
政策制定者可以了解在老龄化人口背景下发展强大的家庭支持系统的经济考量。需要进一步研究财务决策的假设和有效性，以确保服务的可持续性。
