Preliminary Quantitative Analysis and Strategic Approach to Emergency Department Overcrowding at University Hospital Limerick, Ireland's Health Service Executive, Mid-West Health Region

The Mid-West (MW) health region of Ireland’s Health Services Executive (HSE) faces critical challenges, particularly overcrowding and bed shortages at University Hospital Limerick (UHL). Findings show approximately 85% of investment is currently focused in County Limerick. Yet, only 25% of additional beds planned for 2031 are in place. The study’s spatial analysis reveals that healthcare demand in Ennis is nearly three times that of Nenagh, driven by higher population densities and access challenges. Nenagh’s demand closely aligns with the combined needs of Kilkee and Kilrush. Ennis requires 85 ED-dedicated beds. Ennis has 50 beds, with operating theatres under appraisal, while Nenagh has 9 excess beds for projected ED needs but requires additional operating theatres. Addressing these capacity gaps could reduce UHL’s ED burden by over 38,000 annual attendees. At a population level, County Clare requires 402 beds, with 50 existing and 48 planned, requiring 302 unplanned acute beds. For North Tipperary, it amounts to 221 beds, with only 52 beds available and 24 planned in Nenagh, leaving a 145-bed shortfall. This study recommends regional capacity expansion, emphasising a System Science approach and collaboration with stakeholders and decision-makers. System Dynamics modelling is suggested for future work, aligning with the Sláintecare initiative’s vision for decentralised, equitable healthcare across Ireland’s MW region.