1

Draft Guidelines for Health Expenditure and Financing in OECD Health Data 2006

7th Meeting of Health Accounts Experts and Correspondents for Health Expenditure Data

Paris, 29-30 September, 2005

2

Overview

Current status and availability of expenditure data in OECD Health Data 2005

Coordination with joint OECD-EUROSTAT-WHO HQ SHA Questionnaire

Proposed guidelines for OECD Health Data 2006

SHA Electronic Discussion Group

Discussion

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Status and availability of expenditure data - OECD Health Data 2005

Main aims for OECD Health Data 2005:

To improve availability of main aggregates and core variables

Increase the number of countries providing latest expenditure estimates

Improve comparability (methodological information)

4

Availability of main aggregates

MAIN EXPENDITURE AGGREGATE OECD HEATH DATA 2004 OECD HEALTH DATA 2005

TOTAL HEALTH EXPENDITURE 26 27

TOTAL CURRENT HEALTHEXPENDITURE

23 26

TOTAL INVESTMENT ON MEDICALFACILITIES

23 26

EXPENDITURE ON PERSONAL HEALTHCARE

18 20

EXPENDITURE ON COLLECTIVEHEALTH CARE

17 19

EXPENDITURE ON MEDICAL SERVICES 18 20

EXPENDITURE ON MEDICAL GOODS 18 20

PHARMACEUTICALS 19 21

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Number of countries reporting data for 2003 (2002*)OECD Health Data

Number of countries reporting data for 2003 (2002*)OECD Health Data

2726 26 26 26 26 26

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OECD HD 2005

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Key Sub-set of Core Variables% available for period 2000-03 (1999-2002*)

Chart 3: Key Sub-set of Core Variables% available for period 2000-03 (1999-2002*)

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Current status - Conclusions

More countries starting to report SHA-based national health accounts to OECD Health Data - Norway, Poland.

Overall increase in reporting of main aggregates and core variables on last year.

However Only 9 countries report all the agreed sub-set of core

variables; and Some main aggregates (such as pharmaceutical

expenditure) are only reported by two-thirds of countries

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Timeframe - OECD Health Data 2006

Deadline: February 15, 2006

Co-ordination with Joint OECD-EUROSTAT-WHO SHA Questionnaire 2006

If 2004 data is expected to be reported by March 31, 2006

then it will not be necessary to complete the corresponding

sections of the OECD Health Data 2006 questionnaire

Countries should indicate their position as early as possible

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Proposed guidelines - OECD Health Data 2006

Main aims: To improve the coverage of the main aggregates To increase reporting of the agreed sub-set of core

variables Continue harmonisation of variables with SHA-ICHA Ensure a maximum of countries report health expenditure

data for 2004 Improve the methodological information

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Proposed guidelines - specific areas

Long-term care expenditure In-patient care

– Distinction between hospital expenditure and in-patient care– Separation of daycare, homecare, ancillary services, etc– Clear reporting of methodology

Pharmaceutical expenditure– Reporting of 2004– New request for Total expenditure I.e. including In-patient

Investment in medical facilities

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Proposed guidelines - specific areas (2)

Public expenditure on administration– wide variations suggest methodological differences– operating costs of ministries and agencies– distinction from prevention and public health

Price indices

Out-of-pocket payments– new sub-categories - Out-of-pocket excl. cost-sharing

- Cost sharing

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Proposed guidelines – Further items

Temporarily hidden variables– Day-care / Expenditure by age and gender

Time-series breaks– after SHA implementation revisions of past years’ data

Preliminary estimates– OECD Quality Framework - timeliness– feasibility of total public expenditure on health for 2005– “Get More Data”

Sources and Methods– main sources, deviations from SHA, series breaks, etc

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SHA Electronic Discussion Group

Forum for sharing information, questions on all aspects of SHA work

Initial focus on Long-term care expenditure

Access via OLISnet and OECD Internet using username and password

Email alert facility for new messages

Launch in November

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Discussion

Current efforts and strategy to expand, improve and harmonise data reporting with SHA

Feasibility of reporting new items for 2006, such as: – total pharmaceutical expenditure– estimated public expenditure– Out-of-pocket breakdown

Timeframe and deadline - SHA Questionnaire