reconciling health expenditure estimates in sha and sna

Reconciling Health Expenditure Estimates

in SHA and SNA

byAstolfi Roberto

13TH MEETING OF HEALTH ACCOUNTS EXPERTS AND CORRESPONDENTS FOR HEALTH

EXPENDITURE DATA

Paris, 4-5 October, 2011

Project objectives

• Weight for the PPP’s calculationNew output-based methodology

• TransparencySpell-out differences

Weight for the new PPP’s

Functions

Providers FinancingAgents/Scheme

WeightsHealth

expenditure

Prices Reconciling

Totals &Structure

New PPP's

Input -based

Old PPP's

Output -based prices

PPP's Questionnnaire SHA

Expenditure On Personal Health Care in 2008*

based on the 2011 JHAQ**

PPPsQuestionnaire

SHA JHAQHCxHF

&HPxHC

COICOP

COPNI

COFOG

Note: *or latest year available** or latest JHAQ available

Possible sources of discrepancy:

• Boundaries

•Insured population vs. resident population•LTC•Products (e.g. OTC non-health products )•Services• Non-health services (e.g. dental whitening)• Secondary activities (e.g. research in hospitals) •Transfers to hospitals (included in SHA excl. in SNA)

• Classifications

• Data Source Different data samples used for the same aggregate

• Estimation methods

Top-down vs. Bottom-upInput vs. output approach Supply-Demand reconciliation

• Revision Schedules

SHA-SNA differences

(Expenditure On Personal Health Care,2008)Luxembourg

NetherlandsSwitzerland

LithuaniaNorway

GermanyDenmark

FranceAustralia

FinlandCzech Republic

PolandSpain

New ZealandLatvia

CyprusAustriaSweden

KoreaPortugal

CanadaSlovenia

Slovak RepublicIceland

BulgariaEstonia

HungaryUnited States

JapanBelgium

-20% -10% 0% 10% 20% 30%

Group 2:10%<diffSHA-SNA=<15%

Group 1:diffSHA-SNA>15%

Group 3:5%<diffSHA-SNA=<10%

Group 4:diffSHA-SNA=<5%

Conclusions