Summary of the Final report on the National Health Accounts of Suriname 2006

Transcription

1 Summary of the Final report on the National Health Accounts of Suriname 2006 The National Health Accounts of Suriname over 2006 were conducted by T&H Groep and Bright International Consultants in the first half of The basic data used for this study are presented in TABLE 1, and include a population of 504,257, a GDP of 1,916,423,273 USD (incl. the informal sector), resulting in an income per capita of USD 3,800. TABLE 1 also presents the number of employees in government, private and informal sector. The Total Health Expenditures (THE) in 2006 were USD 163,508,436. Of the THE 42.6% was spent by the public sector, 53.5% by the private sector, and 3.9% by nongovernmental organizations (NGO s). Per capita USD was spent on health, with House Hold out Of Pocket (HH- OOP) expenditures of USD 64.18, of which USD was spent on premiums for health insurance and USD as direct OOP expenses for health services. The three main identified groups that constitute the description of the flow of funds in the NHA study are de Sources of Funds, The Financing Intermediaries, and the Health Services Providers. The main source for funds in the Health Sector was the Ministry of Finance (37.5%), followed by the private firms with 34.1%, and the Household Out Of Pocket expenditures (HH-OOP) with 20%. Of the Financing Intermediaries the firms own health services and direct cost were good for 25.7%, the State Health Foundation (SZF) 18%, Ministry of Social Affairs 16.5%, the Ministry of Health 14.4%, direct Out Of Pocket 11.7%, and the private health insurers 8.3%. The Ministry of Social Affairs processes more funds in health than the Ministry of Health itself. The expenses of the Total Health Expenditures to Health Services Providers demonstrates that the largest expenses are for to the hospitals 27.3%, followed by private general practitioners with 12.6%, pharmaceuticals 11.5%, medical specialists 9.2%, laboratory services 4.8%, dentists 3.9% and the RGD 3.3%. 1

2 Analyses of the Total Health Expenditures to health functions learned that 35% was spent on secondary care (hospital services, blood and blood products, and kidney dialyses). The other expenditures were for prevention and primary care 27.2%, pharmaceuticals 11.5%, laboratory services 4.8%, dental care 4.6%, mental health 4.5%, health administration 4.3%, optical care 1.9% and diagnostic imaging 1.7%. The percentage of THE spent on hospital services is reasonable compared to other developing countries and lower than most developed countries. However, it is still a significant part of the THE and likely will not decrease with the more specialized procedures that are introduced in Suriname with an aging population. Comparing the NHA of 2000 with 2006 (TABLE 2) learns that the GDP, the income per capita and the Total Health Expenditures almost doubled. The Out Of Pocket (OOP) expenses increased with 77.7% and people relatively spent much more on health insurance premiums than direct OOP payments. Obvious and surprising is the decline of 6.5% of spending on primary health care and prevention, the cornerstone of the health system. Laboratory and diagnostic imaging expenses, together, increased with 4.0%. Other significant increases were documented for pharmaceuticals, medical specialists and private GP s. Health administration cost stayed nearly constant but concerning was the decline of 0.2% in the expenses for education and training. 2

3 Basic Information for the Context of the NHA 2006 Basic National information for the context of the NHA 2006 was collected along the specific data from the questionnaires. The basic data is presented in TABLE 1. Table 1; Basic National data for the NHA 2006* Population ,829 Population ,257 Number of families 129,296 Average family size 3.9 SRD USD GDP ,483,517,000 1,630,369,818 GDP 2006, including the informal sector 5,270,164,000 1,916,423,273 Percentage of the informal sector in GDP 14.9% National Income per capita ,891 3,233 National Income per capita 2006 including informal sector 10,451 3,800 Number of Employees Percentage of total employment positions government employees 39, % private sector employees 57, % informal sector employees 23, % unemployed 16, % Total employment positions 136, % Ministry of Social Affairs Registered Card Holders (families) poor and near poor 66,236 Total beneficiaries for health services poor and near poor, December ,780 * Source; Algemeen Bureau voor Statistiek (ABS) and Ministry of Labour, Technology and Environment (ATM) 3

4 Comparing the NHA 2000 to the NHA 2006 Table 2; Comparison of data between the NHA in 2000 and 2006 in USD and in percentages NATIONAL HEALTH ACCOUNTS Difference Population 436, ,257 15,5% GDP (USD) 836,133,524 1,916,423, % Income per capita 1,914 3, % THE 78,763, ,508, % THE per capita % THE as % of GDP 9.4% 8.5% -0.9% Total OOP as % of THE 20.0% 19.8% -0.2% Total OOP expenditure per capita % OOP for insurance premium per capita % Direct OOP per capita % HE public sector as % of THE 45.2% 42.6% -2.6% HE private sector as % of THE 40.0% 53.5% 13.5% Health expenditures to services and providers as % of THE Prevention and primary care 33.7% 27.2% -6.5% Hospitals 36.3% 35.1% -1.2% Mental Health 4.5% Laboratory 2.5% 4.8% Diagnostic Imaging 1.7% Pharmaceuticals 7.2% 11.5% 4.3% medical specialists 5.0% 9.3% 4.3% Private GP's 7.5% 12.6% 5.1% Administration 4.7% 4.3% -0.4% Education and Training 0.6% 0.4% -0.2% 4.0% 4

5 In TABLE 2 a comparison is made between data from the NHA in 2000 and Obvious is the 129.2% increase in GDP with a population increase of 15.5%. This resulted in an increase in income per capita of 98.5%. The Total Health Expenditures, USD 163,508,436, increased with 107.6% and decreased as a percentage of GDP with 9.4% to 8.5% of GDP. The health expenditures per capita increased from USD to , an increase of 79.8%. The total OOP expenditures were kept at a percentage of around the 20% of the THE, to be in line with the OOP in 2000 that were based on a household study. The OOP expenditures per capita were USD 64.18, a 77.7% increase compared to the year

6 Comparison of health expenditures in the Caribbean Region Table 3: Health expenditures of Caribbean countries. Averages in the period * Indicators Ant Bah Bdos Bel. Dom. Gren. Gya Jca SKN SL SVG Sur TT THE%GDP PHE%THE GHE%THE GHE%TGE ERH%THE SSHE%GHE OOP%THE THE pc US$ THE pc $PPP * WHO World Health Report 2004 THE----Total Health Expenditure GHE Government (Public) Health Expenditure OOP Out of Pocket Expenditure PHE---Private Health Expenditure ERH External Resources for Health SSHE Social Security Health Expenditure 6

7 Suriname s per capita spending is one of the lowest, while it has the highest percentage of GDP spending in health. Life expectancy ranks 10/14 while IMR 3/14 ranks high and CDR 6/14 ranks in the middle group. This indicates that Suriname can perform well in health with fewer funds than the other countries. For more and detailed information about the National Health Accounts of Suriname 2006 please look in the Final report on the National Health Accounts of Suriname