OECD Health Accounts Experts meeting. Joint Eurostat/OECD Report on the Results from the 2 nd Pilot based on SHA 2011

Transcription

1 OECD Health Accounts Experts meeting Joint Eurostat/OECD Report on the Results from the 2 nd Pilot based on SHA October 2014

2 2 nd Pilot Study based on SHA 2011 BACKGROUND 2012: decision for pilot testing of SHA Tables based on SHA : 1 st pilot testing of SHA countries (CA, FR, HU, IR, IS, KR, LV, NL, CH) submitted data Results discussed by Eurostat Task Force, September 2013, and the 15th Annual Meeting of OECD Health Accounts Experts, October independent studies same results 2014: 2 nd pilot testing of SHA countries submitted data Joint analysis of results October

3 1 st Pilot - Outcome Reporting SHA 2011 variables is feasible, but some issues still remain open SHA2011 implementation brought significant improvements due to new/better: Data sources Methodology Estimation methods Eurostat & OECD analyses in line with each other Time-series Gaps October

4 1 st Pilot Remaining issues Split between modes of provision For Curative & Rehabilitative care (HC.1;HC.2) Day cases of curative and rehabilitative care (HC.1.2; HC.2.2) & Home-based curative and rehabilitative care (HC.1.4; HC.2.4) from other 2nd-digit categories of HC.1; HC.2 Long-term care (HC.3) Separation of Day long-term care (HC.3.2) and Outpatient long-term care (HC.3) (NEW in SHA 2011) from other 2nddigit categories of HC.3 Separation of social component of LTC October

5 1 st Pilot Remaining issues Preventive care (HC.6) Disaggregation at 2 nd digit Separation of hospitals (HP.1) from other providers (HP.2, HP.3) E.g. large integrated organisations Estimation of OOP expenditure (HF.3) October

6 Analysis of 2 nd Pilot based on SHA 2011 Purpose: To provide a feasibility analysis of reporting Health Expenditures under SHA 2011 But also to discuss and share good practices in addressing possible common compilation difficulties/challenges related to SHA October

7 2 nd Pilot: Participating Countries October

8 Analysis of data Methodological approach for the analysis of data 1. SHA 2011-based JHAQ submitted by countries 2. JHAQ 2014 SHA 1.0 data 3. Mapping based on the default correspondence Tables of the SHA 2011 manual (Table 5.1, p. 83, Table 6.2, p. 130, Table 7.4, p.166) 4. SHA 1.0 data SHA 2011 Tables 5. Difference calculated (SHA2011 SHA1.0) October

9 Compilation approaches 2 approaches for compiling data 1 st approach: mapping of SHA 1.0 categories onto SHA 2011 ones, (mainly) by using the default correspondence Tables 2 nd approach: direct allocation of expenditures recorded in National Health Accounts to SHA 2011 categories October

10 Results: Factors for observed changes in SHA 2011 a. Change of boundaries of specific categories under SHA2011 b. Availability of new data sources c. Reclassifications due to: 1. new information on existing data sources 2. better guidance of the SHA 2011 manual 3. in-depth revision of existing classifications 4. changes introduced during discussions with data providers, stakeholders in the data collection and national accountants d. New estimation methods for specific items or refinement of existing estimation methods October

11 Results: Current Health Expenditure Impact of SHA 2011 on CHE still being studied by many countries October

12 Results: Health Care Functions Continuity of reporting without breaks for: HC.1;HC.2 Services of curative and rehabilitative care Disaggregating HC.1;HC.2 into modes of provision still challenging HC.4 Ancillary services to health care HC.5 Medical goods dispensed to out-patients Attention to the split between HC and HC HC.7 Governance and health system and financing administration Attention to the split between HC.7.1 and HC October

13 Results: Long-Term Care (HC.3) LTC (social) for 2 countries: HCR.1 (SHA 2011) larger than HCR.6.1 (SHA 1.0) October

14 Results: Prevention (HC.6) October

15 Results: Health Care Financing Schemes Public/private vs Compulsory/voluntary October

16 Results: Health Care Financing Schemes October

17 Results: Health Care Financing Schemes Mapping of Corporations to Enterprise financing schemes HF.2.5 Corporations (other than health insurance) (SHA 1.0) HF.2.3 Enterprise financing schemes (SHA 2011) or HF Complementary/supplementary insurance schemes? Identify: the entity involved in managing the subscription (collecting revenues, paying providers, etc.) the different financial transactions of all actors involved in this arrangement (e.g. employment company paying premiums to the company managing subscription package; managing company paying the health provider) October