Working Group on Public Health statistics Agenda item 8.2 Main projects and data collection Health Expenditure Statistics (SHA) 26-27 October 2009 EUROSTAT: Working Group Public Health Meeting
SHA Joint Questionnaire: state of play 26-27 October 2009 EUROSTAT: Working Group Public Health Meeting
SHA Joint Questionnaire (SHA JQ): background Common effort of OECD, EUROSTAT and WHO Since 2005: 4 rounds of SHA JQ Evolution and improvement of the SHA JQ SHA JQ package: Excel file with macro checking data consistency (6 tables) Excel file for meta data plus Explanatory notes Technical guidance 26-27 October 2009 EUROSTAT: Working Group Public Health Meeting 3
SHA Joint Questionnaire (SHA JQ): background SHA JQ package (con.) 3 main cross-classification tables of ICHA: Function of health care by Health care financing agents (HC x HF) Function of health care by health care providers (HC x HP) Health care providers by Financing Agents (HP x HF) 2 two additional cross-classification tables (Producer Guide): Health care financing agents by Financing Sources ( HF x FS) Human Resources x Health care Providers (RC x HP) 1 Preliminary aggregates table 26-27 October 2009 EUROSTAT: Working Group Public Health Meeting 4
SHA Joint Questionnaire (SHA JQ): calendar 2009 SHA JQ: Reference year 2007 Previous years for revision 2009 SHA JQ Mid December 2008 :sent out 2009 SHA JQ (2007) End of March 2009: request for data submission April / mid December 2009: common data validation Mid December 2009: sent out 2010 SHA JQ (2008) January 2010: dissemination of 2009 SHA JQ by ESTAT 26-27 October 2009 EUROSTAT: Working Group Public Health Meeting 5
SHA Joint Questionnaire (SHA JQ): results SHA JQ 2006 2007 2008 2009 No. of all countries submitted data 22 26 30 29 Of which MS and EFTA 16 19 23 23 26-27 October 2009 EUROSTAT: Working Group Public Health Meeting 6
HCxHF HCxHP HPxHF HFxFS RCxHP HCxHF HCxHP HPxHF HFxFS RCxHP Country 1 Austria ` 2 Belgium 3 Bulgaria expected 4 Cyprus 5 Czech Republic 6 Denmark 7 Estonia 8 Finland 9 France 10 Germany 11 Greece X 12 Hungary 13 Ireland expected 2010 X 14 Italy X 15 Latvia 16 Lithuania 17 Luxembourg 2009 Joint OECD, EUROSTAT and WHO HEALTH ACCOUNTS (SHA) DATA COLLECTION SHA Tables reported by EU MS /EFTA countries Tables 2003 2004 2005 2006 2007 HCxHF expected 18 Malta X 19 Netherlands 20 Poland 21 Portugal 22 Romania 23 Slovak Republic 24 Slovenia 25 Spain 26 Sweden 27 United Kingdom X 1 Iceland 2 Norway 3 Switzerland HCxHP HPxHF HFxFS RCxHP HCxHF HCxHP HPxHF HFxFS RCxHP HCxHF HCxHP HPxHF HFxFS RCxHP missing Methodology validated 26-27 October 2009 EUROSTAT: Working Group Public Health Meeting 7
SHA Joint Questionnaire (SHA JQ): results Tables availability (MS/EFTA countries): 2009 SHA JQ vs. previous JQ 3 main tables of ICHA: 19 vs. 25 with coverage rate 1 st digit level: 96-100% (depending on table) 2 nd digit level: 78-90% (depending on table) 2 two additional tables (Producer Guide): FS: 8 vs. 13 (some of which partial coverage) RC: 5 vs. 8 (some of which partial coverage) 1 Preliminary aggregates table: 2 26-27 October 2009 EUROSTAT: Working Group Public Health Meeting 8
SHA Joint Questionnaire (SHA JQ): results Main reporting gaps by 3 ICHA dimensions: Functions (HC): curative vs. rehabilitative care (2 nd digit) therapeutic appliance/medical durables (3 rd digit) prevention and public health services (2 nd digit) social and private insurance administration (3 rd digit) Health related functions Memorandum items Financing agent (HF): government (3 rd and 4 th digit) private insurance (2 nd digit) Household cost sharing (3 rd digit) Rest of the world (1 st digit) Providers (HP) hospitals (2 nd digit) nursing and residential facility (2 nd ) providers of ambulatory care (3 rd digit) provision of administration (2 nd digit) 26-27 October 2009 EUROSTAT: Working Group Public Health Meeting 9
MS assistance in the SHA implementation Various means of assistance since year 2000 Written guidelines: SHA Guidelines for EU countries Subject specific meetings and projects (examples) PHARE 2002, 2003, SHA results of Health Account Data in EU grants to support SHA implementation:2006, 2007 SHA workshops: 2004, 2006 2009 (3 rd phase) dedicated to SHA revision: non-awarded Regular meetings of countries experts under EUROSTAT and PARTNERSHIP HEALTH umbrella 26-27 October 2009 EUROSTAT: Working Group Public Health Meeting 10
SHA revision process: state of play 26-27 October 2009 EUROSTAT: Working Group Public Health Meeting
SHA revision process: background Common effort of OECD, EUROSTAT and WHO 2006/2007: SHA problems inventory 2007/2008: start of the process: The programme of work for SHA revision (18 units) Framework for the consultation process (2008 /2009/2010) International Health Account Team Secretariat: OECD SHA webpage: http://www.oecd.org/health/sha/revision 26-27 October 2009 EUROSTAT: Working Group Public Health Meeting 12
SHA revision process: priority settings Unit Topics : 1 st wave Unit Topics: 2 nd wave 1 2 Purposes and Principles of the SHA Global Boundaries of Health Care WHO ESTAT 8 3 Classification of health care provider Key concepts and definitions in health accounts ESTAT OECD 5 7 Types of Health Accounts Classification of Health Care functions OECD WHO 9 10 11 Classification of financial sources Classification of financing agents Classification of beneficiary/recipient characteristics OECD OECD WHO Unit 6 12 4 Topics: 3 rd wave Relationship to other statistical systems Classification of resources for production of health goods and services Dimensions of health expenditure ESTAT ESTAT OECD Unit 14 17 15 Topics: 4 th wave Human resources in health Possible compilation processes Presentation of results ESTAT ESTAT WHO 16 Basic accounting rules and guidelines OECD 18 Analytical use of SHA WHO 13 Classification of health care products WHO 26-27 October 2009 EUROSTAT: Working Group Public Health Meeting 13
SHA revision process: calendar Process steps Input papers Proposal 1 1st draft IHAT Consultation 1 2nd draft IHAT External experts consultation "planned" time 2008 2009 2010 March Apr May Jun Jul Aug Sep Oct Nov Dec Jan Feb March Apr May Jun Jul Aug Sep Oct Nov Dec Jan Feb March Apr May Jun Jul Aug Sep Oct Nov 8 1 1 1 1 2 2 2 2 2 2 2 3 3 3 3 3 4 4 4 4 4 8 1 1 1 2 2 3 3 4 4 8 1 1 1 1 1 1 2 2 3 3 4 4 8 1 1 2 2 3 3 4 4 8 1 1 2 2 3 3 4 4 4 Dec 2011 Jan 2nd draft agreed 4 1 1 2 2 3 3 4 4 Preliminary calendar: only partially followed up input papers: March 2008 /July 2008 / August 2009 Organisations proposals: July 2008 / February2009 IHAT and early IHAT drafts: October 2009 26-27 October 2009 EUROSTAT: Working Group Public Health Meeting 14
SHA revision process: results Programme of Work for SHA 2.0: 18 Units PART II Products Unit 13 Beneficiaries Unit 11 Functions: Unit 7 Financing Sources Unit10 Financing Schemes Unit 9 Providers* Unit 8 Resource Cost Unit 12 Human resources Unit 14 PART I Purposes Unit 1 Boundaries* Unit 2 Concepts Unit 3 Classifications Unit 4 Accounts Unit 5 Interfase Unit 6 PART III Presentation Unit 15 Accounting Rules Unit 16 Compilation Unit 17 Analytical use Unit 18 26-27 October 2009 EUROSTAT: Working Group Public Health Meeting 15
SHA revision process: results Units Status Invitation for comments 1 Purposes and Principles of the SHA Open 20 Nov 2009 2 Global Boundaries of Health Care Early IHAT draft 20 Nov 2009 5 Types of Health Accounts Low priority 7 Functional Classification of Health Care Early IHAT draft 20 Nov 2009 8 Classification of health care provider Early IHAT draft 20 Nov 2009 3 Key concepts and definitions Early IHAT draft 20 Nov 2009 9 Classification of financing agents/schemes IHAT draft 20 Dec 2009 10 Classification of financial sources IHAT draft 20 Dec 2009 11 Classification of beneficiary WHO Proposal Note on Capital Formation Input paper 20 Nov 2009 26-27 October 2009 EUROSTAT: Working Group Public Health Meeting 16
SHA revision process: results Countries feedback via various consultation framework: Concerns about hitherto results and its direction Expectations on improvements of the existing framework of ICHA Stabilisation of current data collection IHAT response / reflection: Awareness about countries concerns focus mainly on the foundation of the SHA system extensions to the SHA beyond the foundation: facultative reflection on different ways of presenting the SHA 2.0 manual 26-27 October 2009 EUROSTAT: Working Group Public Health Meeting 17
SHA revision process: Assistance to EUROSTAT Tender beneficiary: BASYS Aims: to provide general support in the SHA revision input papers / proposals / comments (units under ESTAT coordination) analysis of units coordinated by OECD and WHO as well as input papers at IHAT server assessment of consequences of proposed solutions for the new SHA manual (1 st step: Edinburgh Round Table) technical support to several meetings / conferences IHAT meetings SHA DvG support in drafting the manual (3rd year) 26-27 October 2009 EUROSTAT: Working Group Public Health Meeting 18
EU policy perspective and the need for SHA data request of policy users: DG EMPL / DG SANCO data for EU 27 health care indicators: OMC; ECHI THE per capita and as a % of GDP THE on long-term care as a % of GDP Public /private expenditure (and their split) as % of THE Expenditure on services/ activities by functions: services of curative (HC.1) services of rehabilitative care (HC.2) ancillary services to health care (HC.4) medical goods dispensed to outpatients (HC.5) prevention and public health (HC.6), 26-27 October 2009 EUROSTAT: Working Group Public Health Meeting 19
Discussion of the WGPH members Invitation to discussion: Short to medium term strategy IR on health care statistics Main reasons: countries comments on stabilization of current data collection the experience gained from the 4 rounds of SHA JQ the hitherto methodological and financial efforts to support implementation of SHA the request of policy users to deliver the data for health care indicators the imperative of providing EU health care aggregates. 26-27 October 2009 EUROSTAT: Working Group Public Health Meeting 20