OECD Health Accounts Experts meeting Joint Eurostat/OECD Report on the Results from the 2 nd Pilot based on SHA 2011 22-23 October 2014
2 nd Pilot Study based on SHA 2011 BACKGROUND 2012: decision for pilot testing of SHA Tables based on SHA 2011 2013: 1 st pilot testing of SHA 2011 9 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 2013 2 independent studies same results 2014: 2 nd pilot testing of SHA 2011 16 countries submitted data Joint analysis of results 22-23 October 2014 2
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 22-23 October 2014 3
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 22-23 October 2014 4
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) 22-23 October 2014 5
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 2011 22-23 October 2014 6
2 nd Pilot: Participating Countries 22-23 October 2014 7
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) 22-23 October 2014 8
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 22-23 October 2014 9
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 22-23 October 2014 10
Results: Current Health Expenditure Impact of SHA 2011 on CHE still being studied by many countries 22-23 October 2014 11
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.5.1.1 and HC.5.1.2 HC.7 Governance and health system and financing administration Attention to the split between HC.7.1 and HC.7.2 22-23 October 2014 12
Results: Long-Term Care (HC.3) LTC (social) for 2 countries: HCR.1 (SHA 2011) larger than HCR.6.1 (SHA 1.0) 22-23 October 2014 13
Results: Prevention (HC.6) 22-23 October 2014 14
Results: Health Care Financing Schemes Public/private vs Compulsory/voluntary 22-23 October 2014 15
Results: Health Care Financing Schemes 22-23 October 2014 16
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.2.1.2 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) 22-23 October 2014 17