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