Archive:Healthcare expenditure

Data from April 2008, most recent data: Further Eurostat information, Main tables and Database.

Figure 1: Current health expenditure: totals per country, 2003-2005

Healthcare expenditure statistics describe the process of providing and financing health care in countries by referring to health care goods and services, its providers and financing agents.

Current expenditure on health measures the economic resources spent by a country on health care services and goods, including administration and insurance. Total expenditure on health care represents current expenditure on health enlarged by the expenditure on capital formation (investments) of health care providers.

Main statistical findings

Figure 2: Current health expenditure per capita in euro, 2003-2005

Table 1: Current health care expenditure in euro per capita by selected financing agents, 2003 and 2005

Table 2: Index (2005 compared to 2003) of current health expenditure by selected financing agents

For the collection of the data on health care expenditure the System of Health Accounts (SHA) and its related set of International classification for health accounts (ICHA) is used. The SHA shares the goals of the System of National Accounts (SNA) to constitute an integrated system of comprehensive, internally consistent, and internationally comparable accounts, which should as far as possible be compatible with other aggregated economic and social statistical systems. The SHA is organised around a tri-axial system for the recording of health expenditure, by means of an International Classification for Health Accounts (ICHA), defining:

health care financing agents: who is paying?
health care by function: for which services and goods?
health care service provider industries: who is paid, who provides the services?

Financing agent (ICHA-HF): Mechanisms of health care financing are becoming increasingly complex in many countries with a wide range of institutions involved. The financing of health care is one of the reporting dimensions. At least a basic subdivision of public and private financing is reported in many cases. A detailed breakdown of expenditure on health by financing agents is an essential component of a comprehensive SHA.

Function category (ICHA-HC): The boundaries of a functionally defined health care system delimit the subject area of health accounts. This approach is “functional” in the sense that it refers to the purposes of health care. Health care in a country comprises the sum of activities performed either by institutions or individuals pursuing, through the application of medical, paramedical and nursing knowledge and technology, the purposes of:

promoting health and preventing disease;
curing illness and reducing premature mortality;
caring for persons affected by chronic illness who require nursing care;
caring for persons with health-related impairment, disability, and handicaps who require nursing care;
assisting patients to die with dignity;
providing and administering public health;
providing and administering health programs, health insurance and other funding arrangements.

The core functions of health care refer to the purposes listed above. Health-related functions such as education and training of health workforce, research and development in health and environmental health should be distinguished from the core functions. They can be very closely linked to health care in terms of operations, institutions and personnel, but should, as far as possible, be excluded when measuring activities belonging to core health care functions.

Provider category (ICHA-HP): The production and the provision of health care services along with their financing take place in a wide range of institutional settings that vary across countries. The way of organising health care services reflects the country-specific division of labour between providers of health care services which is becoming increasingly complex in many countries. A classification of health care providers serves the purpose of arranging country-specific institutions into common, internationally applicable categories and providing tools for linking data on personnel and other resource inputs as well as output measurement.

Data sources and availability

The Joint Health Accounts Data Collection (a co-operation between Eurostat, OECD and WHO) started in 2005 and two further waves were launched in 2006 and 2007. The data presented here are the results of the first two waves (data for reference years 2003, 2004 and 2005).

Context

The SHA (System of National Accounts) aims to provide policy makers and other stakeholders with a view on health care financing agents (who is paying?), health care by function (for which services and goods?) and health care service provider industries (who is paid, who provides the services?).