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