Title: HEALTH ACCOUNTS -2000-
1HEALTH ACCOUNTS-2000-
2Health Accounts for Portugal - 2000
- Project Health Accounts for Portugal was
carried out for the year 2000 to answer two
important needs - To meet the OECD requirements
- To offer to policy-makers an important tool for
basing analysis and decision.
3Health Accounts for Portugal - 2000
- Decision was taken to create a Working Group
involving the two bodies of the Ministry of
Health, the National Statistical Institute and
one unit from the Ministry of Finance. - On a first stage it was decided to compile a
Health Account for the year 2000 on a bottom-up
approach, according to the SHA Manual of OECD, in
particular - Table 2 (Current expenditure on health by
function of care and provider industry) - Table 3 (Current expenditure on health by
provider industry and source of funding) - Table 4 (Current expenditure on health by
function of care and source of funding) - Table 5 (Total expenditure on health including
health-related functions)
4Health Accounts for Portugal - 2000
- Changes considered in the classification
breakdown presented on the tables due to domestic
needs - HF1.1 (General Government, excluding social
security funds) is shown differently from what is
proposed in SHA - HF1.1.1 National Health Service
- HF1.1.2 Public health subsystems
- HF1.1.3 Other units.
- Also in HF2.1 (Private social insurance), private
health subsystems are shown separately. - Moreover HP3 is presented in an aggregated way.
5Health Accounts for Portugal - 2000
- The work was based on the basic definition in SHA
(Chapter 5) on the measurement of expenditure on
health care. -
- Total Expenditure on health measures the final
use of resident units of health care goods and
services plus gross capital formation in health
care provider industries (institutions where
health care is the predominant activity). - Therefore the methodology used for the
compilation is based on the identity - Expenditure in goods and services of health care
- ()
- Goods and services produced / available to be
used
6Health Accounts for Portugal - 2000
- Main Stages of the compilation process
Project - Set up of the universe creation of a data set
starting with the classification of the units as
providers and financers - Estimation of the output for the health providers
by provider and by function of health care-
transitional matrix - Estimation of the Expenditure by financer, by
provider and by function of health
care-transitional table - Conciliation of the data starting with table 3 to
establish the level of Output/expenditure - Compilation of the tables.
7Health Accounts for Portugal - 2000
- Analysis was made to units one by one. Health
Output on the providers side was measured
according to the following groups - Market providers
- Market providers, except HP4
- Providers HP4.2 to HP4.9
Health Output S Sales of goods and Services of
Health
Health Output () Value of the goods under HP4.2
to HP4.9 to be included in the actual final
consumption (for sale at the retailers)
8Health Accounts for Portugal - 2000
- Market providers
- Providers HP4.1
- Providers organised as self-employed and
own-account workers
Health Output () Value of medicine sold in the
pharmacies (excluding hospital pharmacies)
Health Output volume of additional employment
X average income
9Health Accounts for Portugal - 2000
Health Output () Compensations of
employees () Intermediate consumption () Consump
tion of fixed capital () Other taxes on
production (-) Other subsidies on
production (-) Non-health sales
10Health Accounts for Portugal - 2000
- Occupational medical offices
- Providers HP6.4 (Other private insurance)
Health Output ( ) Average cost each type of
medical care (X) Number of medical cases of each
type
Output of Health Insurance (service charge of
health insurance) () Total actual premiums
earned () Total premium suplements (-) Total
claims due (-) Change in actuarial reserves and
reserves for with-profits insurance
11Health Accounts for Portugal - 2000
- Health expenditure by financer considered the
following transactions related to health made by
each financer - Current transfers (D75)
- Tax deductions due to Health expenditure
(negative D51 by households) - Social contributions (D61)
- Social benefits other than social transfers in
kind (D62) - Social transfers in kind (D63 P3 for the
non-market financers) - Final consumption expenditure for households.
12Health Accounts for Portugal - 2000
Table 3
Table 2
Table 4
Table 5
- Process of conciliation of the tables (use of
transitional tables)
PROVIDERS ICHA-HP
FINANCERS ICHA-HF
Table 3
Table 2
Table 5
Table 4
FUNCTIONS OF HEALTH CARE ICHA-HC
HEALTH-RELATED FUNCTIONS ICHA-HC.R
13Health Accounts for Portugal - 2000
- Limitations
- It was not possible to breakdown HP3 into a
second level for consistency reasons of the data.
Moreover the distortions increase in the
conciliating process between the expenditure and
production side. - Homes for elderly care were excluded from the
table due to the unavailability of data to
extract the health care expenditure in these
homes. - Difficult allocation of some functions of health
care. - Deduction of the intermediate production for
services rendered by own-account workers to
providers that belong to NPI. - Recording of expenditure of public and/or private
health subsystems that are engaged both in
financing health expenditure and also acting as
providers.
14ANALISYS OF THE RESULTS
Health Accounts for Portugal - 2000
- Health expenditure by financing source
- Health expenditure by function
- Current health expenditure by mode of production
- Current health expenditure by provider
- Current health expenditure by provider and
financing agent - Current health expenditure by function and
financing agent.
15 Health expenditure by financing source (Total
health expenditure 100) Portugal, 2000
Health Accounts for Portugal - 2000
16 Health expenditure by function (Total health
expenditure 100 Portugal, 2000)
Health Accounts for Portugal - 2000
17 Current health expenditure by mode of production
(Total current health expenditure 100)
Portugal, 2000
Health Accounts for Portugal - 2000
18 Current health expenditure by provider (Total
current health expenditure 100) Portugal, 2000
Health Accounts for Portugal - 2000
19 Current health expenditure by provider and
financing agent ?Spending structure of
financing agents
Health Accounts for Portugal - 2000
20 Current health expenditure by function and
financing agent ?Functional structure of
spending by financing agent
Health Accounts for Portugal - 2000
21 Current health expenditure by function and
financing agent ?How the different functions
are financed
Health Accounts for Portugal - 2000
22 Main ratios
Health Accounts for Portugal - 2000
- Total expenditure on health as share of GDP 9.0
- Share of current expenditure in total
expenditure 95.7 - Share of Gross capital formation in total
expenditure 4.3 - Public share in total expenditure on health
64.2 - Private share in total expenditure on health
35.8 - Total public expenditure on health, per capita
649.18 - Total Private expenditure on health, per capita
362.40 - Total expenditure on health, per capita
1011.58
23Health Accounts for Portugal - 2000
- FUTURE WORK
- For the next stages, a working plan is undergoing
aiming - Compilation of health accounts for the years
2001, 2002 and 2003 - Investigation of methodologies and sources to
make improvements in the missing information and
classifications - Compilation of table 10 (Total employment in
health care industries) - Compilation of table 8 (selected price indices
for health care) - We are still in a phase of defining schedules,
priorities and assessment of the eventual needs
of more resources (human resources, etc).