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HEALTH ACCOUNTS -2000-

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Title: HEALTH ACCOUNTS -2000-


1
HEALTH ACCOUNTS-2000-
  • FOR
  • PORTUGAL

2
Health 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.

3
Health 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)

4
Health 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.

5
Health 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

6
Health 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.

7
Health 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)
8
Health 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
9
Health Accounts for Portugal - 2000
  • Non-Market providers

Health Output () Compensations of
employees () Intermediate consumption () Consump
tion of fixed capital () Other taxes on
production (-) Other subsidies on
production (-) Non-health sales
10
Health 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
11
Health 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.

12
Health 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
13
Health 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.

14
ANALISYS 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

23
Health 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).
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