State of play at the international level and ambitions of EUROSTAT

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State of play at the international level and
ambitions of EUROSTAT

• C. van Mosseveld, PhD
• EUROSTAT
• Unit F5 Health and Food Safety statistics

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Content

• EUROSTAT Health statistics
• OECD-WHO-EUROSTAT Joint Questionnaire on Health
  Expenditure
• SHA Revision Process
• Problems and Comparability

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Health statistics in Eurostat
Food safety
Unit F5
Health and safety at work
Public health
Non-expenditure
Physical data of economic units
COD
HIS
Morb
Manpower data
Expenditure
Joint Questionnaire
SHA Revision
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Joint OECD-WHO-EUROSTAT Questionnaire
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Background Goals

• Need for data on SHA WGPH decided to have SHA
  implemented
• SHA data are important for OECD, EUROSTAT and
  WHO-HQ
• Co-operation and co-ordination required
• Result Joint Questionnaire SHA created in 2005
• Reducing the burden for suppliers
• Increase the possibilities of national and
  international analysis of data
• Facilitate the use of the data by stakeholders

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Process

• Starting point tables based on the
  classifications of the manual (OECD, WHO PG)
• Each organisation informs its national
  counterparts
• Nomination of one focal point per country
• Only one data set to be returned
• Installation of IHAT responsible for
  communication with data suppliers
• Validation by either of the 3 organisations
  within 2 months
• Information exchange on all steps of the
  validation process
• Dissemination free to chose by each of the 3
  organisations

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Validation process

• For all 5 tables internal consistency checked at
  all digit levels
• For all 5 tables the consistency is checked
  between identical variables at all levels of
  detail
• For every table the relative shares are presented
• Growth rates between 2 years can be checked
• Finally all data can be checked against the
  methodological information

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SHA Revision
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Background

• 2006 OECD, WHO and EUROSTAT work together in SHA
  revision
• Goal is global SHA standard, manual
• For this
• IHAT (created for JQ) mandate revised
• Consultation process to be created
• Programme of work to be set up
• Membership OECD, WHO and EUROSTAT
• Secretariat OECD

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Reasons behind revision process

• SHA Manual is pilot, first draft
• Implementation started around 1999
• Now around 100 country experiences available
• Problems identified (consistency, boundary, etc.)
• Need for more flexibility and policy relevance

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First step Problem Inventory

• WGPH 2006 requested EUROSTAT to take stock of the
  problems MS face in the implementation of SHA and
  the use of the manual
• OECD and WHO conducted similar processes
• All answers are used in the revision process

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Summary of Results of Problem Inventory

• Definitions and descriptions in manual are not
  clear leading to misinterpretations
• Also requests for more examples
• Boundary problems e.g.
• Production, financing, final use (functions)
• Additional classifications may be necessary e.g.
  for policy needs
• More flexibility to respond to changes in data
  requests
• Links between SHA and SNA appreciated

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IHAT responsibilities

• Set up programme of work for SHA revision
• Distribute the subjects into units
• Provide the rationale behind each unit
• Propose the key issues to be addressed in each
  unit
• Facilitate and co-ordinate the consultation
  process
• IHAT decides based on consensus
• IHAT has to warrant overall consistency

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IHAT steps in the Revision Process

• Invitation to produce Input papers and comments
  on these
• Co-ordinating organisation produces proposal for
  1st IHAT draft
• IHAT discusses and produces 1st IHAT draft
• Invite comments from the international community
• IHAT discusses and produces 2nd IHAT draft in
  case of consensus
• Lacking consensus selected experts opinion and
  back to IHAT accepting or rejecting of proposal
• IHAT (at senior level) submits Draft Manual to
  decision making bodies in three organisations

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Possible involvement, information provided

• Heads of statistical authorities of all OECD and
  EU member and candidate and acceding countries.
• Ministries of Health.
• Experts serving as focal points for the Joint
  OECD-WHO-EUROSTAT Health Accounts data
  collection.
• Health accounts networks.
• European Commission.
• UNSD, OECD Statistics Directorate.
• World Bank, Regional Development Banks, IMF.
• Private experts, ., etc.

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Facilitation of Participation

• A tri-party website is introduced
• A tri-party EDG is installed
• Each of the 3 organisations adds its own formal
  and informal processes
• OECD e.g. Health expert meeting
• WHO e.g. regional networks in the world
• EUROSTAT e.g. SHA Revision Development Group

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Expected results

• Solutions for identified statistical problems
• A sound statistical system
• Backward comparability
• Better links to SNA/ESA and its classifications
• Possibilities to link to national classification
  systems
• Improved cross-country comparability
• Improved usability in framework of policy
  relevance

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Proposed work programme

• Introduction
• Part I
• Principles Concepts

• Reasons for revision, new elements, overview
• Unit 1 Purposes principles
• Unit 2 Global boundaries
• Unit 3 Key concepts definitions
• Unit 4 Expenditure dimensions
• Unit 5 Types of HA
• Unit 6 Relationships to other statistical systems

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Proposed work programme (2)

• Part II
• ICHA

• Unit 7 ICHA-HC health care functional
  classification
• Unit 8 ICHA-HP health care provider
  classification
• Unit 9 ICHA-FS financing sources classification
• Unit 10 ICHA-HF financing schemes classification
  
• Unit 11 ICHA-HB beneficiaries classification
• Unit 12 ICHA-RC resources mobilised in the
  production of health goods and services
• Unit 13 ICHA-P health care products
  classification
• Unit 14 Human resources

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Proposed work programme (3)

• Part III
• Indicators, tables
• compilation

• Unit 15 Presentation of results
• Unit 16 Basic accounting rules and guidelines
• Unit 17 Possible compilation processes
• Unit 18 Policy use
• Glossary

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Time frame remarks

• Proposes finalisation date End of 2009
• The new Manual should provide clear guidance for
  migration from SHA 1.0 to SHA 2.0
• SHA revision should not discourage countries from
  developing NHA based on current methodologies

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Comparability
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Problems solutions

• Problems in cross-country comparability
• 10-20 years ago already known that providers,
  products and financing agents NOT comparable
  (even having the same name).
• New approaches were needed
• For comparability goals the Functional
  Classification was invented, evolved as a natural
  solution
• All problems solved?
• No, but much more comparability is reached by
  using the ICHA and much more expected by SHA II.