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Analysis of trends in GDP and Health Expenditure in OECD countries, with a focus on Health Insurance

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Title: Joint Health Accounts Questionnaire Author: ASTOLFI Roberto Last modified by: cave_w Created Date: 5/13/2008 10:03:22 AM Document presentation format – PowerPoint PPT presentation

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Title: Analysis of trends in GDP and Health Expenditure in OECD countries, with a focus on Health Insurance


1
Analysis of trends in GDP and Health Expenditure
in OECD countries, with a focus on Health
Insurance
Roberto ASTOLFI and Luca LORENZONI Training
Course on Social Health Insurance 2009 National
Health Insurance Corporation Seoul, 17 June 2009
2
Background
  • The System of Health Accounts proposes an
    integrated system of comprehensive and
    internationally comparable accounts and provides
    a uniform framework of basic accounting rules and
    a set of standard tables for reporting health
    expenditure data

3
Background (cont)
The goal of the collaboration between OECD,
EUROSTAT and WHO is to reduce the burden of data
collection for the national authorities
responsible for the provision of statistical
information This joint effort also increases the
use of international standards and definitions
4
Methods
  • In 2005 the 3 organisations agreed to intensify
    their collaborative actions through a joint data
    collection based on
  • a functional classification of health care (HC)
  • a classification of health care financing (HF)
  • a classification of health care providers (HP)
  • a classification of financing sources (FS)
  • a classification of resources (RC)

5
Methods (cont)
  • Core tables (minimum requirement to countries)
  • HC x HP CHE by function of care and provider
  • HC x HF CHE by function of care and financing
    agent
  • HP x HF CHE by provider and financing agent

CHE Current Health Expenditure
6
Joint data collection 2009 Timing
  • 2009 JHAQ sent to health contacts on 15 December
    2008
  • Completed by 31 March 2009 by 27 countries
  • First validation by mid-May 2009

JHAQ Joint Health Accounts Questionnaire
7
Joint data collection 2009 Preliminary results -
Indicators
  • Health expenditure (HE) as a share of GDP
  • total public private
  • Current HE as a share of actual final consumption
  • Private HE components analysis
  • Population covered by private insurance

8
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9
Preliminary results - one
  • OECD countries devoted for the fifth consecutive
    year about 8.9 of their GDP to health spending
  • The share of health spending varies considerably
    across OECD countries, ranging from less then 6
    in Turkey and Mexico up to 16 in the United
    States
  • Also the share of public HE varies considerably
    across OECD countries more than three-fold
    difference between France and Mexico

10
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11
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12
Preliminary results - two
  • Evidence of a positive association between GDP
    per capita and HE per capita across OECD
    countries
  • Association is stronger among OECD countries with
    a low GDP per capita
  • However, there is a wide variation since GDP is
    not the sole factor influencing HE levels

13
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14
Preliminary results - three
  • The share of health goods and services to all
    goods and services consumed by individuals in the
    economy is more refined measure of relative
    importance of health spending
  • The average share of actual consumption allocated
    to health in OECD countries is almost 13, with
    90 of countries devoting more than 10 of
    consumption to health
  • Only Poland, Mexico, and Turkey are below the 10
    threshold, while US, Switzerland, Luxembourg, and
    Norway above 15

15
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16
Preliminary results - four
  • The average share of private health expenditure
    to total health expenditure is stable over time
    for the OECD countries and equals 27-28
  • In 2007, it ranges between 54 for United States
    and 9 for Luxembourg

17
Classification of sources of funding
ICHA Code Sources of funding Sources of funding Sources of funding
HF.1 General government General government General government
HF.1.1 General government excluding social security funds General government excluding social security funds
HF.1.1.1 Central government
HF.1.1.2 State/provincial government
HF.1.1.3 Local/municipal government
HF.1.2 Social security funds Social security funds
HF.2 Private sector Private sector Private sector
HF.2.1 Private social insurance Private social insurance
HF.2.2 Private insurance enterprises (other than social insurance) Private insurance enterprises (other than social insurance)
HF.2.3 Private household out-of-pocket expenditure Private household out-of-pocket expenditure
HF.2.4 Non-profit organisations serving households (other than social insurance) Non-profit organisations serving households (other than social insurance)
HF.2.5 Corporations (other than health insurance) Corporations (other than health insurance)
HF.3 Rest of the world Rest of the world Rest of the world
18
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19
Preliminary results - five
  • Out-of-pocket expenditure is the most important
    component of private health expenditure (PHE) in
    almost all OECD member States
  • However, in the US, France, and the Netherlands
    the share of Private insurance expenditure to PHE
    is the highest
  • Non-profit institutions play an important role in
    UK and Turkey, while corporations are important
    in Australia and Slovak republic

20
Private health insurance coverage, by type 2007
Primary
Complementary
Supplementary
Duplicate
21
Preliminary results - six
  • The share of population covered by Private Health
    Insurance (PHI) varies considerably across OECD
    countries. Seven countries report private
    coverage for over half of the population
    Netherlands France Belgium Canada US
    Luxembourg and Ireland
  • PHI plays a diversity of role in the health
    system. Primary cover for certain population
    groups in the United States and Germany

22
Preliminary results - seven
  • It offers to 88 of the French population
    complementary insurance to cover cost sharing
    applied in the social security system
  • The Netherlands has largest supplementary market,
    followed by Canada whereby PHI pays for
    prescription drugs and dental care that are not
    publicly reimbursed
  • Duplicate markets providing faster private-sector
    access to medical services where there are
    waiting times in public systems are the largest

23
Thank you for your attention!
  • For further information, please visit our
    websites
  • System of Health Accounts
  • www.oecd.org/health/sha
  • Revison of the System of Health Accounts
  • www.oecd.org/health/sha/revision
  • OECD-Eurostat-WHO Joint SHA Data Collection
  • www.oecd.org/health/sha/jointquestionnaire
  • OECD Korea Policy Centre
  • www.oecdkorea.org
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