Guidelines for Improving the Comparability and Availability of Private Health Expenditures
Under the System of Health Accounts Framework
Rannan-Eliya, R. P. and L. Lorenzoni
OECD Health Working Papers, No. 52, 2010OECD Publishing.doi: 10.1787/5kmbrcg0clvc-en
Available online PDF [68p.] at: http://bit.ly/bCuOk5
“…This paper reports on a project to improve the comparability and availability of private health expenditure under the joint health accounts questionnaire (JHAQ) data collection.
The joint health accounts questionnaire JHAQ is a framework for joint data collection in the area of health expenditure data developed by OECD, Eurostat, and WHO.
In particular, the study questions were:
How to overcome the inherent tendency for much private health care financing to occur without the generation of linked, reliable, and comprehensive routine data? How to tackle the issue of private providers likely to operate without reporting of routine data to statistical agencies?........”.
TABLE OF CONTENTS
EXECUTIVE SUMMARY
1. INTRODUCTION
2. DEFINITIONS
3. PROBLEMS AND CHALLENGES IN THE MEASUREMENT OF PRIVATE HEALTH EXPENDITURES
4. GENERAL APPROACH
4.1 Measurement strategy
4.2 Formulating the measurement strategy
4.3 Assessing data sources
4.4 Selecting approaches
4.4.1 Measurement from financing and provider perspectives
4.4.2 Integrative approach to expenditure measurement
5. METHODS FOR SPECIFIC EXPENDITURE FLOWS
5.1 A/B/C classification of methods
5.2 Methods specific to expenditure flows classified by financing agents
5.3 Methods specific to providers
5.3.1 Private expenditures at public providers (cost sharing)
5.3.2 Expenditures at private hospitals – HP.1
5.3.3 Expenditures at private providers of ambulatory care, including physicians – HP.3
5.3.4 Sales of pharmaceuticals through retail outlets – HC.5.1 and HP.4
6. METHODS SPECIFIC FOR ESTIMATION OF HOUSEHOLD OUT-OF-POCKET EXPENDITURE38
6.1 Determining when and how to use household survey data
6.2 Types of household surveys
6.2.1 Household budget surveys
6.2.2 Specialised surveys of household healthcare utilisation and expenditure
6.2.3 Specialised surveys of household health care utilisation only
6.2.4 Diary surveys
6.2.5 General limitations in coverage of household surveys
6.3 Assessing reporting biases in household survey data
6.4 Estimating household expenditures in the absence of reliable provider data
7. PRODUCING FINAL ESTIMATES OF PRIVATE EXPENDITURE BY RECONCILING AND INTEGRATING ESTIMATES
7.1 Estimation of expenditures as a time series
7.2 Organisation of data
7.3 Reconciliation and integration of the estimates
8. CONCLUSIONS
ANNEX 1: REPORTS ON IMPLEMENTING THE DRAFT GUIDELINES
BIBLIOGRAPHY
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