Embed Size (px)
Citation preview
1
1
The Norwegian System of The Norwegian System of Health AccountsHealth Accounts
Ann-Kristin Brændvang
Division for National Accounts
2
Background
The planning started in 2000
Established as a satellite account system to the National Accounts
SHA finalised at the end of 2004 and • time series for the period 1997-2004• constant price estimates for the same
period
3
The implementation
Planning
Adjustments in the NA-system and the need for improving data sources (2-3 years)
Mapping
4
National accounts
Comprehensive accounting framework
Satellite accounts;• flexible tool• consistent with the NA• designed for the purpose of economic analysis
Supply and use including more than 1200 products. The core variable is the product, more than 50 health products.
5
The NA product = data carrier
The classification was implemented by coding products in a specific way
A six digit-code that contents data on provider, type of goods and service and (in most cases) source of funding
Combination of ‘product – user- purpose’ in the core accounts of NA = platform for mapping to ICHA
6
The NA product, an example;
XXXXXX – 85XX – 85116– 85111– 85117– 851161 = Curative care provided
in hospitals, funded by the state.– 851390 = Dental service provided
by dentists and funded by households
7
Sources
The National Accounts
Public accounts
Statistics from public and private hospitals (specialist nursing homes, convalescence and rehabilitation institutions and hospitals)
The Household Budget Survey.
Other sources
8
Local government accounts (KOSTRA)
Better information about the local authorities
– Coherent system – Comparability– Timeliness
More efficient reporting– No data redundancy– Electronic data reporting
9
KOSTRA and Hospital accounts
Unique data source (covers around 75 per cent of the total health expenditure)
Accounting regulations• Classification by Types of
Expenditure• Classification by ‘Function’
10
KOSTRA and Hospital accounts accounting regulations cont….
Classification by Types of Expenditure:
Separating between:– Services produced by the municipalities / institutions– Services bought from others (private companies, municipalities or
the state)– Transfers
Consumption of fixed capital
11
KOSTRA and Hospital accounts accounting regulations cont….
Classification by ’Functions’, examples:• Maternal and child health; family planning and
counselling• Dental care• Basic medical and diagnostic services• Activation of elderly and disabled• Nursing and care, help in institutions• Nursing and care, help at home• Service of curative care• Rehabilitative care• Patient transport etc. • The costs are also classified according too ICHA-
HP for the services produced by the institutions.
12
Health versus Social care
Old age homes (no health personnel are required), are classified as social care
Nursing homes are classifies as health
The share is annually estimated
Figures indicate that about 90 per cent of the cost is related to health in 2002
13
Home care
We have information on man year by education/profession for ”Nursing and care, help at home” in addition to the total costs
The share is annually estimated, 65 per cent in 2002
Tendency towards more health less social care
14
Results – increased health expenditures
• The health expenditures compiled in the new system increased nearly 10 per cent compared to the “old” system
• The total health expenditures resulting from the new system is estimated to nearly 170 billion Norwegian kroner or
• about 10 per cent of GDP
• From 1997 to 2004 the health expenditures at constant prices has increased by 4,1 per cent per year on average, while the current expenditures have increased by 8,6 per cent per year
Total Health Expenditures. Indices 1997=100
0
20
40
60
80
100
120
140
160
180
200
1997 1998 1999 2000 2001 2002 2003 2004
Year
Ind
ex
Growth at current prices
Growth at constant prices
15
16
17
Health expenditure by function. 1997 and 2004 in per cent of total 1997 2004 Total expenditure on health, HC 1:7 + R1 100,0 100,0 HC 1.1 In-patient curative care 26,8 25,3 HC 1.2 Day cases of curative care 2,3 3,4 HC 1.3-1.4 Out-patient curative care 20,1 17,7 HC 2.1 Services of rehabilitative care 1,5 1,4 HC 3.1 In-patient long-term nursing care 14,7 15,2 HC 3.3 Long-term nursing care: home care 6,1 7,5 HC 4.1 Clinical laboratory and diagnostic imaging 3,5 3,3
HC 4.3 Patient transport and emergency rescue 2,4 2,3
HC 5 Medical goods dispensed to out-patients 14,0 13,9 HC 6-7 Prevention and health administration 2,7 2,8 R:1 Capital formation of health care provider institutions 6,0 7,2
