Institute of Health Information and Statistics of the Czech Republic National Health Accounts in the Czech Republic Present state and implementation of

Institute of Health Information and Statistics of the Czech Republic Institute of Health Information and Statistics of the Czech Republic ČRČRÚZISÚZIS

National Health Accounts National Health Accounts in the Czech Republicin the Czech Republic

Present state Present state

and implementation ofand implementation of

the the SSystem of ystem of HHealth ealth AAccounts ccounts methodologymethodology

OECD meeting of experts in NHA, 27-28 October 2003, ParisOECD meeting of experts in NHA, 27-28 October 2003, Paris


Present information systems Present information systems covering area ofcovering area of health health

• National Health Information System National Health Information System (IHIS)(IHIS)

• Government Finance Statistics (Ministry Government Finance Statistics (Ministry of Finance)of Finance)

• International databases (OECD, WHO)International databases (OECD, WHO)

• National Accounts (Czech Statistical National Accounts (Czech Statistical Office)Office)


Activities Activities related torelated to implementation of SHAimplementation of SHA

• Translation of SHA manual and conversion of Translation of SHA manual and conversion of national classifications to ICHAnational classifications to ICHA

• Monitoring of available data sourcesMonitoring of available data sources• Modifications of statements of health Modifications of statements of health

insurance companies, collection and analysis insurance companies, collection and analysis of new dataof new data

• Preparation of data Preparation of data collecting and collecting and methods of methods of expendituresexpenditures estimation estimation from other sourcesfrom other sources


Expenditures Expenditures monitoredmonitored by by current current sourcessources

Source of Source of fundingfunding

Source covers mainly Source covers mainly area of:area of:

ShareShare in totalin total

General General governmentgovernment

- collective health care services- collective health care services- - capital formationcapital formation- health related functions- health related functions

10%10%

Social Security Social Security FundsFunds

- - personal health carepersonal health care services services 80%80%

Private household Private household o-o-p expenditureo-o-p expenditure

- pharmaceuticalspharmaceuticals- therapeutic appliancestherapeutic appliances- services of dental careservices of dental care

10%10%


Main data sourcesMain data sources

• Government expenditureGovernment expenditure– HF.1HF.1 → functions of budget → functions of budget ((HP.x/HC.xHP.x/HC.x))

• Social security fundsSocial security funds– HF.1.2HF.1.2 → segments of care → segments of care ((HP.x/HC.x)HP.x/HC.x)

• Household out-of-pocket expenditure Household out-of-pocket expenditure (Family Accounts Statistics)(Family Accounts Statistics)– HF.2.3HF.2.3 → COICOP → COICOP ((HC.x)HC.x)


Supplementary data sourcesSupplementary data sources

• Economics of health establishments - assets Economics of health establishments - assets and debts, costs (by type of care) and returns and debts, costs (by type of care) and returns (by source) of health establishments(by source) of health establishmentsHF.x → HF.x → HPHP.x.x → → type of caretype of care

• Health employment: Health employment: HPHP.x.x → → occup.&occup.&wageswages• Economic data on pharmacies (revenues)Economic data on pharmacies (revenues)

HF.x → HF.x → HP.4HP.4 → HC.5 → HC.5• Drug consumption by ATC: HC.5Drug consumption by ATC: HC.5• Health care for foreigners: HF.x → Health care for foreigners: HF.x → HP.1HP.1


Potential data sourcesPotential data sources

• Long-term nursing care in social Long-term nursing care in social establishments: establishments: HP.2HP.2 → HC.3 → HC.3

• National accounts - sector accounts and National accounts - sector accounts and branches production accounts (branches production accounts (HF.2.4HF.2.4))

• Occupational health care financed by Occupational health care financed by corporations: corporations: HF.2.5HF.2.5 → HC.6.5 → HC.6.5

• Private health insurance (Private health insurance (HF.2.2HF.2.2))


Problems and Problems and challengeschallenges Functions of health care Functions of health care

• Determination of boundaries for health care, Determination of boundaries for health care, healthhealth--related care and non-health care.related care and non-health care.– inincluded: education and researchcluded: education and research– eexcluded: long-term nursing care in social care xcluded: long-term nursing care in social care

establishmentsestablishments

• Differences in definitions of functionsDifferences in definitions of functions– modes of production: modes of production: day care not definedday care not defined– types of episode of caretypes of episode of care:: data data not not available available or or in in

different structuredifferent structure


Problems and Problems and challengeschallenges Providers of health care Providers of health care

• Boundaries for health care industriesBoundaries for health care industries– problem problem ofof different sources of datadifferent sources of data

• Type of provider reporting dataType of provider reporting data– legal subjects legal subjects (used at present) (used at present) x units of x units of

homogenous productionhomogenous production


Problems and Problems and challengeschallenges Financiers of health care Financiers of health care

• Not all groups of financiers are included Not all groups of financiers are included → involving → involving other other financiersfinanciers

• Real allocation of all resources (a Real allocation of all resources (a concrete purpose of useconcrete purpose of use)) neeneedn’tdn’t be be known when collecting data from known when collecting data from financiers financiers

→ → broader use of data from broader use of data from providersproviders


Forthcoming plansForthcoming plans• To publish first estimates of health To publish first estimates of health

expenditures by SHA structureexpenditures by SHA structure• To To continually continually solve appropriate evaluation of solve appropriate evaluation of

types of health care according to ICHA-HCtypes of health care according to ICHA-HC• TTo join o join expenditure expenditure data with non-monetary data with non-monetary

health data from other sources (e.g. length of health data from other sources (e.g. length of stay stay and and number of hospitalisations by age, number of hospitalisations by age, sex and ICD)sex and ICD)

• To To reviewreview ICHA consistency when combining ICHA consistency when combining data from different sourcesdata from different sources


ContactContact

Institute of Health Information and Institute of Health Information and StatisticsStatistics (www.uzis.cz) (www.uzis.cz)

Jakub HrkalJakub Hrkal [email protected]@uzis.cz

Czech Statistical Office Czech Statistical Office (www.czso.cz)(www.czso.cz)

Jiří PapánekJiří Papá[email protected]@gw.czso.cz

Documents

Institute of Health Information and Statistics of the Czech Republic National Health Accounts in the Czech Republic Present state and implementation of