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Health Accounts

BASYS supports the implementation of Health Accounts.

National and international manuals of health accounts give the following reasons for compiling health accounts:

To provide basic financial information on health systems;
To provide information on how health funds are distributed across the different services, interventions and activities that the health system produces;
To facilitate valid spatial and temporal comparisons of health expenditure;
To show who benefits from health expenditure in terms of its financial value and fairness in distribution;
To inform health policy and thus help to improve the performance of health systems.

The main objectives of the OECD System of Health Accounts are:

To provide a set of internationally comparable health accounts in the form of standard tables;
To present tables for the analysis of flows of financing in health care together with a classification of insurance programs and other funding arrangements;
To provide a framework of main aggregates relevant to comparative research into the meso and micro structure of health care services;
To propose a framework for consistent reporting on health care services over time;
To monitor the economic consequences of health care reform and health care policy;
To provide a framework for analysing health care systems from an economic point of view, consistent with national accounting rules.

A summary of questions, which can be answered by Health Accounts data and Health Accounts indicators with respect to the policy dimensions "sustainability", "efficiency", "effectiveness", and "access" is presented below:

Dimension/ SHA cross-classifications	Questions which can be answered with NHA data	Questions which can be answered with additional information
Sustainability HS x HF*	Where does the money come from? How does the distribution of expenditure by financing source change over time? What is the relative contribution of direct payments and contributions through third-party payers? What is the "incidence of financing" (if proportions of taxes paid by firms, households & the rest of the world can be identified)? What is the role of general revenue financing?	demographic projection data Is the current distribution of proportion of revenue by source sustainable? And the current level of revenue sustainable? strategic policy statements Will the distribution of expenditure by source change in future?
Efficiency HF x HP	How are funds distributed across different types of providers e.g. hospitals versus ambulatory care?	measures of service throughput What is the average spend per unit of service delivered? What is the relative cost-efficiency of different service providers?
Effectiveness
HF x HP HP x HC	What is the contribution of different types of provider to total spending on specific types of goods and services? E.g. where is spending on public health programmes located i.e. which providers receive what proportion of funds for this service?	diagnostic and activity info Which providers and financing agents are contributing to treatment of diseases/conditions identified as priorities for intervention?
HF x HC	Who finances what types of service? What share of total resources is allocated to specific types of health care and healthcare-related activities?	norms for appropriate distribution of expenditure To what extent are health policy aims being achieved e.g. for expenditure on preventive health?
Equity/access
HF x age/gender	How are financial resources allocated from different payers/purchasers to different age/gender groups of the population? What is the coverage with expenditure benefits under insurance for specific groups e.g. older women?	info on policy on age/gender group targeting Are policy objectives being met?
HF x location of residence	Who pays for higher expenditure at regional level? How is expenditure distributed by region/province?

* The classification Sources (HS) x Financing Agents (HF) is proposed by the Producers' Guide.