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8. ICHA-HP CLASSIFICATION OF HEALTH CARE PROVIDERS
Principles and analytical use
From the production point of view a clear notion has to be present on how to treat all economic units to be included in or excluded from health care production. It is necessary to provide a clear guideline for identifying a statistical unit to be taken into account for the purpose of the provider classification. On one side the decision should follow the SHA rules and the SHA global approach. All providers, public and private need to be part of the system of health care and as such also of the provider classification. Providers like traditional healers and providers of oriental medicine should also find their place in the health account classifications.
Without a clear description of the production units a clear view on the consumption and export is very difficult. Moreover production (related to output) is one of the basic tables in the National Accounts. To be able to determine how the classification will be created decisions have to be taken on which type or types of units are going to be included in the classification, which are the units of observation. A large amount of literature is available on this subject. The most relevant units to be selected can include statistical unit, economic unit and unit of observation.
Health care providers are also an important component in the data collection, as they are one of the sources of information. From a policy point of view providers are important as well.
Key Issues
The main issue in the determination of the provider industry units is the set of criteria and rules used. Not only for the determination of the inclusion or exclusion of a unit but also in which part of the classification. Then first goal will be to determine which units of observation are going to be included in the health care provider branch. For this it is imperative to know the boundary of health care. All units of observation performing any activity, providing any service or good within this boundary should be included. Another key issue is the description and determination of the classes and groups to be distinct in the classification. For the distinction of the various sub-branches, groups and sub-groups of the provider classification the rules and criteria used in the classifying economic units in the ISIC/NACE branches might be very useful.
The level of detail in this classification, meaning the amount of groups, sub-groups and classes to be included, is open for discussion. International comparison of health care providers – as experience showed - is problematic due to significant differences of organisational arrangement among countries. However, the possibility of identifying certain activities within particular type of provider can generate value added with respect to monitoring efficiency of these arrangements For national purposes the classification can be more detailed. Another issue that may be of countries interest in the classification of providers is the characteristic of being a market producer or non-market producer.
The relation to the SNA/ESA as well as to the classifications used in those systems (like ISIC/NACE) are obvious although not by definition identical as the purpose for which the various classifications were built differ.
The differences with SHA 1.0 are at this moment not completely clear, but the new HP will have a close relation to the old HP in SHA.
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