|
3. KEY CONCEPTS AND DEFINITIONS IN HEALTH ACCOUNTS
Principles and analytical use
The unit provides definitions for aggregate measures of expenditure on health care. It is therefore central to the SHA. The proposed concepts and accounting rules correspond to SNA guidelines and are thus compatible with the common internationally recognised accounting rules for defining national economic aggregates. Consistently measured health expenditure estimates are important for undertaking comparative analysis. Total health expenditures may be compared using current expenditures, real expenditures (volumes) and expenditures deflated using a denominator (such as PPPs). What is most useful for analysing growth rates, productivity and inflation is health expenditure estimates and components that can be disaggregated in terms of prices and volumes.
Measurement of the volume of output of health services is difficult for complex services and particularly so in a context where there are no economically significant prices1. Previous methodologies assumed that the value of outputs equalled those of inputs. This method is inappropriate for obtaining a measure of the productivity of health services as it is implicitly based on an assumption of zero productivity. This assumption has now been rejected for national accounts compilations as amongst other weaknesses it precludes the measurement of productivity. More details of the development of output measures can be found in the Eurostat Handbook on Price and Volume Measures in National Accounts (2001) and in the draft of the OECD handbook Towards Measuring Education and Health Volume Output.
Thus this unit of the work will develop a framework for the measurement of volumes of health services that can be applied whether provision is by market or non-market producers and which can be used to compare output volumes over time and between countries.
|
