Health policies and data

A System of Health Accounts

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Introduction | Data collection | SHA development work

Introduction

In 2010, OECD countries continued to spend, on average, more than 9% of their GDP on health care, despite a dramatic slow down in the growth of health spending in many countries in the wake of the global economic crisis. However, the long-term trend in health spending is upwards and there is ongoing concern regarding the adequacy of resource levels for health care and the way that those resources are used. Consequently, policy-makers and researchers seek more detailed and comparative information on health care expenditures to address questions such as:

What are the main drivers accounting for health expenditure growth?
What factors explain the observed differences between countries?
What are the main structural differences in health spending between countries?
How are changes in the structure of health spending and performance of health systems related?

These and other issues, such as the effects of an ageing population, or tracking the financial burden of households, have been challenging the traditional system of health expenditure statistics.

In response, the OECD Manual A System of Health Accounts (SHA), first published in 2000 and now revised in 2011, provides a standard framework for producing a set of comprehensive, consistent and internationally comparable accounts to meet the needs of public and private-sector health analysts and policy-makers. The SHA manual establishes a conceptual basis of statistical reporting rules that are compatible with other economic and social statistics.

Countries - both OECD and non-OECD - are at varying stages in the process of implementing the System of Health Accounts (SHA):

The latest SHA data are available on OECD.Stat
Country-specific documents on the status of implementation are also available under SHA Country Reports

Joint OECD-Eurostat-WHO Health Accounts (SHA) Data Collection

Background

Since the publication of A System of Health Accounts in 2000 and the subsequent Producers Guide (WHO, World Bank and USAID, 2003), a number of OECD and non-OECD countries have undergone SHA implementation and produced SHA Tables. In 2004, OECD, Eurostat and WHO agreed on the need for a common strategy for the joint collection of health statistics. Building on this general approach, the three organisations developed a framework for a joint data collection in the area of health expenditure data in order to:

Reduce the burden of data collection for the national authorities
Increase the use of international standards and definitions for health expenditure data
Further encourage harmonisation across national health accounting practices in order to improve availability and comparability of health expenditure data

The resulting Joint Questionnaire is based on the original (detailed) set of classifications of the SHA manual with some additional minor amendments to the classifications, drawing on feedback and experience from implementation since the publication of the manual. In addition, two further dimensions were included in the questionnaire, seeking data on sources of funding and information on human resource costs. A number of additional memorandum items, deemed important from a health policy perspective were also added.

Results

The seventh Joint Health Accounts (SHA) Questionnaire, conducted in 2012, received health expenditure data for 27 OECD countries. The main comparative tables and charts are:

Total Health Expenditure as % of GDP, 2008-2010 [Excel]

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Health policies and data

A System of Health Accounts

Introduction

Joint OECD-Eurostat-WHO Health Accounts (SHA) Data Collection

Background

Results

SHA Development Work

Main components of SHA developmental work

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