Health policies and data

Estimating Expenditure by Disease, Age and Gender



Estimating Expenditure by Disease, Age and Gender under the System of Health Accounts (SHA) Framework

Expenditure by disease data based on national health accounts can provide valuable information for use in policy analysis. Examples include global resource tracking, increased understanding of cost drivers in expenditure growth and analysing financing and coverage of priority diseases. In order to move further in this important area, it is necessary both to refine the definitions and approach that is followed, but also to demonstrate that such accounts can be developed in a cost-effective manner under the framework of the System of Health Accounts.


The overall objective is to accelerate the process of deriving consistent and comparable health expenditure data by disease categories. The aim of this project is expand the scope of available data by (i) increasing the number of countries for which similar data can be derived and (ii) expand the data collection beyond hospital expenditures to include the other major health care expenditure categories, i.e. outpatient (ambulatory) and pharmaceutical spending.

In 2008, the OECD completed a project entitled Estimating Expenditure by Disease, Age and Gender under the System of Health Accounts (SHA) Framework. Under the first phase, a set of guidelines was developed covering the main concepts and definitions and a methodology to allocate health expenditures (as defined under SHA) according to disease, age and gender. The second phase of the project consisted of a pilot study to test the feasibility of implementing these draft guidelines under differing health care system characteristics in six countries (Australia, Germany, Hungary, Korea, Slovenia and Sweden) with varying degrees of experience in undertaking such studies.

Project management and timeline

In a follow-up to the previous project, the OECD convened a meeting of experts in February 2012 with the goal of reviewing these guidelines, assessing developments since the project and making recommendations with respect to revising the guidelines. An interim report of the current project, which was presented and discussed at the meeting, has been prepared.

The final project report including an expanded OECD database on expenditure by disease, age and gender according to a revised set of guidelines is expected to be completed shortly.



Ms Yuki Murakami (
Mr David Morgan (