Over recent decades, an increasing number of countries around the world have started producing health accounts on a regular basis to systematically track the financial resources dedicated to health and thus provide input to inform policy making. In this context, the publication of A System of Health Accounts 2011 (SHA 2011) by OECD, WHO and the Statistical Office of the European Union can be considered a milestone in creating a global standard of health accounting concepts and boundaries, leading to a measurable improvement in the international comparability of data on health spending and financing, as well as an increased relevance of this data. As of now, nearly all OECD countries have implemented health accounts to enable them to regularly estimate health spending. Beyond the OECD, the SHA 2011 framework is also widely applied in many low- and middle‑income countries.
Yet, the way in which countries have institutionalised the regular production of health spending data to ensure that they are in line with international standards has so far not been analysed thoroughly. This is the focus of this report. Based on the experiences of 13 OECD countries, the report teases out good practices when it comes to governance of the production process, the technical process to produce health spending data, and the strategies to disseminate results for increased policy use of health accounts results.
The authors of this report are Michael Mueller, Jose Manuel Jerez Pombo and David Morgan of the OECD Health Division. The production of the report and the broader project of which this report is one of the outputs were managed by Michael Mueller.
This report was informed through structured interviews with health accounts experts from 13 OECD countries. The authors would like to thank Geoff Callaghan (AIHW, Australia), Waltraud Kavlik, Elisabeth Schappelwein and Johannes Schimmerl (Statistik Austria, Austria) Chris Kuchiak (CIHI, Canada), Gloria Farias Sarmiento and Jonathan Muñoz Gutiérrez (Ministry of Health, Chile), Mariannela Villalobos Cortés and Stward Hernández Cruz (Ministry of Health, Costa Rica), Clément Delecourt, Anne‑Sophie Kontopoulos and Geoffrey Lefebvre (Ministry of Health, France), Kristin Klein and Stefan Rübenach (Destatis, Germany), Hyoung-Sun Jeong (Yonsei University, Korea), Jaime Rozema (CBS, the Netherlands), Carmen Rodríguez Blas (Ministry of Health, Spain), Stefano Puddu and Jonas Tschantz (BFS, Switzerland), James Cooper (ONS, the United Kingdom), Aaron Catlin, Micah Hartman and Lekha Whittle (CMS, the United States) for their time and invaluable insights.
This report was made possible thanks to financial support from the Ministry of Health of Brazil. The authors would like to thank Danilo Oliveira Imbimbo, Pedro Buril Saraiva Lins, Gabriel Coelho Squeff, Luciana Simões Camara Leão and Erika Santos de Aragão (Ministry of Health) for the initial discussions and suggestions on the scope of this report. They would also like to thank Talita Vieira Antonio (Ministry of Health) and Felipe Pinheiro Mello (Ministry of Foreign Affairs) for administrative support. Hapsatou Touré, Natalja Eigo and Julien Dupuy from the World Health Organization also provided useful comments and suggestions. Within the OECD the authors would like to thank Francesca Colombo and Frederico Guanais for their suggestions and support, and Aleksandra Bogusz, Line Hansen, Sahnur Soykan, Guillaume Haquin and Isabelle Vallard for administrative support. Lucy Hulett provided essential support in the publication process.