1970-2014 Current Health Expenditures and National Health Accounts in Korea: Application of SHA2011

IntroductionNational Health Accounts are a significant source of health expenditure data, designed to be comprehensive and comparable across countries. However, there is currently no single repository of this data and even when compiled major gaps persist. This research aims to provide policymakers and researchers with a single repository of available national health expenditures by healthcare functions (ie, services) and providers of such services. Leveraging these data within statistical methods, a complete set of detailed health expenditures is estimated.MethodsA methodical compilation and synthesis of all available national health expenditure reports including disaggregation by healthcare functions and providers was conducted. Using these data, a Bayesian multivariate regression analysis was implemented to estimate national-level health expenditures by the cross-classification of functions and providers for 195 countries, from 2000 to 2017.ResultsThis research used 1662 country-years and 110 070 data points of health expenditures from existing National Health Accounts. The most detailed country-year had 52% of the categories of interest reported. Of all health functions, curative care and medical goods were estimated to make up 51.4% (uncertainty interval (UI) 33.2% to 59.4%) and 17.5% (UI 13.0% to 26.9%) of total global health expenditures in 2017, respectively. Three-quarters of the global health expenditures are allocated to three categories of providers: hospital providers (35.4%, UI 30.3% to 38.9%), providers of ambulatory care (25.5%, UI 21.1% to 28.8%) and retailers of medical goods (14.4%, UI 12.4% to 16.3%). As gross domestic product increases, countries spend more on long-term care and less on preventive care.ConclusionDisaggregated estimates of health expenditures are often unavailable and unable to provide policymakers and researchers a holistic understanding of how expenditures are used. This research aggregates reported data and provides a complete time-series of estimates, with uncertainty, of health expenditures by health functions and providers between 2000 and 2017 for 195 countries.

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Regional Health Accounts for Pakistan—Provincial and District Health Expenditures and the Degree of Districts Fiscal Autonomy on Health.

The Pakistan Development Review ◽

10.30541/v48i4iipp.621-634 ◽

2009 ◽

Vol 48 (4II) ◽

pp. 621-634

Author(s):

Christian Lorenz ◽

Muhammad Khalid

Keyword(s):

National Health ◽

Regional Differences ◽

Health Expenditure ◽

Government Expenditure ◽

Health Expenditures ◽

Provincial Government ◽

District Health ◽

Fiscal Autonomy ◽

District Government ◽

Health Accounts

Since May 2009 the first National Health Accounts (NHA) for Pakistan have been finalised and published by Federal Bureau of Statistics (FBS) in cooperation with German Technical Cooperation (GTZ). This paper goes one step ahead the report and analyses in more detail the regional differences in health expenditure structures in Pakistan. The further analyses can be divided into four parts: health expenditures in provinces (Provincial Health Accounts, PHA),2 Punjab provincial and district governments health expenditures and its comparison with ADB figures, all districts of Pakistan and comparison between total district government and provincial government expenditure for each province; the latter calculation is applied as indication for the degree of fiscal autonomy of the districts in each province. Consequently we first analyse the provincial health expenditures by Financial Agents and compare them between the provinces which leads to very heterogeneous results (Section 2); the per capita health expenditures differ from 16 to 23 USD. Secondly, we compare NHA results on Punjab district government with available ADB results and present differences in methods as possible reasons for different results (Section 3). Third, we analyse district data of all district governments in all four Pakistani provinces on the level of detailed function codes in Section 4; the aim is to discover regional differences between districts of the same as well as of different provinces. Fourth, we analyse in Section 5 the degree of fiscal autonomy on health of the districts in each province; therefore we review the ordinance description and compare total district government with total provincial government expenditures per province. Finally we give recommendations for future rounds of NHA in Pakistan regarding formats and necessities of detailed health expenditure data collection to ensure evidence based decision-making not only on federal, but also on provincial and district level. JEL classification: H51, I1, O18, R1 Keywords: National Health Accounts, Health Expenditures, Regional Comparison, Regional Accounts, Fiscal Autonomy, Pakistan

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Measuring inequalities in the selected indicators of National Health Accounts from 2008 to 2016: evidence from Iran

Cost Effectiveness and Resource Allocation ◽

10.1186/s12962-020-00235-7 ◽

2020 ◽

Vol 18 (1) ◽

Author(s):

Mohammad Hossein Mehrolhassani ◽

Vahid Yazdi-Feyzabadi ◽

Marzieh Lashkari

Keyword(s):

National Health ◽

Service Providers ◽

National Development ◽

Health Resources ◽

Health Expenditures ◽

Health Financing ◽

Evidence Base ◽

Average Deviation ◽

Health Accounts ◽

Disparity Index

Abstract Background Increase in total health expenditures is one of the main challenges of health systems worldwide, and its inequality is considered as a concern in global arena especially developing countries. This study aims to measure inequality in the distribution of selected indicators of national health accounts across the Iranian provinces. Methods In this study, the data on health financing agents from provincial health accounts from 2008 to 2016 were collected. Gini coefficient (GC) was used to measure inequality. The population and the number of service providers in each province were the bases to measure the GC. The Coefficient of Variation (CV) and the Rate Ratio (RR) were used to determine the dispersion and variation across the provinces. Disparity index was employed to measure the average deviation of the out-of-pocket (OOP) proportion from the desired OOP proportion presented in national development plans (NDPs) of Iran. Results The distribution of resources using both bases were unequal, especially in OOP, with the highest rate over the years studied, ranging from 0.50 to 0.59. The inequality in public resources was lower, with Health Insurance Organization dropping from 0.42 to 0.40 over the years. CV and RR also confirmed the inequality in health resources distribution. In the years 2014 and 2015, the lowest and highest levels were 0.22 and 0.39, respectively. The values of disparity index for OOP had a fluctuating trend ranging from 37.01 to 65.85%. Conclusion Inequality in the distribution of public health expenditures was moderate to high. Moreover, inequality in private health expenditures was higher than public one. Distribution of OOP spent by households at provincial level showed a high inequality. It is suggested that inequality measures to be considered in NDPs to illustrate how resources are distributed at the geographical level. NHA framework can help to provide robust evidence base for policymaking.

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Assessment of financial flow in the health system of Serbia in a period 2003-2006

Vojnosanitetski pregled ◽

10.2298/vsp1005397g ◽

2010 ◽

Vol 67 (5) ◽

pp. 397-402 ◽

Cited By ~ 4

Author(s):

Milena Gajic-Stevanovic ◽

Nevenka Teodorovic ◽

Snezana Dimitrijevic ◽

Dragan Jovanovic

Keyword(s):

Health Services ◽

Health System ◽

National Health ◽

Health Expenditures ◽

Financial Resources ◽

Healthcare Expenditures ◽

State Institutions ◽

European Unity ◽

Financial Flow ◽

Health Accounts

Background/Aim. The main goal of every health policy is not merely the establishment of the health system sustainability, but the accessibility of health services to the whole population, as well. This objective is shared in European Union countries, and the consequence is the implementation of National Health Accounts (NHA). NHA, as a tool for evidence-based management, provides data regarding financial flow in health at national level and alows international comparability. The aim of this study was to determine Serbian overall health spending patterns by National Health Accounts, and to determine health care indices to provide policy makers with internationally comparable health indicators. Methods. A retrospective analysis of healthcare expenditures was obtained from the published final financial reports of relevant state institutions during a period of 2003 to 2006. The various sources of data on healthcare expenditures were connected according to instructions by the OECD 'A System of Health Accounts (SHA)' Version 1.0. Results. The obtained results showed: health expenditures in Serbia made up 8.6%, 8.3%, 8.7% and 9 % of the GDP in 2003, 2004, 2005 and 2006, respectively; the Health Insurance Fund was a predominant financing source of the public sector with 93% in 2006; the largest part of the total health expenditures went towards hospitals and for health services; the expenditure per capita in 2006 was 365 US$; Serbian population finances the state institutions 'out of pocket' with 21.28% of their sources, which was 7.3% of the total healthcare expenditures, and the private institutions with 78.72% of their financial sources, which is 27% of the total healthcare expenditures. In 2006 Serbia allocated financial resources out of GDP in the amount similar to the European Unity, while comparing to the countries of the region, these funds were less only than in Bosnia and Herzegovina. This allocating of financial resources in total, however, was low as the consequence of relatively low level of GDP in Serbia. Conclusion. Establishing NHA provided a pattern of national healtcare spending and allowed a comparison of healthcare system in Serbia with the systems of other countries. Analysing a period 2003- 2006 revealed a similarity between Serbia and the countries of the European Unity in regard to the level of average financial resources allocation for healthcare expressed as a percentage of GDP, as well as in regard to financiers in the system of healthcare. A high purchasing power disparity, however, in healthcare services was observed between the population of Serbia and other European countries.

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Vital Signs: National Health Expenditures As Percentage of Gross Domestic Product

Cardiology News ◽

10.1016/s1544-8800(08)70079-4 ◽

2008 ◽

Vol 6 (2) ◽

pp. 1

Keyword(s):

Gross Domestic Product ◽

National Health ◽

Vital Signs ◽

Health Expenditures ◽

Domestic Product

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The Arguments against a National Health Program: Science or Ideology?

International Journal of Health Services ◽

10.2190/7vcp-eg5g-13g5-g05r ◽

1988 ◽

Vol 18 (2) ◽

pp. 179-189 ◽

Cited By ~ 2

Author(s):

Vicente Navarro

Keyword(s):

United States ◽

National Health ◽

Health Program ◽

Health Expenditures ◽

The United States ◽

Federal Deficit ◽

Rate Of Growth ◽

Empirical Information ◽

Universal Health ◽

Program Science

This article provides empirical information that questions some of the major arguments put forward against the establishment of a comprehensive and universal health program in the United States. The positions that (1) “Americans do not want a further expansion of government roles in their lives,” (2) “a National Health Program would further increase the rate of growth of health expenditures,” (3) “the federal deficit is too large and needs to be reduced before establishing a National Health Program,” and (4) “people do not want to pay higher taxes,” are shown to be ideological rather than scientific. The author presents evidence that questions each of these assumptions.

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Annual Prevalence, Health Expenditures, and Co-Morbidities Trend of Iron Deficiency Anemia in Korea: National Health Insurance Service Data from 2002 to 2013

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17124433 ◽

2020 ◽

Vol 17 (12) ◽

pp. 4433

Author(s):

Yoo-Jin Park ◽

Hee-Sook Lim ◽

Tae-Hee Kim

Keyword(s):

Iron Deficiency ◽

Nutritional Status ◽

Iron Deficiency Anemia ◽

National Health ◽

Health Expenditures ◽

Medical Costs ◽

Deficiency Anemia ◽

Prevalence Rates ◽

Annual Prevalence ◽

Hospitalization Costs

Despite improvements in nutritional status, iron deficiency anemia (IDA) remains a debilitating nutritional problem worldwide. We estimate annual IDA prevalence rates by sex and age and the trends therein in Korea. We also calculate the health expenditures of IDA and its co-morbidities by analyzing claims data in the National Health Information Database from 2002 to 2013. All analyses were performed based on diagnosis codes of IDA (D50, D50.0, D50.8, and D50.9) regardless of whether IDA was the principal or a coexisting disease. Trends in IDA prevalence rates were evaluated by calculating annual percent changes (APCs) in prevalence. The health expenditures of IDA were calculated based on the direct medical costs (outpatient and hospitalization costs, pharmaceutical costs) and direct non-medical costs (travel costs). The overall IDA prevalence in both sexes increased approximately 2.3-fold from 2002 to 2013; the APC was +7.6%. In females, the prevalence of IDA was highest in aged 30–39 and 40–49 years. The APC was highest in those aged <10 years (+18.2%), followed by those aged ≥80 (+14.7%) and 70–79 (+9.8%) years. In males, the prevalence rates were highest in aged <10 years, followed by those aged ≥60 years. The APC was highest in those aged <10 years (+19.1%), followed by those aged ≥80 years (+10.5%). The total health expenditures increased 2.8-fold during 12 years. Diseases of the respiratory or gastrointestinal tract were the most prevalent co-morbidities in both males and females. The annual prevalence of IDA continues to rise in association with adverse health expenditures and co-morbidities in spite of improvements in nutritional status. Most importantly, infants and young children, the elderly, and females aged 30–49 years are at highest risk of IDA. A national, prospective, and well-organized effort to improve iron status and to manage IDA is required.

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