A System of Health Accounts 2011 provides a systematic description of the financial flows related to the consumption of health care goods and services. As demands for information increase and more countries implement and institutionalise health accounts according to the system, the data produced are expected to be more comparable, more detailed and more policy relevant.
This new edition builds on the original OECD Manual, published in 2000, and the Guide to Producing National Health Accounts to create a single global framework for producing health expenditure accounts that can help track resource flows from sources to uses. The Manual is the result of a four-year collaborative effort between the OECD, WHO and the European Commission, and sets out in more detail the boundaries, the definitions and the concepts - responding to health care systems around the globe - from the simplest to the more complicated.
Acknowledgments Acronyms PART I. FOUNDATIONS OF THE SYSTEM OF HEALTH ACCOUNTS Chapter 1. Introduction -Background -Differences and improvements between SHA 1.0 and SHA 2011 -The role of the Manual and its organisation Chapter 2. Purposes and Principles of Health Accounts -Introduction -Background -Purposes and objectives of the System of Health Accounts 2011 -Principles of the System of Health Accounts 2011 -Analytical uses Chapter 3. Accounting Concepts and SHA Aggregates -Introduction -Accounting and national accounting as a base for the System of Health Accounts -The consumption, availability and use of health care goods and services -Main aggregates of health expenditure -Rest of the world -Time of recording -The measurement of consumption and output: market and non-market production -The treatment of subsidies and other transfers to provider industries -The production boundary of health care services -The relationship between current expenditure on health and the SNA components of consumption Chapter 4. Global Boundaries of Health Care -Introduction -Defining current health care expenditures -The boundary of the current health care expenditure account -The boundaries of the additional expenditure accounts of SHA Chapter 5. Classification of Health Care Functions (ICHA-HC) -Introduction -Health care consumption by purpose -Uses of the functional approach -Features of SHA 2011 functional classification -Rationale of the functional classification -Explanatory notes to the ICHA-HC classification of health care functions Chapter 6. Classification of Health Care Providers (ICHA-HP) -Introduction -Concept of the classification of health care providers -Description and guidelines for compilers -Explanatory notes to the ICHA-HP classification of health care providers Chapter 7. Classification of Health Care Financing Schemes (ICHA-HF) -Introduction -Main concept -Definition of health care financing schemes -Explanatory notes to the ICHA-HF classification of health care financing schemes -Specific conceptual issues -Main steps in adjusting SHA 1.0 or NHA Producers Guide of a country to SHA 2011 accounting of health financing PART II. FURTHER CLASSIFICATIONS, APPLICATIONS AND METHODOLOGY CONCERNING HEALTH ACCOUNTS Chapter 8. Classification of Revenues of Health Care Financing Schemes (ICHA-FS) -Introduction -Main concept -Definition of revenues of health care financing schemes -Explanatory notes to the ICHA-FS classification of revenues of health care financing schemes -Specific conceptual issues -SHA tables on revenue collection -Additional tools Chapter 9. Classification of Factors of Health Care Provision (ICHA-FP) -Introduction -Main concept Notes related to the classification and selected types of classes -Explanatory notes to the ICHA-FP classification of factors of health care provision Chapter 10. Health Spending by Beneficiary Characteristics -Introduction -Background -Analytical uses -Possible framework for analysing expenditures per different beneficiaries -Scope of health expenditures considered in analyses by beneficiary characteristics -Linkage to main SHA estimates -Classifications of beneficiaries -Possible methodological approaches Chapter 11. Capital Formation in Health Systems -Introduction -Definition of gross capital formation in SHA -Gross fixed capital formation -Changes in inventories and acquisitions less disposals of valuables -Different approaches to the estimation of gross capital formation -The consumption of fixed capital in SHA -Capital account -Other memorandum items Chapter 12. Trade in Health Care -Introduction -Background and policy issues -Basic concepts and definitions -Imports and exports under the System of Health Accounts -Data sources for estimating international trade in health services under SHA -Reporting of trade in health care goods and services under the SHA framework Chapter 13. Price and Volume Measures -Introduction -Measurement of changes in price and volume in the SHA framework -Inter-temporal indexes of price and volume -Market and non-market measures for health care -Products classification for price and volume measures -Measurement by provider industry -Measurement of quality changes -Inter-country indexes of price and Chapter 14. Basic Accounting and Compilation Guidance -Introduction -Basic accounting criteria -Summary introduction to SHA compilation processes -General measurement issues -Measurement issues in a special case Chapter 15. Presentation of Results, Tables and Basic Indicators -Introduction -The health accounts report -HA time series -Using HA with other health system information -Country background -Metadata and data sources -Quality checks -National, regional and international databases -The selection of tables presented in this chapter Annex A. Relationship of the ICHA to Other Classifications Annex B. The Relationship between SHA and SNA Annex C. Health and Health Associate Professionals and ISCO-08 Annex D. Financing of Health Systems - Supplementary Tools Annex E. Classifying Health Care Products Annex F. Medical Classifications Annex G. International Standards and Classifications of Trade and Tourism