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Developing a System of Health Accounts in an Industrialized Economy: Progresses & Challenges

Developing a System of Health Accounts in an Industrialized Economy: Progresses & Challenges. Chung-Fu Lan, DrPH, FICD, FPFA, FRAI Associate Dean, School of Medicine National Yang-Ming University Fourth OECD/Korea RCHSP-ASNHAN Meeting of Regional Health Accounts Experts July 10, 2008.

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Developing a System of Health Accounts in an Industrialized Economy: Progresses & Challenges

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  1. Developing a System of Health Accounts in an Industrialized Economy:Progresses & Challenges Chung-Fu Lan, DrPH, FICD, FPFA, FRAI Associate Dean, School of Medicine National Yang-Ming University Fourth OECD/Korea RCHSP-ASNHAN Meeting of Regional Health Accounts Experts July 10, 2008

  2. Contents • Introduction • Progresses in the First Year of the SHA-Based NHA Study Project • Revealed from the National Health Account 2006 • Inquiry of Health Data/Metrics & Related Information for Taiwan’s SHA Project • Conclusion

  3. The State of NHE/NHA Developmentin Taiwan1 • Taiwan has begun the development of national incomes/national accounts in mid-1970’s. • Since the earlier 1990’s, the DOH & the academic have gradually developed & published the NHE/NHA followed the above-mentioned statistical methods and experiences.

  4. The State of NHE/NHA Developmentin Taiwan2 • After the implementation of the NHI in 1995, healthcare budgets/funds have increased tremendously, & the contents of the flow of funds have changed significantly (the total expenditure on health as % of GDP is 6.1% in 2007). • Taiwan has facing several important health policy issues such as very rapid demographic transition, the emergence of public health problems, shifting health paradigm, & great impacts of NHI’s global budget on health care delivery modules & providers’ behaviors.

  5. The State of NHE/NHA Developmentin Taiwan3 • Calls for more efficient use of resources and/or more resources are also facilitate the interests & tasks on embarking a better national health accounting exercises. • Keeping the path with methodological advancement & a series of standardized internationally classification for health accounts by the OECD, World Bank, WHO, USAID, the literature, & personal communications, the DOH & the scholars in Taiwan have worked on improving the contents & measurements, & continuing the updates of NHE/NHA.

  6. Progresses in the First Year of the SHA-Based NHA Study Project

  7. Progresses in Year 2007’s Study 1 • Literature reviews • Reviews of international SHA experiences • Conceptual, methodological & administrative considerations • Compiling the existing database & information • Discussions on strategies for meeting the items that data currently unavailable

  8. Progresses in Year 2007’s Study 2 • SHA tables (year 2005) preparation • Current expenditure on health by function of care, provider & source of funding • Current expenditure on health by function of care & provider industry • Current expenditure on health by provider industry & source of funding • Current expenditure on health by function of care & source of funding

  9. Revealed from theNational Health Account 2006

  10. Inquiry of Health Data/Metrics & Related Information for Taiwan’s SHA Project

  11. General Economic Indicators 1 • Total Output, Income, & Spending • Gross Domestic Product (GDP) • Real GDP • Implicit Price Deflators for GDP, (or Price Deflators) • GDP & Related Price Measures: Indexes & Percent Changes • National Income • Real Personal Consumption Expenditure • Sources of Personal Income • Disposition of Personal Income • Business Investment (Capital Expenditure) by Industry

  12. General Economic Indicators 2 • Employment, Unemployment, & Wages • Status of Labor Force • Selected Unemployment Rates • Nonagricultural Employment • Average Weekly Hours, Hourly Earnings, & Weekly Earnings – Private Nonagricultural Industries • Employment cost Index – Private Industry • Productivity & Related Data, Business Sector

  13. General Economic Indicators 3 • Production & Business Activity • Industrial Production & Capacity Utilization • Industrial Production – Major Market Groups & Selected Manufactures • New Construction • Prices • Producer Prices • Consumer Prices – All Urban Consumers • Changes in Producer Prices for Finished Goods • Changes in Consumer Prices – All Urban Consumers

  14. General Economic Indicators 4 • Government Finance • Government Receipts, Outlays, & Debt • Government Receipts by Source & Outlays by Function • Government Sectors, National Income Account Basis • International Trade • International Trade in Goods & Services • International Transactions

  15. Health Economic Indicators 1 • Total Health Care Output, Income, & Spending • Gross Health Care Output • Adjusted Health Care Output • Health Care Related Price Measures: Indexes & Percent Changes • Real Personal Consumption Expenditure in Health Care • Real Personal Out-of-Pocket Expenditure in Health Care • Health Care Capital Investment • Health Care Employment, Unemployment, & Wages • Status of Health Care Labor Force • Selected Health Care Professionals’ Nonhealth Employment & Unemployment (including Inactive) Rates • Average Weekly Hours, Hourly Earnings, & Weekly Earnings – Private Nonagricultural Industries • Health Care Employment cost Index – Private & Public Health Care Sectors • Productivity & Related Data, Health Care Sector

  16. Health Economic Indicators 2 • Health Care Production & Related Activities • Health Care Industrial Production • Health Care Resources’ Capacity Utilization • New Construction in Health Care • Health Care Prices • Health Care Producer Prices • Health Care Consumer Prices – Rural & Urban Consumers • Medical Consumer Price Index (MCPI) & • Changes in Health Care Producer Prices by Service Category • Changes in Health Care Consumer Prices – Rural & Urban Consumers

  17. Health Economic Indicators 3 • Central & Local Governments’ Finance in Health Care • Government Receipts, Outlays, & Debt in Health Care • Government Receipts in Health Care by Source & Outlays by Function • Government Sectors, National Health Account Basis • International Health Care Statistics • International Trade in Medical Equipments & Service • International Trade in Pharmaceuticals & Services • International Trade in Health-related Commercial Insurance Programs • International Trade in Medical Care Services • International Trade in Long-Term Care & Social Assistive Services • International Trade in Other Health Care Related Services • International Health Care Transactions

  18. National Household Health Expenditures Survey • Especially on the out-of-pocket (OOP) expenditures • Defining health & healthcare broadly; including traditional medical-related practices • Examples: • Long-term care • Complementary & alternative medicine • Over-the-counter (OTC) pharmaceuticals • Private health insurances

  19. Building a Better Health System with the Basis of a Better Health Information

  20. Health System Reform & National Health Account • Essentially, structural reform in pricing & cost control as well as regulations of providers • In details: • improving cost efficiency, • assuring quality, • promoting competition, • equitabling access, • decentralizing administration, & • responding to aging.

  21. Many Thanks !!

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