Draft Guidelines for Health Expenditure and Financing in OECD Health Data 2006

1. Draft Guidelines for Health Expenditure and Financing in OECD Health Data 2006 7th Meeting of Health Accounts Experts and Correspondents for Health Expenditure Data Paris, 29-30 September, 2005

2. Overview • Current status and availability of expenditure data in OECD Health Data 2005 • Coordination with joint OECD-EUROSTAT-WHO HQ SHA Questionnaire • Proposed guidelines for OECD Health Data 2006 • SHA Electronic Discussion Group • Discussion

3. Status and availability of expenditure data - OECD Health Data 2005 Main aims for OECD Health Data 2005: • To improve availability of main aggregates and core variables • Increase the number of countries providing latest expenditure estimates • Improve comparability (methodological information)

4. Availability of main aggregates

5. Number of countries reporting data for 2003 (2002*)OECD Health Data * For HD2004

6. Key Sub-set of Core Variables% available for period 2000-03 (1999-2002*)

7. Current status - Conclusions • More countries starting to report SHA-based national health accounts to OECD Health Data - Norway, Poland. • Overall increase in reporting of main aggregates and core variables on last year. However • Only 9 countries report all the agreed sub-set of core variables; and • Some main aggregates (such as pharmaceutical expenditure) are only reported by two-thirds of countries

8. Timeframe- OECD Health Data 2006 • Deadline: February 15, 2006 • Co-ordination with Joint OECD-EUROSTAT-WHO SHA Questionnaire 2006 If 2004 data is expected to be reported by March 31, 2006 then it will not be necessary to complete the corresponding sections of the OECD Health Data 2006 questionnaire Countries should indicate their position as early as possible

9. Proposed guidelines - OECD Health Data 2006 Main aims: • To improve the coverage of the main aggregates • To increase reporting of the agreed sub-set of core variables • Continue harmonisation of variables with SHA-ICHA • Ensure a maximum of countries report health expenditure data for 2004 • Improve the methodological information

10. Proposed guidelines - specific areas • Long-term care expenditure • In-patient care • Distinction between hospital expenditure and in-patient care • Separation of daycare, homecare, ancillary services, etc • Clear reporting of methodology • Pharmaceutical expenditure • Reporting of 2004 • New request for Total expenditure I.e. including In-patient • Investment in medical facilities

11. Proposed guidelines - specific areas (2) • Public expenditure on administration • wide variations suggest methodological differences • operating costs of ministries and agencies • distinction from prevention and public health • Price indices • Out-of-pocket payments • new sub-categories - Out-of-pocket excl. cost-sharing - Cost sharing

12. Proposed guidelines – Further items • Temporarily hidden variables • Day-care / Expenditure by age and gender • Time-series breaks • after SHA implementation revisions of past years’ data • Preliminary estimates • OECD Quality Framework - timeliness • feasibility of total public expenditure on health for 2005 • “Get More Data” • Sources and Methods • main sources, deviations from SHA, series breaks, etc

13. SHA Electronic Discussion Group • Forum for sharing information, questions on all aspects of SHA work • Initial focus on Long-term care expenditure • Access via OLISnet and OECD Internet using username and password • Email alert facility for new messages • Launch in November

14. Discussion • Current efforts and strategy to expand, improve and harmonise data reporting with SHA • Feasibility of reporting new items for 2006, such as: • total pharmaceutical expenditure • estimated public expenditure • Out-of-pocket breakdown • Timeframe and deadline - SHA Questionnaire