slide1
Download
Skip this Video
Download Presentation
SHA based National Health Account Hiroyuki SAKAMAKI, MBA

Loading in 2 Seconds...

play fullscreen
1 / 25

SHA based National Health Account Hiroyuki SAKAMAKI, MBA - PowerPoint PPT Presentation


  • 118 Views
  • Uploaded on

SHA based National Health Account Hiroyuki SAKAMAKI, MBA Institute for Health Economics and Policy (IHEP) Tokyo, Japan Meeting of Experts in National Health Accounts Organisation for Economic Co-operation and Development (OECD) Directorate for Employment, Labour and Social Affairs

loader
I am the owner, or an agent authorized to act on behalf of the owner, of the copyrighted work described.
capcha
Download Presentation

PowerPoint Slideshow about ' SHA based National Health Account Hiroyuki SAKAMAKI, MBA' - ursa


An Image/Link below is provided (as is) to download presentation

Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author.While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server.


- - - - - - - - - - - - - - - - - - - - - - - - - - E N D - - - - - - - - - - - - - - - - - - - - - - - - - -
Presentation Transcript
slide1

SHA based

National Health Account

Hiroyuki SAKAMAKI, MBA

Institute for Health Economics and Policy (IHEP) Tokyo, Japan

Meeting of Experts in National Health Accounts

Organisation for Economic Co-operation and Development (OECD)

Directorate for Employment, Labour and Social Affairs

Chateau de la Muette, Paris, 27-28 October 2003

slide2

Japan

SHA Member

Manabu YAMAZAKI

Koki HAYAMIZU

Sumie IKEZAKI

Masahiro TASHIMA

outline of presentation
Outline of Presentation
  • Overview of the NHA estimates in 2000
  • LTC System and Estimating Expenditure of LTC
  • Key Issues
trend of national medical expenditure nme

Bio Yen

35,000

30,000

25,000

20,000

15,000

10,000

5,000

0

1990

1991

1992

1993

1994

1995

1996

1997

1998

1999

2000

Trend of National Medical Expenditure (NME)

Shifted to LTC

slide5

The Structure of

National Health Accounts

(Billion Yen, 2000)

Total Expend. on Health

39,534

Current Expend.

37,306

Investment

2,227

Personal Expend.

35,283

Collective Expend.

2,022

Medical Services

27,724

Medical Goods

7,559

Prevent. & Public Health

1,165

Admin. &Insurance

875

structure of sha

Personal Expenditure

Structure of SHA
  • Spending on medical-related services
  • HC 6 Preventive health and health Promotion
  • Medical services
    • OTC drugs,Private-duty nursing,etc.
  • Medical-related services
    • Personal dental services, Special meals,etc.

HCR.

Sub-systems supporting the medical system

education, R&D, etc

LTC Welfare services

NME as currently defined.

HC.7 Indirect NME as currently defined.

Administration of health insurance system

HCR.1 Public expenditures on medical institutions.

Subsidies, Public payments, etc.

trend of personal health expenditure and nme

BioYen

40,000

36,068

35,034

35,000

34,118

7,940

Medical Goods

32,879

7,559

7,213

32,119

31,633

National Medical Expend

7,272

7,734

29,950

7,949

30,000

31,323

30,934

30,358

7,823

247

Ancillary Services

29,825

247

212

29,065

Home Care

28,521

161

207

150

26,958

105

198

25,000

81

193

59

190

40

12,595

12,230

Out Patient Care

21

12,143

20,000

11,449

10,765

10,487

9,620

15,000

In Patient Care

10,000

15,126

14,848

14,445

13,870

13,363

12,964

12,296

5,000

0

1995

1996

1997

1998

1999

2000

2001

Trend of Personal Health Expenditure and NME

Estimation in 2001 is tentative data

current expenditure by function

23,691

HC.1 Services of curative care

(63.5%)

7,216

HC.5.1 Pharmaceuticals and

(19.3%)

other medical non-durables

HC.3 Services of long-term

3,517 (9.4%)

nursing care

HC.6 Prevention and

1,165 (3.1%)

public health services

HC.7 Health administration

857 (2.3%)

and health insurance

HC.5.2 Therapeutic appliances

343 (0.9%)

and other medical durables

HC.2 Services of rehabilitative

269 (0.7%)

care

Bil Yen

2000

HC.4 Ancillary services

247 (0.7%)

to health care

-

5,000

10,000

15,000

20,000

25,000

Current Expenditure by Function
current expenditure by financing

25,501

HF.1.2 Social security funds

(68.4%)

HF.2.3 Private household out

6,570

-of-pocket expenditure

(17.6%)

HF.1.1 General government excluding

4,518

social security funds

(12.1%)

593

HF.2.5 Corporations

(1.6%)

124

HF.2.2 Private insurance enterprises

(0.3%)

-

5,000

10,000

15,000

20,000

25,000

30,000

Current Expenditure by Financing

(Billion Yen, 2000)

current expenditure by provider

18,871

HP.1 Hospitals

(50.6%)

7,860

HP.3.1 Offices of physicians

(21.1%)

HP.4 Retail sale and other

4,566

providers of medical goods

(12.2%)

HP.3.2 Offices of dentists

2,559 (6.9%)

HP.5 Provision and administration

1,165 (3.1%)

of public health programmes

HP.2 Nursing and residential

1,088 (2.9%)

care facilities

HP.6 General health

857 (2.3%)

administration and insurance

247 (0.7%)

HP.3.9.1 Ambulance services

HP.3.9 Other providers of

247 (0.7%)

Bil Yen, 2000

ambulatory health care

HP.3.6 Providers of home

93 (0.3%)

health care services

-

5,000

10,000

15,000

20,000

Current Expenditure by Provider
public long term care insurance act
Public Long Term Care Insurance Act
  • In effect since April 1, 2000.
  • To allow those in need of care and support to lead their daily lives as independently as possible making use of the capabilities.
  • To provide long term care by integrating health, medical care and welfare services as select by the user.
mechanism of ltc insurance system
Mechanism of LTC Insurance System

municipalities

30%

Premiums

of elderly

(17%)

Premiums

Aid to municipality

Prefecture

No.1 Insured

(65 and over)

Public

expenditure

70%

Deducted from

pension

Premiums

of

non-elderly

(33%)

State

(25%)

Premiums

Medical insurers

No.2 Insured

(from 40 to 64)

Prefecture

(12.5%)

Federation of National Health

Insurance Associations

Lump-sum payment

National pool

Examinations,payments,etc.

Municipality

(12.5%)

Social Insurance

Medical Care Fee

Payment Fund

Transfer

domiciliary service
Domiciliary Service
  • Home-visit services

Home help service / Bathing service / Nursing / Home rehabilitation

  • Short-term stay services

Day service (at day care center) / Outpatient rehabilitation (at medical care facility) / Short stay therapy / Group therapy to counter dementia (home for senile dementia patients) / Long term care for residents of special facilities

  • Others

Home treatment management and guidance / Leasing of welfare appliances/Provision for purchase of home care welfare appliances / Provision for home improvements associated with care / Home help service support

facility services
Facility Services
  • Long Term Care Welfare Facilities for the Elderly (Special Nursing Homes for the Elderly)
  • Long Term Care Health Facilities for the Elderly (Facilities of Health Care Services for the Elderly)
  • Long Term Care Medical Treatment Facility
    • Medical treatment beds
    • Beds for treatment of senile dementia
    • Long Term Care strength building hospital
ltc funding

HF.2.3Out of Pocket

HF.1.1.2Prefecture

(12.5%)

HF.1.1.1

State

(25%)

Public Expenditure

HF.1.1.3

Municipalities

(12.5%)

HF.1.2

Social Security Funds

(50%)

Insurance Premium

LTC funding
key issues
Key Issues.

Items those are not counted in the National Expenditure on Health by SHA definition due to lack of data.

Following data are NOT available, therefore cause for underestimation:

  • Expenditure for amenities, advanced med care (ie. ESWL)
  • HC.2.3 Non-Insured Acupuncture and JUDO reposition.
  • HC.6 Educational interventions for health promotion. Expenditure for the public health center admin.
  • HC.7 Expenditure for the general government admin.
  • HCR.1 Capital investment for specialized hospitals.
  • HCR.2,4-7 Not available.
conclusion
Conclusion
  • The total expenditure on health in Japan 2000 is about 700 billions of Yen (22%) higher than the value based on the National Medical Care Expenditure
  • In 2000, 293,916 Yen per capita – that is 7.3 % of GDP – were spent on total expenditure on health. Public funds financed 80% of the total expenditure.
  • Between 1996 and 2000, the growth of total expenditure on health varied between 1.5% (1996/1997) and 4.4% (1999/2000) per year.
slide25

Kinkaku-Ji:The Golden Temple

Thank you for your attention

Kimono

Tea Ceremony

ad