Results of the pilot SHA study in Poland

1. Results of the pilot SHA studyin Poland Dorota Kawiorska Cracow University of Economics

2. Results of the pilot SHA study in PolandThe time of the study, the data approach applied and the possibilities of matching national to ICHA classification • For the purpose of the study the year 1999 was adopted as a base year • For collecting data the financial agent approach was in general applied • For matching national classifications to the ICHA ones, the title of expenditure reported by financing agents were (with few exceptions) attributed to particular functions and providers at a one to one basis • The consequence: certain departures of the Polish NHAs from the SHA-ICHA determine in considerable degree the level of international comparability of the Polish data

3. Results of the pilot SHA study in PolandGeneral statement about data availability and departures from SHA-ICHA • A considerable part of information sources available for 1999 did not make the disaggregating of existing data and their ‘pure’ adjustment to the particular function and provider categories possible • Same data sources were also fragmentary or so general that it was necessary to make estimations to place these items in appropriate categories of these two classification • National classifications and existing reporting practices allow for a relatively complete attribution of expenditure to the first digit level of functional and provider’s classification. However, some departure are still visible, especially in the case of functional classification • Further digital division, depending on particular sources of health care funding, ought to be treated with care, as larger disparities emerging from lack of data or their aggregation and leading to some confusion among subcategories, are evident in the Polish NHA classification • For the purpose of the Polish NHAs it also turned out to be necessary to create an additional category of so-called ‘non classified services’ for both functional and providers classification of the ICHA

4. Results of the pilot SHA study in PolandMain departures from SHA-ICHA-HC on first digit level

5. Results of the pilot SHA study in PolandTotal health expenditure by financing sources

6. Results of the pilot SHA study in PolandTotal health expenditure by functions according to basic purpose of care

7. Results of the pilot SHA study in PolandCurrent health expenditure by function according to mode of production

8. Results of the pilot SHA study in PolandCurrent health expenditure by provider

9. Results of the pilot SHA study in PolandMain findings • Total health expenditure • 6.7% of GDP • 548.8 in US$PPP • The difference between pre-SHA and pilot SHA calculation of THE • 3.183 ml. PLN • 7.7% of the THE according to SHA calculation • This difference appeared due to: • Newly identified sources of health care funding (around 2.2%) • Wider boundaries of health care sector (around 5.5%) • The general ratio of private to public spending amount to 0.4 but • in the case of providers of ambulatory care to 0.6 • in the case of medical goods dispensed to out-patient to 1.9

10. Results of the pilot SHA study in PolandConclusions • What is the current state • using currently available findings could lead to inappropriate policies • care should be taken when comparing these findings internationally • What we know • A lot of disaggregated data exist, however they are not available/presented at national level • What we expect • The real rate of private health care financing in Poland would be even greater as well as the total expenditure of health • What should be done • An additional effort on standardisation of some health expenditure categories • A redesigning the way of reporting data between providers ,financing agents, and certain institution of data collection • The institutionalisation of NHA

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