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Revision of the International Classification for Health Accounts William Cave OECD Health Division

Revision of the International Classification for Health Accounts William Cave OECD Health Division. UN Expert Group on Classifications 1-4 September 2009 New York. Overview. Background to SHA and ICHA What is SHA? What is ICHA? Why revise? Health Functions Health Providers

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Revision of the International Classification for Health Accounts William Cave OECD Health Division

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  1. Revision of the International Classification for Health Accounts William Cave OECD Health Division UN Expert Group on Classifications 1-4 September 2009 New York

  2. Overview • Background to SHA and ICHA • What is SHA? • What is ICHA? • Why revise? • Health Functions • Health Providers • Health Financing

  3. Background to SHA and ICHA • ICHA first published in an OECD Manual “A System of Health Accounts” SHA in 2000 • WHO “Guide to producing national health accounts “ PG published 2003 • OECD, WHO and Eurostat have agreed to revise SHA and ICHA to be finalised end 2010 • Revision conducted by IHAT • Supported by EDG, website and regional expert meetings

  4. What is SHA? • Policy interests: • drivers of health expenditure growth? • observed differences between countries e.g. public v private? • changes in health expenditure v performance of health systems? • SHA addresses 3 main questions • Where does the money come from? • Where does the money go? • What kind of services and goods are purchased? • Common concepts, definitions and accounting rules

  5. Basic definition of SHA Current expenditure on health: final consumption expenditure of resident units on health care goods and services

  6. What is ICHA? • 3 main dimensions • Health functions HC • Health providers HP • Health financing agents/schemes HF • Additional dimensions • Financing sources FS • Resource costs RC • With cross-classified tables HPxHC, HFxHP etc • Joint data collection

  7. Why revise? • 10 years experience • Evolving health systems organiosation • Conceptual and methodological weaknesses • Greater complexity of financing • Related systems are changing • Analysts would like extra dimensions such as capital expenditure or expenditure by disease, age and gender

  8. HC health functions • Types of health services / goods for final domestic consumption • Treatment of disease or prevention or public health or administration • Products with a purpose • Relates to CPC, COFOG, COICOP, COPNI

  9. HP Health providers • Who provides the services • Hospitals • Primary care centres • Nursing homes • Pharmacies • Health insurers • Ministries of health • Etc • Relates to ISIC

  10. HF/FS Health financing • Who is paying? • Third party payers • Risk pooling • Access • Schemes becoming more complex • Financing interest comes down to which institutional sector is paying how much for what? • Public/private partnerships • Foreign aid for health • Relates to SNA institutional sectors

  11. Finally • Would like any Expert Group advice please • More information at http://www.oecd.org/health/sha/revision • Thank you

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