developments in uk health accounts oecd meeting of experts in national health accounts 27-28 october...
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Developments in UK Health Accounts
OECD Meeting of Experts in National Health Accounts 27-28 October 2003
Gavin WallisHealth Accounts Team
Office for National Statistics
Outline
• Introduction
• Total UK Health Expenditure
• UK Health Accounts
• Results
• Next Steps
• Conclusions
• Questions / Discussion
Introduction to UK Health Accounts
• Stimulating debate
• Previous releases
• Next releases
• Project Board
• Key users identified
• Use of National Accounts
• Major deviations dealt with:
(i) Nursing Care not funded by NHS
(ii) Research and Development
(iii) education and training
• Charities, religious organisations, prisons, armed forces
Total UK Health Expenditure sources
Total UK Health Expenditure issues
• Private finance most problematic
• Conformity with SHA:
(i) Household production of health care services
(ii) Occupational health care
• Further deviations: using National Accounts
UK Health Accounts sources
• Health administrations
(i) Main source activity costs
(ii) Budgetary information
(iii) Double counting?
• Household expenditure based on National Accounts
• Nursing care
• Public / private split
UK Health Accounts issues
• Reasonable first estimate
• Some "top-down" methods
• Exclusion of Household production & Occupational health care
• NPISH, prisons, armed forces not fully cross-classified
• Financial year basis
• No time series
• Health related functions?
Results: UK Health Accounts 1999/2000
Total current expenditure on health by function, UK, 1999/2000
HC.1-267%
HC.36%
HC.41%
HC.518%
HC.73%
NPISH2%
Prisons and armed forces
1%HC.62%
HC.1-2. Cure/rehabilitationHC.3. LT nursingHC.4. Ancillary servicesHC.5. Goods (and related services) to outpatientsHC.6. Prevention & publicHC.7. Administration
Total current expenditure on health by provider, UK, 1999/2000
HP.1 HospitalsHP.2 Nursing facilitiesHP.3 Ambulatory facilitiesHP.4 Retailers of goodsHP.5 Providers of public healthHP.6 AdministrationHP.9 Rest of the world (imports)
HP.158%
HP.23%
HP.316%
Prisons and armed forces
1%
HP.90%
HP.50%
NPISH2%
HP.418%
HP.62%
Next Steps
• Household production of health services
• Further investigation into sources and methods
• Primary data sources (“bottom-up”)
• Function and provider for NPISH, prisons, armed forces?
• Calendar year basis
• Time series
Conclusions
• Reasonable first estimate
• Some documented deviations from SHA
• Improvements in pipeline
• Growing user demand
• Publication on 16 December 2003
Questions / Discussion