1. HEDIC Health expenditures by diseases and conditions
WG Public Health Statistics, December 17, 2014
Marian Craig, HEDIC Project Manager

2. Eurostat Contract No: 07154.2013.001-2013.239
HEDIC
Background and context
Why make international comparisons of health expenditure by diseases?
- understand the determinants of health care expenditure (e.g. demography, epidemiology, health technology, pricing policy, organisational determinants of access);
- predict trends in health care expenditure;
- inform priority setting for health treatment and prevention activities;
- understand indirect costs of illness (e.g. early retirement due to illness, incapacity to work).
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3. Eurostat Contract No: 07154.2013.001-2013.239
HEDIC
Project aims and objectives
to develop a methodology for systematically collecting information on transactions within health systems in relation to health outcomes, related to disease, age and sex
applicable to as many European countries as possible
within the overall goal of increasing the use of official public health data within the European Statistical System (ESS).
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4. Eurostat Contract No: 07154.2013.001-2013.329
HEDIC Distribution of health expenditure by condition and activity, Germany, 2008 (Source: BASYS)
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5. Holistic approach will lead to better results
Example: Analysis of cancer related cost
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6. Consortium members – 17 countries
HEDIC
Consortium members – 17 countries
Project Lead: Luxembourg *
Active participants: Austria*, Bulgaria**, Czech Republic**, Germany BASYS, Greece Athens University, Hungary**, Lithuania SEC Consultancy, Latvia**, Netherlands**, Sweden*, Finland *
Subcontractors: Netherlands Public Health Institute, Slovenia Stanislav Marn Consultant
Observers: Austria Austrian Social Insurance Institutions, Switzerland **, Spain*, Germany**, Poland**, UK*
* Ministry of Health/Social Security ** Central Statistical Office
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7. Eurostat Contract No: 07154.2013.001-2013.239
HEDIC
Main tasks
Task 1 Compile a data inventory
Task 2 Prepare the HEDIC Manual
Task 3 Pilot projects to test the methodology for compiling expenditure by disease
Task 4 Analysis of pilot project data
Task 5 3 workshops Stockholm (June 2014), The Hague (March 2015) , Budapest (Spring 2016)
Task 6 Final report - Eurostat Working Paper (May 2016)
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8. Eurostat Contract No: 07154.2013.001-2013.239
HEDIC
A. Current health expenditure by providers/functions/financing (with a decision to be taken about which years to use for the compilation) B. Allocation of current expenditure by disease, age and gender B.1 Expenditure B.2 Utilisation B.3 Unit cost B.4 Reproductive health B.5 Metadata C. Indirect costs D. Studies of cost of illness E. Data sources
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9. Eurostat Contract No: 07154.2013.001-2013.239
HEDIC Key challenges I
Objective of HEDIC: develop a methodology for compiling data on cost of illness applicable in all European countries (EU and EFTA). Consortium carrying out the work currently consists of organisations from 17 European countries. 28 of 31 EU/EFTA countries have responded to our request for information about HEDIC data availability.
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10. Responses to data inventory questionnaire, 27/11/14
Country
Completed
questionnaire
Need more time to complete questionnaire
Interested in principle but no resources
Referred to work already done
No response
Austria 
Belgium
Bulgaria
Croatia
Cyprus
Await implementation of NHIS
Czech Republic
Denmark
Estonia
End 12/14
Finland
France
CNAMTS, Expenditure by major pathologies
Germany
Greece
Hungary
Iceland
Ireland
Italy
Latvia
Lithuania
Luxembourg
Malta
Netherlands
Norway
Poland  
Portugal
Romania
Spain
Slovak Republic
Slovenia
Sweden
Switzerland
Will support the project as observers UK
DoH, Programme Budgets
Total 16 5 2 3
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11. HEDIC Key challenges II
Securing access to data on health expenditure by disease generated and controlled by social and commercial health insurance organisations, is arguably the biggest challenge for the work of HEDIC. In the absence of this data, the picture we develop of health expenditure by disease will be significantly incomplete.
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12. Eurostat Contract No: 07154.2013.001-2013.239
HEDIC Next steps
Work to develop the HEDIC methodology: - countries with social insurance funded health systems to meet in Augsburg, January 2015: to develop the MDS from the publicly funded system on which the HEDIC compilation will be based; rules for further compilation; adding additional sources; reconciliation - revise the HEDIC manual (ATC-ICD mapping and allocation of primary care expenditure) - prepare first compilations of expenditure by disease, for analysis and discussion in The Hague in March 2015
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