1. Institute of Health Information and Statistics of the Czech Republic National Health Accounts in the Czech Republic Present state and implementation of the System of Health Accounts methodology the System of Health Accounts methodology OECD meeting of experts in NHA, 27-28 October 2003, Paris

2. Institute of Health Information and Statistics of the Czech Republic Present information systems covering area of health National Health Information System (IHIS)National Health Information System (IHIS) Government Finance Statistics (Ministry of Finance)Government Finance Statistics (Ministry of Finance) International databases (OECD, WHO)International databases (OECD, WHO) National Accounts (Czech Statistical Office)National Accounts (Czech Statistical Office)

3. Institute of Health Information and Statistics of the Czech Republic Activities related to implementation of SHA Translation of SHA manual and conversion of national classifications to ICHATranslation of SHA manual and conversion of national classifications to ICHA Monitoring of available data sourcesMonitoring of available data sources Modifications of statements of health insurance companies, collection and analysis of new dataModifications of statements of health insurance companies, collection and analysis of new data Preparation of data collecting and methods of expenditures estimation from other sourcesPreparation of data collecting and methods of expenditures estimation from other sources

4. Institute of Health Information and Statistics of the Czech Republic Expenditures monitored by current sources Source of funding Source covers mainly area of: Share in total General government - collective health care services - capital formation - health related functions 10% Social Security Funds - personal health care services 80% Private household o-o-p expenditure - pharmaceuticals - therapeutic appliances - services of dental care 10%

5. Institute of Health Information and Statistics of the Czech Republic Main data sources Government expenditureGovernment expenditure –HF.1 → functions of budget (HP.x/HC.x) Social security fundsSocial security funds –HF.1.2 → segments of care (HP.x/HC.x) Household out-of-pocket expenditure (Family Accounts Statistics)Household out-of-pocket expenditure (Family Accounts Statistics) –HF.2.3 → COICOP (HC.x)

6. Institute of Health Information and Statistics of the Czech Republic Supplementary data sources Economics of health establishments - assets and debts, costs (by type of care) and returns (by source) of health establishmentsEconomics of health establishments - assets and debts, costs (by type of care) and returns (by source) of health establishments HF.x → HP.x → type of care Health employment: HP.x → occup.&wagesHealth employment: HP.x → occup.&wages Economic data on pharmacies (revenues)Economic data on pharmacies (revenues) HF.x → HP.4 → HC.5 Drug consumption by ATC: HC.5Drug consumption by ATC: HC.5 Health care for foreigners: HF.x → HP.1Health care for foreigners: HF.x → HP.1

7. Institute of Health Information and Statistics of the Czech Republic Potential data sources Long-term nursing care in social establishments: HP.2 → HC.3Long-term nursing care in social establishments: HP.2 → HC.3 National accounts - sector accounts and branches production accounts (HF.2.4)National accounts - sector accounts and branches production accounts (HF.2.4) Occupational health care financed by corporations: HF.2.5 → HC.6.5Occupational health care financed by corporations: HF.2.5 → HC.6.5 Private health insurance (HF.2.2)Private health insurance (HF.2.2)

8. Institute of Health Information and Statistics of the Czech Republic Problems and challenges Functions of health care Determination of boundaries for health care, health-related care and non-health care.Determination of boundaries for health care, health-related care and non-health care. –included: education and research –excluded: long-term nursing care in social care establishments Differences in definitions of functionsDifferences in definitions of functions –modes of production: day care not defined –types of episode of care: data not available or in different structure

9. Institute of Health Information and Statistics of the Czech Republic Problems and challenges Providers of health care Boundaries for health care industriesBoundaries for health care industries –problem of different sources of data Type of provider reporting dataType of provider reporting data –legal subjects (used at present) x units of homogenous production

10. Institute of Health Information and Statistics of the Czech Republic Problems and challenges Financiers of health care Not all groups of financiers are included → involving other financiersNot all groups of financiers are included → involving other financiers Real allocation of all resources (a concrete purpose of use) needn’t be known when collecting data from financiersReal allocation of all resources (a concrete purpose of use) needn’t be known when collecting data from financiers → broader use of data from providers

11. Institute of Health Information and Statistics of the Czech Republic Forthcoming plans To publish first estimates of health expenditures by SHA structureTo publish first estimates of health expenditures by SHA structure To continually solve appropriate evaluation of types of health care according to ICHA-HCTo continually solve appropriate evaluation of types of health care according to ICHA-HC To join expenditure data with non-monetary health data from other sources (e.g. length of stay and number of hospitalisations by age, sex and ICD)To join expenditure data with non-monetary health data from other sources (e.g. length of stay and number of hospitalisations by age, sex and ICD) To review ICHA consistency when combining data from different sourcesTo review ICHA consistency when combining data from different sources

12. Institute of Health Information and Statistics of the Czech Republic Contact Institute of Health Information and Statistics (www.uzis.cz) Jakub Hrkalhrkal@uzis.cz Czech Statistical Office (www.czso.cz) Jiří Papánekpapanek@gw.czso.cz