Health Accounts and National Accounts : Linking Health Care Expenditure Statistics to National Accounts Statistics
This paper investigates the links between health care expenditure statistics in Health Accounts (System of Health Accounts; SHA11 edition revised in 2017) and in National Accounts statistics; the latter are based on the universal and European guidelines on national accounts (System of National Accounts, SNA2008; European System of National Accounts, ESA2010). Linking health expenditure statistics in health accounts and national accounts is important to better understand their relationship and the major differences. This link can then be used to improve the relevance, timeliness, accuracy, scope and detail of health care expenditure statistics.The link with three types of National Accounts aggregates are discussed, i.e. government final consumption for the COFOG-function Health, household final consumption for the COICOP-function Health and final consumption expenditure for Pharmaceutical products, Human health services as well as Residential and social care in the use-table. These links are illustrated numerically for the Netherlands and with respect to the link with COFOG-function Health also for Belgium.In general, National Accounts statistics show less detail on health than SHA statistics, but are also in several respects more comprehensive, e.g. they include information on price and volume changes, employment and value added of producers of health-products, imports of pharmaceutical products and government R&D on health. As a consequence, National Accounts statistics can be used to supplement SHA statistics: this possibility is illustrated for the Netherlands.This linkage exercise can be elaborated and repeated for other countries. This can then reveal to what extent different health care systems and different data sources and compilation methods have an impact on the link between health care expenditure in SHA and in National accounts statistics. Several proposals are put forward to advance work on the linkage with national accounts statistics, e.g. the link with long term care and social protection statistics (ESSPROS) and using national accounts statistics on prices, volumes and employment to decompose the development of health care expenditure in terms of price- and volume-change