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    Guidelines for improving the comparability and availability of private health expenditures

    OECD Health Working Papers No. 52, DELSA/HEA/WD/HWP(2010)3

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    Ravi P. Rannan-Eliya and Luca Lorenzoni
    26 May 2010 | 67 pages

    Abstract: This paper reports on a project to improve the comparability and availability of private health expenditure under the joint health accounts questionnaire (JHAQ) data collection. The JHAQ is a framework for joint data collection in the area of health expenditure data developed by OECD, Eurostat, and WHO. In particular, the study questions were: How to overcome the inherent tendency for much private health care financing to occur without the generation of linked, reliable, and comprehensive routine data? How to tackle the issue of private providers likely to operate without reporting of routine data to statistical agencies?

    In order to do this, draft guidelines for improving the comparability and availability of private health expenditures were prepared. Seven countries were invited to provide more detail on the data sources and estimation methods used to compile private health expenditure data under the SHA framework.

    The guidelines reported in this working paper draw on country information in terms of the data sources used and estimation methods applied in order to report components of private health expenditure. The guidelines were informed by the discussion at a workshop held at OECD headquarters in Paris on the 12th June 2009, which all the participating country experts participated in, together with other experts from BASYS, Eurostat and WHO. Experts from Estonia also attended this meeting, and shared the work that they had done to review and improve methodologies for estimation of household spending on health.

    The guidelines provide advice on the general approach to be taken in measuring private expenditures, in particular how a measurement strategy should be formulated, and how data sources and methods should be identified. They equally provide a tool for a national self-assessment of existing methodology. They review in detail potential methods for estimating private expenditure flows, with those specific to financing agents presented before those specific for providers. The methods to be used for estimating household out-of-pocket are only presented afterwards, as these require consideration of when and how household survey data can be used. Finally, the guidelines discuss how the different estimation methods and data sources can be combined to produce overall and final estimates in an integrated approach.




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