National health accounts
- Total expenditure on health as a percentage of GDP
- General government expenditure on health as a percentage of total general government expenditure
- Per-capita total expenditure on health at international dollar rate
Rationale for use
Health financing is a critical component of health systems. National health accounts (NHA) provide a large set of indicators on the basis of the expenditure information collected within a internationally recognized framework. NHA are a synthesis of the financing and spending flows recorded in the operation of a health system, from funding sources to the distribution of funds between providers, and functions of health systems and benefits across geographical, demographic, socioeconomic and epidemiological dimensions.
Definition
Total health expenditure as a percentage of gross domestic product (GDP).
Percentage of total general government expenditure that is spent on health.
Per-capita total expenditure on health at international dollar rate.
Associated terms
Total expenditure on health is the sum of general government health expenditure and private health expenditure in a given year, calculated in national currency units in current prices.
GDP is the value of all goods and services provided in a country by residents and non-residents without regard to their allocation among domestic and foreign claims. This corresponds to the total sum of expenditure (consumption and investment) of the private and government agents.
General government expenditure includes consolidated direct outlays and indirect outlays (e.g. subsidies to producers, transfers to households), including capital of all levels of government, social security institutions, autonomous bodies, and other extrabudgetary funds.
General government expenditure on health (GGHE) comprises the direct outlays earmarked for the enhancement of the health status of the population and/or the distribution of medical-care goods and services in the population by the following financing agents: central/federal, state/provincial/regional, and local/municipal authorities; extrabudgetary agencies, social security schemes; parastatals. All can be financed through domestic funds or through external resources.
International dollars: derived by dividing local currency units by an estimate of their purchasing power parity (PPP) compared with the US dollar, i.e. the measure that minimizes the consequences of differences in prices between countries.
Data sources and methods of estimation
Only about 95 countries have either produced full national health accounts or report expenditure on health to the Organisation for Economic Co-operation and Development (OECD). Standard accounting estimation and extrapolation techniques have been used to provide time series. The principal international references used are the International Monetary Fund (IMF) government finance statistics and international financial statistics; OECD health data and international development statistics; and the United Nations national accounts statistics. National sources include: national health accounts reports, public expenditure reports, statistical yearbooks and other periodicals, budgetary documents, national accounts reports, statistical data on official web sites, central bank reports, nongovernmental organization reports, academic studies, and reports and data provided by central statistical offices and ministries.
Disaggregation
By public and private components and subcomponents: is not presented here but is available on the NHA website.
References
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The world health report 2006—working together for health
WHO. The world health report 2006—working together for health. Geneva, World Health Organization, 2006.
Database
Comments
Data on estimated health expenditure are collected by triangulating information from several sources to ensure that the outlays constitute the bulk of the government/private expenditure on health. Some figures may be underestimated when it is not possible to obtain data on expenditures for local governments, nongovernmental organizations or insurance.