The Norwegian System of Health Accounts

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The Norwegian System of Health Accounts

• Ann-Kristin Brændvang
• Division for National Accounts
• AKB_at_SSB.no

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Background

• The planning started in 2000
• Established as a satellite account system to the
  National Accounts
• SHA finalised at the end of 2004 and
• time series for the period 1997-2004
• constant price estimates for the same period

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The implementation

• Planning
• Adjustments in the NA-system and the need for
  improving data sources (2-3 years)
• Mapping

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National accounts

• Comprehensive accounting framework
• Satellite accounts
• flexible tool
• consistent with the NA
• designed for the purpose of economic analysis
• Supply and use including more than 1200 products.
  The core variable is the product, more than 50
  health products.

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The NA product data carrier

• The classification was implemented by coding
  products in a specific way
• A six digit-code that contents data on provider,
  type of goods and service and (in most cases)
  source of funding
• Combination of product user- purpose in the
  core accounts of NA platform for mapping to ICHA

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The NA product, an example

• XXXXXX
• 85XX
• 85116
• 85111
• 85117
• 851161 Curative care provided in hospitals,
  funded by the state.
• 851390 Dental service provided by dentists and
  funded by households

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Sources

• The National Accounts
• Public accounts
• Statistics from public and private hospitals
  (specialist nursing homes, convalescence and
  rehabilitation institutions and hospitals)
• The Household Budget Survey.
• Other sources

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Local government accounts (KOSTRA)

• Better information about the local authorities
• Coherent system
• Comparability
• Timeliness
• More efficient reporting
• No data redundancy
• Electronic data reporting

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KOSTRA and Hospital accounts

• Unique data source (covers around 75 per cent of
  the total health expenditure)
• Accounting regulations
• Classification by Types of Expenditure
• Classification by Function

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KOSTRA and Hospital accounts accounting
regulations cont.

• Classification by Types of Expenditure
• Separating between
• Services produced by the municipalities /
  institutions
• Services bought from others (private companies,
  municipalities or the state)
• Transfers
• Consumption of fixed capital

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KOSTRA and Hospital accounts accounting
regulations cont.

• Classification by Functions, examples
• Maternal and child health family planning and
  counselling
• Dental care
• Basic medical and diagnostic services
• Activation of elderly and disabled
• Nursing and care, help in institutions
• Nursing and care, help at home
• Service of curative care
• Rehabilitative care
• Patient transport etc.
• The costs are also classified according too
  ICHA-HP for the services produced by the
  institutions.

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Health versus Social care

• Old age homes (no health personnel are required),
  are classified as social care
• Nursing homes are classifies as health
• The share is annually estimated
• Figures indicate that about 90 per cent of the
  cost is related to health in 2002

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Home care

• We have information on man year by
  education/profession for Nursing and care, help
  at home in addition to the total costs
• The share is annually estimated, 65 per cent in
  2002
• Tendency towards more health less social care

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Results increased health expenditures

• The health expenditures compiled in the new
  system increased nearly 10 per cent compared to
  the old system
• The total health expenditures resulting from the
  new system is estimated to nearly 170 billion
  Norwegian kroner or
• about 10 per cent of GDP
• From 1997 to 2004 the health expenditures at
  constant prices has increased by 4,1 per cent per
  year on average, while the current expenditures
  have increased by 8,6 per cent per year

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Health expenditure by function. 1997 and 2004 in
per cent of total
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More information

• http//www.ssb.no