Construction of Korean Health Accounts and of Tables Cross-classifying Expenditure by financing agents, providers and functions

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Construction of Korean Health Accounts and of
Tables Cross-classifying Expenditure by
financing agents, providers and functions

• Hyoung-Sun JEONG, Ph.D.
• Department of Health Administration
• Yonsei University

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CONTENTS
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KOREAN NATIONAL HEALTH ACCOUNTS

• Before the OECD SHA is adopted,
• considerable differences emerged in both methods
  (different health expenditure items) and results
  (total amount different by over 30) among
  independent estimates of total health expenditure
  produced by several researchers

• With the new accounts by the OECD SHA,
• it is now possible to better compare total health
  expenditure of Korea with other OECD countries
  and
• GDP share of total health expenditure in the OECD
  Health Data is currently the most frequently
  quoted figure on health expenditure in Korea

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• Constructing of a set of health expenditure
  tables that follow the framework of the OECD
  manual A System of Health Accounts (SHA)
• Until last year, Ministry of Health and Welfare
  (MOHW) commissioned Korean Institute for Health
  and Social Affairs (KIHASA) to produce Total
  Health Expenditure. Thus, produced were tables
  cross-classifying expenditure both by financing
  agents and by functions (sources-to-uses matrix).
• This year, MOHW commissioned Yonsei University to
  construct health accounts including
  classification by providers additionally. The
  figures presented here are its interim results,
  whose completion would be submitted for OECD
  Health Data 2004. (sources-to-providers and
  providers-to-uses matrices as well as
  sources-to-uses matrix)

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CONSTRUCTING PROCESS

• Explanation of the Whole Process
• New estimations depends on the Health and
  Nutrition Survey in terms of Private Health
  Expenditure
• The survey has been periodically performed
  through interviews with about 40,000 persons
  sampled from all over the country.
• The survey includes many items on medical use,
  such as name of disease, health care providers,
  number of visits, money paid out-of-pocket, etc.
• Health expenditure is not well classified
  according to function such as curative-rehabilitat
  ive care, long-term care and ancillary services
• Long-term care facilities are not yet popular in
  Korea.

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RESULTS AND POLICY IMPLICATIONS

• Health expenditure is below the level expected
  for a country with Koreas income
• Low level of health expenditure is due, at least
  in part, to the high level of out-of-pocket
  payments (one of the highest in the OECD area)
• Can this be interpreted as showing that Korean
  government or consumers have attached lower
  priority to health care than have those in other
  OECD countries?

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• Public funding share has been increasing most
  quickly, but is still one of the lowest among
  OECD countries
• Korea has rapidly approached the OECD norm, but
  is still facing equity issue by leaving more
  medical services uncovered by health insurance
  and putting a higher co-payment burden on the
  people
• However, particularly after the reform for the
  separation between prescribing and dispensing of
  drugs in 2000, the public funding share has much
  increased.

• Korea has an unusual mix of health expenditure by
  mode of production, compared with other OECD
  countries
• Very low in-patient share (23.4), considerably
  high out-patient share (41.2) and high drug
  share (20.3) of total health expenditure in 2001.

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CONCLUSION

• New estimation supported by the Ministry has
  added new tables including providers aspects,
• which are expected to be a paramount contribution
  for evidence-based health policy in Korea as well
  as for the construction of Korean health account
  itself.
• Further developments to be made for the KOREAN
  NHA
• Linking of existing tables on expenditure by
  broad disease categories and age gender to NHA
  tables

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THANK YOU