Hungarian National Health Accounts, 1998 - 2000

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Hungarian National Health Accounts, 1998 - 2000

• Separation of expenditure by function within
  hospitals

Maria Goschi MANNO Maria Mihalyne HAJDU
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Hungarian National Health Accounts, 1998 - 2000

• Topics
• Completed SHA and other tables
• Raw databases
• SHA Table 2. calculations
• Estimations
• Importance of Sector of Hospital
• Problems to be solved in the future

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Hungarian National Health Accounts, 1998 - 2000

• Completed SHA tables
• SHA Table 2. ( HNHA table 5)
• Total current health expenditures by functions
  of health care and types of service providers
• SHA Table 3. ( HNHA table 9)
• Total current health expenditures by types of
  service providers and financing agents
• SHA Table 4. ( HNHA table 7)
• Total current health expenditures by functions
  of health care and financing agents

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Hungarian National Health Accounts, 1998 - 2000

• Completed other tables
• HNHA Table 1 Health expenditures by financing
  agents
• HNHA Table 2 Development of health expenditures
  as percentage of GDP
• HNHA Table 3 Real value of health expenditures
• HNHA Table 4 Current health expenditures by
  functions of health care and types of
  service providers
• HNHA Table 6 Current health public expenditures
  by functions of health care and types
  of service providers
• HNHA Table 8 National Health Insurance
  expenditures by functions of health
  care
• HNHA Table 10 Total current health expenditures
  by type and form of service providers
  and by financing agents

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Hungarian National Health Accounts, 1998 - 2000

• Raw databases
• Annual reports of the budgetary institutions
• Financing data of the National Health Insurance
  Fund
• Hungarian Central Statistical Office (HCSO)
  Household statistics
• HCSO Non-profit organisations
• HCSO National Accounts
• HCSO Investment statistics
• Tax Finance and Control Office (TFCO)
  Self-employed
• TFCO Enterprises
• Private Health Insurance Fund - surveying
• Enterprises - at an estimations

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Hungarian National Health Accounts, 1998 - 2000
SHA Table 2. calculations Step 1

• Sort of the budgetary institutions
• Sort of functions of budgetary institutions

• Individual classification to four groups by three
  Hungarian legal rules.
• Breakdown to eight main categories on the basis
  of codes of so-called special tasks. The first
  main group is the group of healthcare functions.
• Within the healthcare group the functions were
  primarily collated with the SHA functions.

• Results
• Separation of non-health care functions of
  healthcare institutions.
• Elaboration of SHA table of the budgetary
  institutions
• (Version 1).

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Hungarian National Health Accounts, 1998 - 2000
SHA Table 2. calculations Step 1
Breakdown of current health expenditures by
functions
Summary of breakdown of current expenditures
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Hungarian National Health Accounts, 1998 - 2000
SHA Table 2. calculations Step 2 - 3
Correction with financing data of the National
Health Insurance Fund

• Functional separation
• Separation of one-day care from inpatient care
• Separation from inpatient service
• Clinical laboratory services
• Diagnostic imaging services
• Kidney dialysis
• Home special care
• Result a functional classifications is
  identical with of OECD SHA
• (Version 2)

• NHIF payments to private institutions
• All cells in the SHA 2. (Version 2) table were
  increased by NHIF payments to private sector
• Result SHA 2. (Version 3)
• SHA 2. (Version 3)
• SHA 2. (Version 2) NHIF to private

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Hungarian National Health Accounts, 1998 - 2000
SHA Table 2. calculations Step 4
Correction with data of private sector

• Incomes of private hospitals from private sector
• The value of paying from private sector is
  decreased by item to budgetary institutions.
• These results were added to the data of the SHA
  2. (Version 3)

Supposition the total expenditure of private
hospitals are allocated to inpatient services.
Result Final SHA 2. SHA 2 SHA 2 (Version 3)
private sector
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Hungarian National Health Accounts, 1998 - 2000
SHA Table 2. calculations - outcome
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Hungarian National Health Accounts, 1998 - 2000
Estimations 1 (Screening overlaps)

• Representative collection of unspecified income
  data of the budgetary hospitals
• Unspecified income amounted to 10 of the total
  revenues of the hospitals

• Result
• Elimination of cumulated data
• About 30 of the unspecified income was
  eliminated

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Hungarian National Health Accounts, 1998 -
2000
Estimations -2 (Universities of medical sciences)

• The three main tasks of Universities of medical
  sciences
• Education
• Research
• Health care services
• Integration of Universities
• In 1998 and 1999 years
• independent institutions
• From 2000 year
• integrated institutions

• Separation of Universities of medical sciences
• Clinical institution
• This data appears in SHA tables
• Education and research institution
• SHA tables were not included.

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Hungarian National Health Accounts, 1998 - 2000
Estimations -2 (Universities of medical sciences)
Distribution of expenditures of universities of
medical sciences
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Hungarian National Health Accounts, 1998 - 2000
Role and weight of the hospital sector - 1
Breakdown of total current health expenditure by
types of service providers

• Almost 40 of health care expenditures is
  dedicated to hospitals activities.
• The objective of healthcare policy decrease the
  rate.

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Hungarian National Health Accounts, 1998 - 2000
Role and weight of the hospital sector - 2
Breakdown the total health expenditures by
functions health care

• The total health expenditures realised
• 31 to inpatient care
• 39 to medical goods
• 16 to outpatient care

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Hungarian National Health Accounts, 1998 - 2000
Role and weight of the hospital sector 3
(general hospitals)
Breakdown of health expenditures of general
hospitals by functions of health care

• General hospitals
• General hospitals
• Clinical institutions
• Out of hospitals health expenditures almost 80
  is dedicated to inpatient services.
• The diagnostic services rendered to inpatients
  are recorded under inpatient function. (These
  expenses are included in DRG.)

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Hungarian National Health Accounts, 1998 - 2000
Role and weight of the hospital sector 4 (The
hospitals in outpatient services)
Breakdown of expenditures of outpatient services
by types of service providers
Within outpatient services hospitals represent a
significant proportion.

• The expenditures realised at the hospitals
• 73 of the total outpatient rehabilitative care
• 59 of the total specialised outpatient care
  (HC.1.3.3)
• 28 of the total outpatient care

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Hungarian National Health Accounts, 1998 - 2000
Problems to be solved in the future

• Studying of functional structure of healthcare
  expenditure in private sector.
• Completion of the Non-profit statistics.
• Indirect calculation from data of the Household
  statistics.
• Elaboration the rest SHA tables.
• Development of IT system.
• Elaboration of regional accounts.

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Hungarian National Health Accounts, 1998 - 2000

• Thank you for all your attention.

Lunch break