Health expenditure

DEFINITIONS

Constant price price of products or services in average prices of the base year, current price deflated by the price index of goods and services.

Current expenditure on health care the reporting year's expenses for health care services, medicines and other health care products. Current health care expenditure do not include sickness, care and maternity benefits paid from the health insurance budget, nor the costs of training orders for state health workers, as well as gross fixed capital formations.

Current price the price of goods and services in the accounting period.

Financing scheme in health care expenditure (ICHA-HF) shows the financing of the final consumption of health goods and services and focuses on the allocation of resources. Answers the question through which funding arrangement people have access to health services.

Gross Domestic Product (GDP) the economic value created by a country's residents, businesses and institutions.

Health expenditure calculation of the country's health care costs based on the international methodology SHA 2011.

Health care service in health care expenditure (ICHA-HC) shows the consumption of health care goods and services according to the purpose of their use. The first-level groups divide consumption according to the type of service user need: curative care, rehabilitation, long-term care, ancillary services, medical goods, prevention, administration.

Health care provider in health care expenditure (ICHA-HP) a legal entity whose main or secondary activity is the provision of health care services.

Revenues of Health Care Financing Schemes in health care expenditure (ICHA-FS) show the collection of health revenues for financing models.

METHODOLOGY

Data about the health expenditure provides an overview of the health care financing system and the movement of the cash flows, it also provides an opportunity to evaluate the efficiency of different financing schemes when determining political priorities and making decisions.

The amount of health expenditures is calculated on the basis of the methodology developed by OECD, Eurostat and WHO, named System of Health Accounts (SHA), current version SHA 2011. According to this methodology, such health care functions as curative care, rehabilitation, long-term care, health care ancillary services (non-specified by function), expenditure on medical goods, prevention, governance and health system and financing administration are all included in current health expenditure. At the same time, current health expenditure does not include expenses on capital formation, expenses incurred in relation to research and development work in the area of health care, environmental health and other services (which are not aimed at health improvement). Data for capital formation is published separetly in table KK07. The data does not reflect expenses incurred as a result of health care service provision to foreigners and the purchase of health care goods on behalf of foreigners.

The data, which serve as the basis for the accounting of health expenditures, mainly originates from administrative sources. Data sources are the state budget, annual reports of local governments, health care expenses incurred by the ministries, data about the expenses incurred by the Estonian Health Insurance Fund and data about the health expenditures incurred by private insurance companies. Estonian Ministry of Social Affairs proovides data of health care projects, The Council of Gambling Tax expenditures on health care projects and health care expenditures incurred in residential long-term care facilities. Household out-of-pocket expenditure methodology uses data from health care provider annual economic report and different health service provider reports which are both collected by National Institute for Health Development (NIHD).

Health expenditure is calculated each year.

From 2014, long-term care (health) (HC.3) include the following expenditures on social welfare services: in section HC.3.2 - everyday life support service for people with high support and care needs, day care for adults, childcare services for children with severe and profound disabilities; in section HC.3.4 - care allowance for the disabled and personal assistant service. Expenditure on general care services provided outside the home and 24-hour special care services (HC.3.1) include all 24-hour services costs (incl. accommodation) of long-term care dependent persons. Health care costs of earlier years have less social care long-term care services: only 24-hour services costs (HC.3.1) without accommodation costs.

DATA VISUALIZATION: Current health expenditure

CLASSIFICATIONS

International Classification for Health Accounts (ICHA), version SHA 2011 is

a system of classifications used in health costs

In addition, an additional dimension is considered in health expenditure:

The classification in English (revised in 2017) is available on the OECD webpage.

The previous health care accounts methodology, version SHA 1.0 is available here.

PUBLICATIONS

Ruuge M, Inno M. Tervishoiukulud 2020. Tallinn: National Institute for Health Development; 2022. Analysis is available here in pdf-format (in Estonian, but summary also in English)

Ruuge M, Inno M. Tervishoiukulud 2019. Tallinn: National Institute for Health Development; 2021. Analysis is available here in pdf-format (in Estonian, but summary also in English)

OECD, European Union. Chapter 5: Health expenditure and financing. Health at a Glance: Europe 2020: State of Health in the EU Cycle. Paris: OECD Publishing; 2020. Report's chapter is available here

Ruuge M, Inno M. Estonian Health Care Expenditure in 2015. Tallinn: National Institute for Health Development; 2017. Analysis is available here in pdf-format

Ruuge M, Inno M. Health expenditure 2014. Tallinn: National Institute for Health Development; 2016. Analysis is available here in pdf-format

CONTACTS

Mare Ruuge

Department of Health Statistics

National Institute for Health Development

Phone: +372 659 3818

E-mail: Mare.Ruuge[at]tai.ee

 

Marika Inno

Department of Health Statistics

National Institute for Health Development

Phone: +372 659 3816

E-mail: Marika.Inno[at]tai.ee

 

Updated: 5.07.2022