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Hungary

Health care expenditure (SHA 2011) (hlth_sha11)

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National Reference Metadata in Euro SDMX Metadata Structure (ESMS)

Compiling agency: Hungarian Statistical Office

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Health care expenditure quantifies the economic resources dedicated to health functions, excluding capital investment. Healthcare expenditure concerns itself primarily with healthcare goods and services that are consumed by resident units, irrespective of where that consumption takes place (it may be in the rest of the world) or who is paying for it. As such, exports of healthcare goods and services (to non-resident units) are excluded, whereas imports of healthcare goods and services for final use are included.
Health care expenditure data provide information on expenditure in the functionally defined area of health distinct by provider category (e.g. hospitals, general practitioners), function category (e.g. services of curative care, rehabilitative care, clinical laboratory, patient transport, prescribed medicines) and financing scheme (e.g. social security, private insurance company, household). For the collection of the data on health care expenditure the System of Health Accounts (SHA) and its related set of International Classification for the Health Accounts (ICHA) is used. SHA sets out an integrated system of comprehensive and internationally comparable accounts and provides a uniform framework of basic accounting rules and a set of standard tables for reporting health expenditure data. The System of Health Accounts - SHA 2011  is a statistical reference manual giving a comprehensive description of the financial flows in health care.

It provides a set of revised classifications of health care functions, providers of health care goods and services and financing schemes. The SHA is currently used as a basis for a joint data collection by OECD, Eurostat and WHO on health care expenditure. The manual sets out in more detail the boundaries, the definitions and the concepts of health accounting – responding to health care systems around the globe with very different organisational and financing arrangements.

Accounting period: Health expenditure and financing data pertain to the calendar year (1 January to 31 December).

30 March 2024

SHA concept is the consumption of health care goods and services.

Health care statistics describe the process of providing and financing health care in countries by referring to health care goods and services, its providers and financing. For the collection of the data on health care expenditure the System of Health Accounts (SHA) and its related set of International Classification for the Health Accounts (ICHA) is used. SHA is a tri-axial system in which the financing, provision and consumption dimensions are covered by the ICHA (International Classification for Health Accounts): Health Care Functions (HC), Health Care Providers (HP), Health Care Financing Schemes (HF).

Data are presented in 3 summary (one-dimensional) tables and 3 cross-classification tables (2-dimensional tables).

Summary tables provide data on:

  • Current expenditure by provider (ICHA-HP);
  • Current expenditure by function (ICHA-HC);
  • Current expenditure by financing scheme (ICHA-HF).

Cross-classification tables refer to:

  • HC x HP: Health care expenditure by function and provider: data on which type of health care goods and services are supplied by which health care provider;
  • HC x HF: Health care expenditure by function and by financing scheme: data on how are the different types of services and goods financed;
  • HP x HF: Health care expenditure by provider and by financing scheme: data on from which health care provider and under which particular financing scheme are the services and goods purchased.

The classifications and definitions presented in the SHA 2011 manual are to be followed. Additional guidelines and material useful for compilers are also available at this address.

Commission Regulation (EU) 2021/1901, and Commission Regulation (EU) 2015/359 previously in force,  concern the collection of data on "current expenditure on healthcare" which is defined as the "final consumption expenditure of resident units on health care goods and services".

There is a very close relationship between the concept of "final consumption expenditure" as defined in the System of Health Accounts (SHA) and in National Account and, as a consequence, also between the underlying economic transactions as recorded in the two accounting frameworks.

In National Accounts there are two types of statistical units: institutional units and local kind-of-activity units (KAU). A local KAU groups all the parts of an institutional unit in its capacity as producer which are located in a single site. A local KAU belongs to one and only one institutional unit.

SHA uses the same two types of units for data compilation.

Local KAUs operating as providers of healthcare goods and services to resident units are statistical units in SHA.

Also transactions by institutional units are recorded in SHA, in which framework institutional units are also referred to as "financing agents". More precisely, SHA financing agents are institutional units that manage one or more financing schemes. The transactions are executed by the financing agents, according to the rules of the financing schemes.

Financing agents serve as key statistical units in producing national health accounts. While financing schemes are the key units for analysing how the consumption of health care goods and services is financed, the data concerning the relevant transactions are collected either from the financing agents that operate the different financing schemes or from the providers.

The concept of "healthcare financing schemes" in SHA is an application and extension of the concept of "social protection schemes" defined by the European System of Social PROtection Statistics (ESSPROS):  "a distinct body of rules, supported by one or more institutional units, governing the provision of social protection benefits and their financing ...". The social protection scheme is the statistical unit in ESSPROS. It is an analytical unit that allows describing the complete structure of the social protection financing system:  expenditure and receipts.

According to SHA Manual 2011, "the key concepts for describing the structure of the health care financing system are based on measuring: (a) the expenditure of health care financing schemes, under which goods and services are purchased directly from health care providers, on the one hand, and (b) the types of revenues of health care financing schemes, on the other hand.  

Commission Regulation (EU) 2021/1901  and (prior Commission Regulation (EU) 2015/359) limits its scope to the collection of data on the expenditure of health care financing schemes.

SHA focuses on the consumption of health care goods and services by the resident population irrespective of where this takes place. This implies the inclusion of imports (from non-resident providers) and the exclusion of exports (health care goods and services provided to non-residents).

Hungary.

Health care expenditure data are annual data, corresponding to the calendar year.

This quality report covers the following reference years: 2022.

The sources to compile the data on health care expenditure are mainly administrative and register-based data, only a small percentage of the figures come from surveys or other means. Accordingly, for the health care expenditure data collection, accuracy deals with problems of coverage as the main possible source of errors.

Current expenditure data are presented according to following units:

  • expenditure amount in millions of euro;
  • expenditure amount in millions of national currency;
  • expenditure amount in millions of PPS;
  • percentage of GDP;
  • amount in euro per capita;
  • amount in national currency per capita;
  • amount in PPS per capita;
  • percentage of current health expenditure (CHE).
SHA variable(s) Main method
(see comment box for definitions)		 Brief description of methodology
HC.3.1 Pro-rating/Utilisation key The number of health workers in nursing and residential health care facilities multiplied with the average salaries of heath personnel categories and with the social insurance contributions
HF.3 Other Detailed distribution on HC categories based on survey 2016
Deducted: Medical goods consumption of the voluntary health funds
Deducted: Health consumption of the foreign tourists, based on Questionnaire on expenditures of foreigners visiting Hungary
HF.2.1. Pro-rating/Utilisation key One item from the financial report of the voluntary health fund is distributed according to the distribution ratio of revenues deriving from voluntary health funds payment (survey 2016)
HF2.1xHC.7.2 Pro-rating/Utilisation key Administrative costs distributed according to the ratio of the health-related spending from total spending.  
Source name Brief description of source
(e.g. coverage, reference year, etc)		 Type of data source Primary SHA variable(s) using this data source
Annual budget reports from the Hungarian State Treasury The source contain general/local government data by governmental COFOG classification on aggregate level and on health care institutes  Public administrative records All HC, HF.1.1, HF.2.3, all HP
Survey No 2120 Data of National Health Insurance Administration and Ministries;  National Institute for Quality and Organizational Development in Healthcare and Medicines Surveys/censuses HF.1.2, HP.1-7
Web-page of the Hungarian Financial Supervisory Authority Data on voluntary health funds Financial reports all HC, HF.2.1, all HP
Household health consumption Household health consumption of the National Accounts Dept. Other all HC, HF.3, all HP
Survey No 2016 Survey on Revenues and Expenditure of Non-public Health Providers Surveys/censuses all HC, HF.3, all HP, partly HF.2.1
Survey No 1943 Questionnaire on expenditures of foreigners visiting Hungary Surveys/censuses all HC, HF.3, all HP
Survey No 1156 Non-profit statistics (Register of non profit organisations VFA) Surveys/censuses all HC, HF.2.2, all HP
Occupational health care reports Data on occupational health care reports Other HC.6, HF.2.3, HP.8
Statistics of the Hungarian National Bank Data on voluntary health insurance Financial reports HF.2.1.

Annual.

Member States were required to transmit their data to Eurostat in compliance with the Commission Regulation (EU) 2015/359 transmission deadlines, until reference year 2020. As of reference year 2021, data are transmitted pursuant to Commission Regulation (EU) 2021/1901.
Data and reference metadata for the reference year T should be transmitted to Eurostat by 30 April T+2.

Not applicable.

II.4. Breaks in time series

Year Items affected by the break Explanations
1998 All items There are differences in data pre-1998 and data from 1998 to 2002 both in concepts and estimation methods. Pre-1998 data on public expenditures were based on payments by financing agents (data by NHIF, MoF, and MoH). Private expenditures contained only household expenditures. For data from 1998 to 2002 totat health expenditure is defined as final use of health care goods and services by residents plus gross capital formation in health care provider industries
2003 All items On 2003, the Hungarian Central Statistical office made a revision of the National Accounts back to 1995. It also resulted in a revision of the households' expenditure of health
2007 HP.2, HP.3.3 Reorganisation of the public health care providing institutions (continued in the following year)
2008 HP.2. Reorganisation of the public health care providing institutions
2010 HC.5.1, HC.5.2 Since 2010 data for HC.5.1.3 is available. Before 2010 it was accounted under HC.5.2
2010 HC.7.1 New Governmental COFOG classification was introduced
2011 HP.1, HP.3 In 2011 there was a break in the expenditure for hospitals and providers for ambulatory health care as establishments were re-classified between the two sectors. This break, however, does not affect the aggregate current health expenditure
2011 HC7 Due to restructure of HIF responsibilites
2012 HC.1.2, HC.1.4, HC.2.4, HP.1.2, HP.1.3, HP.2, HP.3.3, HP.6, HP.4.9, HP.8.2 Due to revision of the financing system - provided in the mid of year 2012, having an influence both on time series covering year 2012 and 2013 
2012 HCR.1 Due to revision of the ESSPROS calculation (new revision in 2019)
2013 HC.7.1, HP.1, HP.2, HP.3 Due to revision of the financing system - provided in the mid of year 2012, having an influence both on time series covering year 2012 and 2013 
2015 HF.2.2 New non-profit classification was introduced. This break does not affect the aggregate value. 
2016 HF3xHC11, HF3xHC12, HF3xHC21, HF3xHC131, HF3xHC133, HF3xHC139, HF3xHC3, HF3xHC4, HF3xHC6, and HF2.1. for the following HC categories: HC.1-HC.4 and HC.6 Due to revision of the survey No 2016. The breaks do not affect the aggregate value