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For any question on data and metadata, please contact: Eurostat user support |
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1.1. Contact organisation | National Statistical Institute of Bulgaria |
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1.2. Contact organisation unit | Health Care and Justice Statistics Department, Demographic and Social Statistics Directorate |
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1.5. Contact mail address | 2, P. Volov str. Sofia 1038 Bulgaria |
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2.1. Data description | |||
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. 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). |
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2.2. Classification system | |||
Healthcare expenditure is recorded in relation to the international classification for health accounts (ICHA) defining:
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2.3. Coverage - sector | |||
1. Household individual consumption on health, including the collective consumption with two exceptions: In addition, Bulgarian NSI includes (part of) other NACE-groups (NACE rev.2) if they are within the scope of SHA: C.21, C.26, C32, G.46, G.47, section O, K.65. |
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2.4. Statistical concepts and definitions | |||
SHA concept is the consumption of health care goods and services. Summary tables provide data on:
Cross-classification tables refer to:
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2.5. Statistical unit | |||
Commission Regulation 2015/359 concerns 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". |
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2.6. Statistical population | |||
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). |
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2.7. Reference area | |||
The data aims at providing a complete overview of expenditure on health care goods and services consumption of services and goods by the resident population on the national territory of a country. |
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2.8. Coverage - Time | |||
The time coverage of this Quality report is 2014 to 2016 reference years. 2011 - 2016 data are available according to the SHA 2011 methodology. 2003 - 2013 data are available according to the SHA ver.1 methodology.
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2.9. Base period | |||
Not applicable. |
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3.1. Source data | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Several data sources are used (as of data notification in March 2018): - Surveys/census: 1 - Public administrative records: 2 - Financial reports: 3 - Other: 1
Surveys/censuses
Public administrative records
Financial reports
Other
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3.2. Frequency of data collection | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Annual. |
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3.3. Data collection | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Data are collected through the joint health accounts questionnaire (JHAQ) that countries submit to Eurostat during the annual data collection exercise. There is a voluntary deadline to send the JHAQ questionnaire for the calendar year T by the 31st of March T+2. The joint health accounts questionnaire (JHAQ) is coordinated in agreement with the World Health Organisation (WHO) and the Organization of Economic Co-operation and Development (OECD). These three international organisations are known collectively as the International Health Accounts Team (IHAT). Countries submit data to Eurostat on the basis of Commission Regulation (EU) 2015/359 of 4 March 2015 implementing Regulation (EC) No 1338/2008 of the European Parliament and of the Council as regards statistics on healthcare expenditure and financing.
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3.4. Data validation | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
The 2018 JHAQ includes a number of features which allow national data correspondents to perform various quality checks before submitting the data. The embedded programmes allow the verification of:
2- Consistency of the data within tables,
Entries in the tables cannot be negative as they refer to the consumption of goods and services.
The atypical entries check provides information whether the data tables contain values in cells which are – if at all – only reported by very few countries and are thus atypical for health accounting.
3- The growth rates against the previous year and the magnitude of revisions as compared to previously submitted data. Results are grouped into three different categories:
Before the validation process provided by the JHAQ, national data validation is carried out in order consistency and completeness of the results to be ensured:
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3.5. Data compilation | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
SHA data is compiled both by a bottom-up approach as well as by a top-down approach, depending on the data source. Compilation is done by financing schemes and by different health care functions/task areas. The results of the several calculations are then aggregated. To gain the differentiation between the different SHA-dimensions (especially HC and HP) quotas and pro-rating and utilisation keys are applied on some spending items. For some spending items it is necessary to extra-/intrapolate data as there is no up-to-date data available or data is missing for certain years. For some other spending items, estimation methods have to be applied.
Several methods are normally used for estimations:
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3.6. Adjustment | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Data are published in accordance with the SHA 2011 methodology only. |
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4.1. Quality assurance | |||
Authorities responsible for SHA data collection are working to ensure that the statistical practices used to compile national health accounts are in compliance with SHA methodological requirements and that good practices in the field are being followed, according to the methodology underlined in the SHA 2011 Manual and European Statistics Code of Practice respecting professional independence of the statistical authorities. Procedures are in place to plan and monitor the quality of the health care expenditure statistical production process. |
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4.2. Quality management - assessment | |||
Most of the data sources are exhaustive surveys as well as administrative data and estimations are only made where data are not available. Some items may be over- or underestimated, but these errors are negligible in view of the general expenditure amount. |
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5.1. Relevance - User Needs | |||
State and regional authorities, international organisations, national and foreign users. |
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5.2. Relevance - User Satisfaction | |||
NSI conducts a regular statistical survey "Users' satisfaction" which covers all statistical domains. It aims to assess user satisfaction in NSI data provision and to outline the recommendations for future development of statistical system according to the needs of the users. |
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5.3. Completeness | |||
For the compulsory variables of the HC categories - the category HC.2.4 "Home-based rehabilitative care" is reported in HC2.3 "Outpatient rehabilitative care". The categories HC.3.2 "Day long-term care (health)" and HC. 3.3 "Outpatient long-term care (health)" are missing. The day long-term care as well as outpatient long-term care are part of the duties of GPs or specialists and the expenditures are reported in HC1. |
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5.3.1. Data completeness - rate | |||
Table HPxHF = 90.9% Table HCxHP = 86.7% Table HCxHF = 79.3% |
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6.1. Accuracy - overall | |||
The quality of the data depends significantly on the quality of the primary data sources. Most of them are administrative data (e.g. reports on budget execution) and exhaustive statistical surveys. |
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6.2. Sampling error | |||
Not applicable. |
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6.2.1. Sampling error - indicators | |||
Not applicable. |
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6.3. Non-sampling error | |||
Overcoverage - Health care goods and services by non-residents are included. Undercoverage - There is some underestimation of the LTC expenditure. The distinction between health and social long-term care in Bulgaria is based on national legislation and NACE classification. Within health care, only hospices provide long-term health care as a main function. Palliative care in hospitals have been classified as curative care as a function, rather than long-term care. Homes for the disabled and elderly – which come under social care establishments – do not provide on-site medical care. Medical treatment is provided under contract by GPs and other specialists, as for the rest of the population. All other community and residential services come under the umbrella of social services. An under-coverage exists in OOP payments. Underground/informal/illegal health services and goods are not included. At this stage we are not able to report these payments. |
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6.3.1. Coverage error | |||
Health care goods and services by non-residents are included. An under-coverage exists in OOP payments. Underground/informal/illegal health services and goods are not included. At this stage we are not able to report these payments. |
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6.3.1.1. Over-coverage - rate | |||
Overcoverage - Health care goods and services by non-residents are included.
Undercoverage - There is some underestimation of the LTC expenditure. The distinction between health and social long-term care in Bulgaria is based on national legislation and NACE classification.
Within health care, only hospices provide long-term health care as a main function. Palliative care in hospitals have been classified as curative care as a function, rather than long-term care.
Homes for the disabled and elderly – which come under social care establishments – do not provide on-site medical care. Medical treatment is provided under contract by GPs and other specialists, as for the rest of the population.
All other community and residential services come under the umbrella of social services.
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6.3.1.2. Common units - proportion | |||
If double-counting of expenditure is detected it is removed and consolidated. |
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6.3.2. Measurement error | |||
National data validation is carried out - analysis of trends, growth rates and anomalies. In case of errors detected, the data are revised. |
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6.3.3. Non response error | |||
Not applicable. |
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6.3.3.1. Unit non-response - rate | |||
Not applicable. |
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6.3.3.2. Item non-response - rate | |||
Not applicable. |
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6.3.4. Processing error | |||
National data validation is carried out - analysis of trends, growth rates and anomalies and cross-validation between different data sources. In case of errors detected, the data are revised. |
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6.3.4.1. Imputation - rate | |||
Not applicable (no imputations). |
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6.3.5. Model assumption error | |||
Not relevant for SHA. |
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6.4. Seasonal adjustment | |||
Not applicable. |
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6.5. Data revision - policy | |||
In practice, there are two main types of revisions:
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6.6. Data revision - practice | |||
Where a new source of information is identified and used, the data for previous years shall be revised if possible. |
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6.6.1. Data revision - average size | |||
Changes resulting from data revisions in the last years range from -0.1% to + 0.04% (grow rates) depending on the kind of revision. |
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7.1. Timeliness | |||
Member States are required to transmit their data to Eurostat in compliance with the Commission Regulation 359/2015 transmission deadlines. |
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7.1.1. Time lag - first result | |||
Bulgaria does not publish first results. |
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7.1.2. Time lag - final result | |||
Data are disseminated according to the Release Calendar presenting the results of the statistical surveys carried out by the National Statistical Institute - usually T+22 months. |
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7.2. Punctuality | |||
Bulgarian NSI complies with the Commission Regulation 359/2015 transmission deadlines. |
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7.2.1. Punctuality - delivery and publication | |||
Transmission to Eurostat: 30 April in year t for figures on year t-2. |
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8.1. Comparability - geographical | ||||||
Not applicable at national level. |
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8.1.1. Asymmetry for mirror flow statistics - coefficient | ||||||
Not applicable. |
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8.2. Comparability - over time | ||||||
Breaks in time series resulting from methodological changes
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8.2.1. Length of comparable time series | ||||||
Data according to SHA 2011 is available from 2011 to 2016 and comparable over this period with the exception of 2011. 2011 data are available on first digit level of the classifications. |
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8.3. Coherence - cross domain | ||||||
The SHA figures can be reconciled with figures from Business statistics. A full coherence between SHA and ESSPROS is not feasible. Compilation methods for SHA and ESSPROS are different for Bulgarian NSI and therefore data cannot be mapped. |
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8.4. Coherence - sub annual and annual statistics | ||||||
Not applicable. |
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8.5. Coherence - National Accounts | ||||||
Coherence in accounting principles exist. However, as differences in the scope and the concepts used by SHA and National accounts exist, a full coherence is not applicable. |
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8.6. Coherence - internal | ||||||
Atypical entries:
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9.1. Dissemination format - News release | |||
Not applicable. |
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9.2. Dissemination format - Publications | |||
Not applicable. |
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9.3. Dissemination format - online database | |||
Detailed data on the system of health accounts are available to all users on the NSI website under the heading Health - System of Health Accounts: http://www.nsi.bg/en/node/5568 |
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9.3.1. Data tables - consultations | |||
The information is currently not available. |
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9.4. Dissemination format - microdata access | |||
Not applicable. |
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9.5. Dissemination format - other | |||
Information service on request, according to the Rules for the dissemination of statistical products and services in NSI. |
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9.6. Documentation on methodology | |||
Metadata are available on the NSI website: http://www.nsi.bg/en/content/5568/system-health-accounts?qt-statistical_domain_en=2#qt-statistical_domain_en |
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9.7. Quality management - documentation | |||
Quality reports are based on self assessment for the process. |
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9.7.1. Metadata completeness - rate | |||
100% |
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9.7.2. Metadata - consultations | |||
Information is not available. |
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Restricted from publication |
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11.1. Confidentiality - policy | |||
The Regulation (EC) No 223/2009 on European statistics (recitals 23-27, 31-32 and Articles 20-26) applies. |
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11.2. Confidentiality - data treatment | |||
Individual data are not published in accordance with article 25 of the Law on Statistics. |
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HP5xHC5 dissagregation and HP8.2xHC5 - Since 2011 expenditure are estimated in more detail. Business statistical surveys (annual records on accountancy and statistical reports and survey on domestic trade) conducted by NSI are the main data source. Data is compiled on the basis of data obtained through annual accounting and statistical reports, regularly collected by the NSI. Retail sales by group of goods are used. Estimations are done based on NACE code of the enterprises. HP5.9 - electronic or mail-order shopping is included (NACE 47.91); HP8.2 - over-the counter medicine sales in supermarkets are included (NACE 47.1, 47.2, 47.78). Except mail-order shoping and over-the counter medicine sales in supermarkets all other household’s expenditures can not be disaggregated to prescribed and non-prescribed. |
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