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For any question on data and metadata, please contact: Eurostat user support |
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1.1. Contact organisation | Ministry of Health |
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1.2. Contact organisation unit | Office for health economics (Danish: Kontor for sundhedsøkonomi) |
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1.5. Contact mail address | Holbergsgade 6, 1057 København, Denmark |
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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: |
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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 | |||
2010-2017 |
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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: 1 - Financial reports: 1 - Other: 0
Surveys/censuses
Public administrative records
Financial reports
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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:
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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 | ||||||||||||||||||||||||||||||||||||||||||
None. |
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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. The national system to allocate the spending across different dimensions (HC, HF, HP) and across the different categories within each dimension is based on a program (SAS) that import data from the sources. In this system there are multiple validation functions to ensure that numbers are consistent across dimensions. |
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4.2. Quality management - assessment | |||
The quality of the data is assessed to be good. One reason for this is that most spending is governmental in which there is a great degree of transparency. |
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5.1. Relevance - User Needs | |||
National users are mostly researchers, journalists and bureaucrats. |
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5.2. Relevance - User Satisfaction | |||
Not applicable. |
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5.3. Completeness | |||
Good, though some data are missing, most important is spending from HF2.3 (Enterprise financing schemes). |
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5.3.1. Data completeness - rate | |||
High degree of completion. |
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6.1. Accuracy - overall | |||
Overall very good, as most of the spending is from primary accounts. |
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6.2. Sampling error | |||
Only survey data is on out-of-pocket spending that comes from consumer survey. |
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6.2.1. Sampling error - indicators | |||
Not applicable. |
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6.3. Non-sampling error | |||
Not applicable. |
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6.3.1. Coverage error | |||
Not applicable. |
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6.3.1.1. Over-coverage - rate | |||
Not applicable. |
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6.3.1.2. Common units - proportion | |||
Not applicable. |
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6.3.2. Measurement error | |||
Not applicable. |
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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 | |||
Not applicable. |
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6.3.4.1. Imputation - rate | |||
Not applicable. |
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6.3.5. Model assumption error | |||
Not applicable. |
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6.4. Seasonal adjustment | |||
Not applicable. |
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6.5. Data revision - policy | |||
Not applicable. |
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6.6. Data revision - practice | |||
Expenses for physiotherapists, chiropractors etc. are moved from HC131xHP33xHF11 to HC139xHP33xHF11 cf. note 8 in the validation round for the 2015 reporting. OOP (out-of-pocket) spending for inpatient LTC are moved from (HC34xHP35xHF31) to (HC31xHP21xHF31) cf. note 14.a in the validation round for the 2015 reporting. Home-based LTC provided by households are moved from home-based LTC provided by households (HC34xHP35) to (HC34xHP81) cf. note 14.b in the validation round for the 2015 reporting. |
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6.6.1. Data revision - average size | |||
Very limited. |
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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 | |||
The primary accounts for the expenditure in year t-1 is ready in about October / November in year t. |
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7.1.2. Time lag - final result | |||
1-5 months. |
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7.2. Punctuality | |||
Not applicable. |
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7.2.1. Punctuality - delivery and publication | |||
Not applicable. |
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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 | ||||||||||||
Roughly from 2003 to 2017 though some smaller issues in the period. |
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8.3. Coherence - cross domain | ||||||||||||
Data is quite similar to data from other sources (primary accounts, national accounts). |
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8.4. Coherence - sub annual and annual statistics | ||||||||||||
Not applicable. |
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8.5. Coherence - National Accounts | ||||||||||||
Not applicable. |
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8.6. Coherence - internal | ||||||||||||
Atypical entries:
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9.1. Dissemination format - News release | |||
The OECD SHA data is often used in the media in Denmark for comparison of Danish spending with other countries. Here an example: https://videnskab.dk/kultur-samfund/derfor-er-danmarks-sundhedsvaesen-baade-bedre-og-billigere-end-usas |
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9.2. Dissemination format - Publications | |||
There are different publications in which the figures from OECD are used. An example could be found here: https://pure.vive.dk/ws/files/2306314/301206_flere_aeldre_sundhedsvaesenets_oekonomi_pdfa.pdf |
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9.3. Dissemination format - online database | |||
9.3.1. Data tables - consultations | |||
Not applicable. |
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9.4. Dissemination format - microdata access | |||
Not applicable. |
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9.5. Dissemination format - other | |||
Not applicable. |
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9.6. Documentation on methodology | |||
Not applicable. |
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9.7. Quality management - documentation | |||
There is no online documentation available. However, there is ongoing work on establishing this. |
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9.7.1. Metadata completeness - rate | |||
Not applicable. |
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9.7.2. Metadata - consultations | |||
Not applicable. |
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Cost is around 240.000 kr yearly equivalent to 320 working hours. |
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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 | |||
All legal requirements are met. |
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None. |
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