Health care expenditure (SHA 2011) (hlth_sha11)

National Reference Metadata in ESS Standard for Quality Reports Structure (ESQRS)

Compiling agency: Hellenic Statistical Authority (ELSTAT)


Eurostat metadata
Reference metadata
1. Contact
2. Statistical presentation
3. Statistical processing
4. Quality management
5. Relevance
6. Accuracy and reliability
7. Timeliness and punctuality
8. Coherence and comparability
9. Accessibility and clarity
10. Cost and Burden
11. Confidentiality
12. Comment
Related Metadata
Annexes (including footnotes)
 



For any question on data and metadata, please contact: EUROPEAN STATISTICAL DATA SUPPORT

Download


1. Contact Top
1.1. Contact organisation

Hellenic Statistical Authority (ELSTAT)

1.2. Contact organisation unit

Division of Social Statistics Department of Health Statistics and Social Security and Protection

1.5. Contact mail address

46 Peiraeus and Eponiton street 185 10, Peiraeus


2. Statistical presentation Top
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.
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).
The time coverage of this Quality report is 2014 to 2016 reference years.

The definitions and classifications of the System of Health Accounts (SHA) are followed, e.g. International Classification for Health Accounts - Providers of health care (ICHA-HP).

Data related to Health Expenditure are mainly collected from the administrative sources of the country, such as:

  • Ministry of Health for data related to General Government excluding Social Security Funds (SSFs),
  • Ministry of Health for Social Security Funds,
  • Ministry of Defense(for military hospitals), Ministry of Education (for university hospitals)
  • Hellenic Association of Insurance Companies (for private health coverage) and
  • Non Government Organizations (NGO’s), the Church of Greece etc. for other health expenditures,

And, from ELSTAT’s survey results

  • Household Budget Survey (HBS).

ELSTAT publishes SHA2011 data on an annual basis, within the first quarter of the second year after the reference year of the data, according to the timetable of publications of the OECD and of Eurostat.

Health care data on expenditure are mainly based on census and administrative (register) data sources (except for the HBS where sampling techniques are implemented by the respective Division of ELSTAT).

The database is based on a co-operation between EUROSTAT, the OECD (Organisation for Economic Co-Operation and Development) and the WHO (World Health Organisation), executing a Joint Questionnaire on Health expenditure since 2005.

Data based on SHA2011 methodology cover the years 2009 to 2017.

2.2. Classification system

Healthcare expenditure is recorded in relation to the international classification for health accounts (ICHA) defining:

  • healthcare expenditure by financing schemes (ICHA-HF) — which classifies the types of financing arrangements through which people obtain health services; health care financing schemes include direct payments by households for services and goods and third-party financing arrangements;
  • healthcare expenditure by function (ICHA-HC) — which details the split in healthcare expenditure following the purpose of healthcare activities — such as, curative care, rehabilitative care, long-term care, or preventive care;
  • healthcare expenditure by provider (ICHA-HP) — which classifies units contributing to the provision of healthcare goods and services — such as hospitals, residential facilities, ambulatory health care services, ancillary services or retailers of medical goods.

For all data on expenditure the source for classification is described in:

  • the System of Health Accounts SHA 2011.

Data are classified at 2-digit level of SHA codes, thus fully covering the requirements of the international organizations. Moreover, there is correspondence between the functions of health activities as they are defined by SHA2011 (eg. In-patient, outpatient care etc.) with the international system of classification of general government COFOG (Classification of the Functions of Government) on an aggregated level.

2.3. Coverage - sector

1. Household individual consumption on health, including the collective consumption with two exceptions:
i. Occupational health care (intermediate consumption within establishments) minus an estimated share of occupational health in health providers’ and other medical industries net administration;
ii.“Remunerated” unpaid household production in the form of transfer payments (social benefits in cash) for home care of sick, disabled and elderly persons provided by family members.
SHA 2011 Manual recommends following the standard System of National Account (SNA) rules for drawing the production boundary of health care services, albeit with two notable exceptions:
- Occupational health care is included in the national totals of health care spending. In SNA, this item is recorded as ancillary services and part of intermediate production of enterprises and
- Part of the cash transfers to private households for care givers of home care for the sick and disabled are treated as the paid household production of health care.
2. Health care financing schemes: HF1 Government schemes and compulsory contributory health care financing schemes; HF2 -voluntary health care payment schemes;
HF3 - Household out-of-pocket payment; HF4 - rest of the world financing schemes.
3. NACE rev. 2, section Q, human health and social work activities.

Health Expenditures of General Government, Private  Households, Private Insurance Companies and the Rest of the World plus various NPISHs for health related expenditures. Production side of the health sector is not covered as SHA data do not compile the relevant SHA table.

2.4. Statistical concepts and definitions

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.

Health care statistics describe the process of providing and financing health care in Greece by referring to health care goods and services, its providers and financing.

Current expenditure on health measures the economic resources spent by Greek residents on health care services and goods, including administration and insurance.

For the collection of the data on health care expenditure the System of Health Accounts (SHA2011) comprises the goals of the System of National Accounts (SNA) to constitute an integrated system of comprehensive, internally consistent, and internationally comparable accounts, which should as far as possible be compatible with other aggregated economic and social statistical systems.

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".
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 2015/359 limits its scope to the collection of data on the expenditure of health care financing schemes.

SHA relies on three axes:

  • The financing of health services by financing agency (demand)
  • The direction of health expenditure by health provider and by health care activity (supply)
  • The financing of health providers by financing agency (consumption).
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).

 Data related to the provision of health goods and services consumed by domestic residents within the boundaries of domestic economy.

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.

Covers the geographical area of Greece.

2.8. Coverage - Time

ELSTAT publishes SHA2011 data on an annual basis, within the first quarter of the second year after the reference year of the data, according to the timetable of publications of the OECD and Eurostat.

In particular, ELSTAT publishes statistical data of the System of Health Accounts (SHA2011) for the years 2009-2017 with first reference year, the year 2009.

2.9. Base period

Not applicable.


3. Statistical processing Top
3.1. Source data

Several data sources are used (as of data notification in March 2018):

-          Surveys/census: 3

-          Public administrative records: 6

-          Financial reports: 0

-          Other: 0

 

Surveys/censuses

Source name

Brief description of source

Primary SHA variable(s) using this data source

Time period covered by this data source

Timeliness

(Number of months after the end of the accounting period)

Frequency

Processing

Expenditure disbursed by households ( out of pocket expenditures)

The Household Budget Survey (HBS) of ELSTAT is used; covererage 100% of all health related activity of households HF.3.1 2009-2016 12 months Annual Each expenditure code of households related to health is classified according to health provider (public hospitals, private hospitals, diagnostic centres etc.).

Private Insurance Companies

Annual records of activity and spending financed by Private Insurance Companies; coverage 100% of all health related activiry of Private Insurance Companies HF.2.1 2009-2016 12 months Annual Each expenditure code of the total of Private Insurance Companies related to health is classified according to health provider (public hospitals, private hospitals, diagnostic centres etc.).

Occupational Health related data

Annual administrative data HF.2.3 2009-2016 12 months Annual Each expenditure code classified according to health provider

 

Public administrative records

Source name

Brief description of source

Primary SHA variable(s) using this data source

Time period covered by this data source

Timeliness

(Number of months after the end of the accounting period)

Frequency

Processing

Statistics of Social Security Funds (SSFs)

Annual records on activity and spending financed by SSFs; coverage 100% of all activity of SSFs HF.1.2 2009-2016 12 months Annual Each expenditure code of SSFs is clasified according to health provider (public hospitals, private hospitals, diagnostic centres etc.).

State Budget

Annual records on activity and spending financed by State Budget HF.1.1 2009-2016 12 months Annual Each expenditure code of State Budget is clasified according to health provider (public hospitals, private hospitals, diagnostic centres etc.).

Expenditure of Military Hospitals and University Hospitals

Annual records on activity and spending financed by Military Hospitals and University Hospitals; coverage 100% of all health related activity of military and university hospitals HF.1.1 2009-2016 12 months Annual Each expenditure code of Military and University Hospitals is clasified according to health provider (public hospitals, private hospitals, diagnostic centres etc.).

Local Authorities data on health

Annual records on health activities (eg. Social pharmacies) financed by Local Authorities HF.1.1 2009-2016 12 months Annual Each expenditure code of the Local Authorities is classified according to health provider (public hospitals, private hospitals, diagnostic centres etc.).

Greek Orthodox Church

Annual records of activity and spending financed by the Greek Orthodox Church; coverage 100% of all health related activiry of the Greek Orthodox Church HF.2.2 2009-2016 12 months Annual Each expenditure code of the Greek Orthodox Curch  related to health is classified according to health provider (public hospitals, private hospitals, diagnostic centres etc.).

European Programms

Annual administrative data HF.4.0 2009-2016 12 months Annual Each expenditure code classified according to health provider

The data are collected, stored and disseminated via different tables (expenditure by provider, by financing agency and by function). The data are collected from the following agencies:

  •  the Ministry of Health , the Ministry of Defense,
  •  the Ministry of Education,
  •  all Social Security Funds,
  •  the Household Budget Survey (HBS),
  •  information collected from the Union of  Private Insurance Companies,
  •  and various NPISHs.
3.2. Frequency of data collection

Annual.

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.

 

Data collection method relates to direct contact with the administrative sources aiming at the transmission of health expenditure data in the form that they are available from the administrative sources themselves. Data are collected from the Ministry of Health, Ministry of Education, Ministry of Defense, EOPYY (the main SSF in Greece since the year 2012 and afterwards), Household Budget Survey (HBS) from ELSTAT , Private Insurance Companies, various NPISHs and RoW health related data. Data are then given the relevant SHA2011 codification according to health financing sector, health provider and health care activity (HF, HP, HC, respectively).

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:


1- Consistency of the data between tables,
This step checks if the marginal totals reported in each table of the JHAQ are consistent across all tables. For example, for each function (HC), the total across all financing schemes (HF) in the HCxHF table has to be equal to the total across all providers (HP) in the HCxHP table, i.e. the values in the column “All HF” in the HCxHF table have to be equal to the values in the column “All HP” in the HCxHP table. Any detected differences are flagged up in the corresponding row or column in the relevant tables and all inconsistencies are listed in the “Report” worksheet by variable code together with the amount by which the respective variable differs between the two compared tables. A positive value indicates that the first listed table has a higher value for the same variable, and vice versa.

 

2- Consistency of the data within tables,
Any detected inconsistencies are listed by variable code together with an indication of which total is not equal to the sum of its subcomponents as well as the numerical difference. A positive figure indicates that the total is greater than the reported sub-components, and vice versa.

  • The presence of negative values,

Entries in the tables cannot be negative as they refer to the consumption of goods and services.
If an individual data table is checked for internal consistency, the negative values check is performed for the relevant table and then any negative values are highlighted red and crossed out.

  • The presence of atypical entries,

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.
If an individual data table is checked for internal consistency, the atypical entries check is performed for the relevant table. In the data tables, any cell containing an atypical entry will be highlighted for national data providers.
Should any atypical entries be identified, compilers should scrutinize in detail the transactions that led to entries in those cells and assess whether the accounting rules of SHA have been correctly applied. If they come to the conclusion that the transactions are recorded in the correct categories of the ICHA classifications, then the corresponding atypical entries represent unique – and correctly accounted for – features of the country’s health system. In this case a short description of the nature of the transactions should be included in the accompanying Metadata file under “II.3. Atypical entries”.
If, on the other hand, compilers come to the conclusion that the transactions are not recorded correctly, then they need to make adjustments in the concerned tables. In case the transactions recorded in a cell do not belong to the boundaries of SHA (e.g. they refer to intermediate consumption) the value of the respective cell should be deleted (and all cells that are affected by this change adjusted accordingly). In case the transactions are misreported and another category of the ICHA classification is more appropriate, the value of the cell should be transferred to the correct cell of the table.

 

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:

  • Breaks in series (the current questionnaire shows no data for an item that is not null in the other file)
  • Newly reported (the current questionnaire contains data for an item that is empty in the other file)
  • Differences (all other types of differences)

Data are validated by Eurostat in co-operation with OECD and WHO health accountants.

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:

  • Balancing item/Residual method: For example, if data are available from the financing side, which permit accurate estimation of the flows to a provider or function, then an acceptable estimation method is to subtract these expenditure flows from the total revenues, and derive the expenditure flows from the unmeasured financing scheme as a residual.
  • Pro-rating/Utilisation key: Typically in the absence of direct spending data, a utilisation key linked to the proportion of resources used can be constructed in order to distribute e.g. aggregate provider spending across functions. For every key a fraction of total utilisation within the cost-unit is assigned: fractions in the key must add up to 100% of all care delivered by the cost-unit. Examples of utilisation keys are admissions, bed-days, contacts, staffing, etc.
  • Interpolation/Extrapolation: In the absence of data for the period in question, missing values can be estimated using known data points.
  • Or other.

Data are compiled according to the Manual of the System of Health Accounts (SHA), 2011 edition. All expenditure items covering health and LTC are assigned a classification of provider and function. Data are included for military hospitals, and data for general population protection. Every effort is exercised to record data on an accrual basis and for this reason all data related to general government are compared with the respective health data of national accounts. Also COFOG data (health category GF07) are also taken into account, and compared with the SHA2011 data. Data are classified according to SHA2011 codification (categories HF,HP,HC) and are inserted on a unified working table covering all sectors, before being transferred to the formal JHAQ data.

3.6. Adjustment

No adjustment.


4. Quality management Top
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 quality assurance system is presented on ELSTAT’s website at:

http://www.statistics.gr/el/statistics?p_p_id=documents_WAR_publicationsportlet_INSTANCE_0qObWqzRnXSG&p_p_lifecycle=2&p_p_state=normal&p_p_mode=view&p_p_cacheability=cacheLevelPage&p_p_col_id=column-1&p_p_col_count=4&p_p_col_pos=1&_documents_WAR_publicationsportlet_INSTANCE_0qObWqzRnXSG_javax.faces.resource=document&_documents_WAR_publicationsportlet_INSTANCE_0qObWqzRnXSG_ln=downloadResources&_documents_WAR_publicationsportlet_INSTANCE_0qObWqzRnXSG_documentID=115873&_documents_WAR_publicationsportlet_INSTAN

As well as within the European Statistics Code of Practice, which was established by the Statistical Programme Committee in February 24, 2005 and published as Commission Recommendation in May 25, 2005, regarding the independence, integrity and responsibility of national and community statistical Authorities after its revision which was adopted in September 28, 2011 by the Commission of the European Statistical System.

4.2. Quality management - assessment

The basic advantages of the overall quality of the System of Health Accounts compilation refer to the availability of primary data sources form the official national administrative sources (Ministry of Health, Social Security Funds, ELSTAT, Church of Greece etc.).

However, the need of a detailed classification of total health expenditures by provider and by health care activity defines the need of re-examining the total operational structure of the health sector in every data revision for each reference year.


5. Relevance Top
5.1. Relevance - User Needs

The basic users of the System of Health Accounts data are the Ministry of Health, various Universities and other scientific agencies (researchers, students etc.).

5.2. Relevance - User Satisfaction

Currently, incidents of non-satisfaction by users have not been recorded referring to the published System of Health Accounts results. The last available results of the User’s Satisfaction Survey 2016, are presented on ELSTAT’s website at:

http://www.statistics.gr/en/user-satisfaction-survey

The Division of Statistical Information and Publications of ELSTAT, conducts the survey on User’s satisfaction.

5.3. Completeness

The completeness rate of data is considered satisfactory. However some three digit codes are no feasible to be completed and their respective sub-category is included within its broader (two digit) health category. Also some categories of health related expenditures are at present unfeasible to be recorded (for example category of HC.2.4-Home based rehabilitative care) but these cases are mentioned within the SIMS documentation.

5.3.1. Data completeness - rate

The completeness rate of data is considered satisfactory. However some three digit codes are no feasible to be completed and their respective sub-category is included within its broader (two digit) health category. Also some categories of health related expenditures are at present unfeasible to be recorded (for example category of HC.2.4-Home based rehabilitative care) but these cases are mentioned within the SIMS documentation.


6. Accuracy and reliability Top
6.1. Accuracy - overall

Accuracy of the data that are related to administrative sources is checked by themselves as they refer to census data. Regarding the data that derive from ELSTAT’s Household Budget Survey (HBS), their accuracy is checked within the evaluation framework of the survey itself, conducted by the respective Division of ELSTAT.

6.2. Sampling error

The survey is a census survey; there are no sampling errors.

6.2.1. Sampling error - indicators

Errors related to non-coverage of the population (framework weaknesses), non-response errors of the respondents, response errors which are due to the respondents, response errors which are due to statistical interviewers and processing errors are checked by the involved administrative sources themselves, as well as by the Division of Population Statistics and Labour Market regarding data related to HBS.

6.3. Non-sampling error

We use census not samples. 

Estimation for underground health goods and services are not included in the data.

Data on shadow economy are not included (for example data related to the shadow economy of home nursing care).

Accuracy of the data that are related to administrative sources is checked by themselves. Regarding the data that derive from ELSTAT’s Household Budget Survey (HBS), their accuracy is checked within the evaluation framework of the survey itself. Health care goods and services by non-residents are excluded from domestic providers. So far we were not able to report the informal /illegal health care goods and services within the data collection.

6.3.1. Coverage error

Not applicable.

6.3.1.1. Over-coverage - rate

Not applicable.

6.3.1.2. Common units - proportion

Not applicable.

6.3.2. Measurement error

Not applicable.

6.3.3. Non response error

Not applicable.

6.3.3.1. Unit non-response - rate

Not applicable.

6.3.3.2. Item non-response - rate

Not applicable.

6.3.4. Processing error

No processing error occurs.

6.3.4.1. Imputation - rate

Not applicable.

6.3.5. Model assumption error

Not applicable.

6.4. Seasonal adjustment

Not applicable.

6.5. Data revision - policy

Data are considered provisional and are subject to revision.

The Revision policy implemented by ELSTAT is presented on ELSTAT’s website at:

 http://www.statistics.gr/documents/20181/a49dca9a-dacf-4b52-b5df-b156216cb354

 

6.6. Data revision - practice

Usually, data are revised every March following the reference year.

ELSTAT’s Revision Policy is being implemented as presented on ELSTAT’s website at:

http://www.statistics.gr/documents/20181/a49dca9a-dacf-4b52-b5df-b156216cb354

Data for the years 2009 to 2011 were not revised for any of the sub sectors. Data for the years 2012 to 2015 were revised for the sub sector of Social Security Funds (HF.1.2) .The present revised data follow the accruals principles of National Accounts in a more consistent way, while at the same time, trying to adhere to the primary cash based data received directly from the SSFs (in cases where this is feasible). Data for the years 2012 and 2015 were revised for the sub sector of central government (HF.1.1) (in the case of the year 2015 the revision is substantial, around 260 mio euro, and is due to revised estimations of the salaries of personel employed in public hospitals as reported in the respective National Accounts data.

6.6.1. Data revision - average size

For the year 2017 SHA notification data revision is of a small scale.


7. Timeliness and punctuality Top
7.1. Timeliness

Member States are required to transmit their data to Eurostat in compliance with the Commission Regulation 359/2015 transmission deadlines.
Data and reference metadata for the reference year T should be transmitted to Eurostat by 30 April T+2.

Eurostat, OECD and WHO request data transmission for the reference year: N in time N+15 months.

7.1.1. Time lag - first result

N+15 months.

7.1.2. Time lag - final result

N+15 months.

7.2. Punctuality

No delays in the publication and transmission of data have been recorded.

7.2.1. Punctuality - delivery and publication

No delays in the publication and transmission of data have been recorded.


8. Coherence and comparability Top
8.1. Comparability - geographical

Data are compatible with the respective data of the rest of the countries where SHA2011 Methodology is in force.

8.1.1. Asymmetry for mirror flow statistics - coefficient

Not applicable.

8.2. Comparability - over time

Breaks in time series resulting from methodological changes

Year

Items affected by the break

Explanations

2009

series break for all categories

 

2015

series break for HC13xHP34 and HC13HC23xHP34

 
8.2.1. Length of comparable time series

The time series for the years 2009-2017 is annually revised and data are considered fully comparable with the previous notification for the same time period. 

8.3. Coherence - cross domain

Coherence checks are carried out regarding the Social Security Funds survey of the Division of Social Statistics as well as with relevant data of the National Accounts Division and the ESSPROS data format. In particular scheme 18 of the ESSPROS data are based (on the uses side) on SHA2011 data (after the exclusion of non ESSPROS related data recorded in SHA2011).

8.4. Coherence - sub annual and annual statistics

Not applicable, the survey is annual.

8.5. Coherence - National Accounts

SHA2011 is consistent with the National Accounts data (at least for the sector of general government). Every year accruals based data from national accounts are processed and classified according to SHA2011 codification.

Additionally, data related to general government which is recorded in the SHA 2011 system is cross checked with the respective data of the national accounts.

8.6. Coherence - internal

The System of Health Accounts is compatible according to the three (3) tables compiled as they appear at ELSTAT’s website at:

http://www.statistics.gr/el/statistics/-/publication/SHE35/-

Data are checked against their internal consistency if two different data sources are used. However consistency among data does not seem to be a problem since both SHA2011 and national accounts data receive their primary data from the same data sources.


9. Accessibility and clarity Top
9.1. Dissemination format - News release

News release available on ELSTAT’s website at:

http://www.statistics.gr/en/statistics?p_p_id=documents_WAR_publicationsportlet_INSTANCE_qDQ8fBKKo4lN&p_p_lifecycle=2&p_p_state=normal&p_p_mode=view&p_p_cacheability=cacheLevelPage&p_p_col_id=column-2&p_p_col_count=4&p_p_col_pos=1&_documents_WAR_publicationsportlet_INSTANCE_qDQ8fBKKo4lN_javax.faces.resource=document&_documents_WAR_publicationsportlet_INSTANCE_qDQ8fBKKo4lN_ln=downloadResources&_documents_WAR_publicationsportlet_INSTANCE_qDQ8fBKKo4lN_documentID=361932&_documents_WAR_publicationsportlet_INSTANCE_qDQ8fBKKo4lN_locale=en

9.2. Dissemination format - Publications

Data on the System of Health Accounts for the years 2009-2017 are available on ELSTAT’s website at:

http://www.statistics.gr/en/statistics/-/publication/SHE35/-

 and on Eurostat’s website:

https://ec.europa.eu/eurostat/statistics-explained/index.php?title=Healthcare_expenditure_statistics

9.3. Dissemination format - online database

Data are available in ELSTAT’s data base:

http://www.statistics.gr/en/statistics/-/publication/SHE35/-

9.3.1. Data tables - consultations

The total access to the networking page regarding the specific survey for the year 2018 is 5,746 page views (total hits).

9.4. Dissemination format - microdata access

Not applicable.

The microdata are available upon request at:

Division of Statistical Information and Publications

46, Peiraeus & Eponiton str., 185 10 Peiraeus

Tel. (+30) 213-1352173, FAX : (+30) 213-1352022

e-mail : data.dissem@statistics.gr

 

Confidentiality of data is always ensured.

9.5. Dissemination format - other

Please visit:

http://dlib.statistics.gr/portal/page/portal/ESYE/

9.6. Documentation on methodology

Categorization of health expenditures is based and is analytically described at:

the System of Health Accounts  http://www.who.int/health-accounts/methodology/sha2011.pdf as presented by the OECD in 2011.

9.7. Quality management - documentation

The quality assurance system is presented on ELSTAT’s website at:

http://www.statistics.gr/documents/20181/1609796/ELSTAT_Quality_Instructions_EN.pdf/4095e67c-2fe4-450b-8a95-18bc992a83c6

As well as within the European Statistics Code of Practice, which was established by the Statistical Programme Committee in February 24, 2005 and published as Commission Recommendation in May 25, 2005, regarding the independence, integrity and responsibility of national and community statistical Authorities after its revision which was adopted in September 28, 2011 by the Commission of the European Statistical System.

The basic advantages of the overall quality of the System of Health Accounts compilation refer to the availability of primary data sources from the official national administrative sources (Ministry of Health, Social Security Funds, ELSTAT, Church of Greece etc.).

9.7.1. Metadata completeness - rate

The metadata are entirely covered.

9.7.2. Metadata - consultations

Information not available.


10. Cost and Burden Top

Not estimated.


11. Confidentiality Top
11.1. Confidentiality - policy

     The issues concerning the observance of statistical confidentiality by the Hellenic Statistical Authority (ELSTAT) are arranged by articles 7, 8 and 9 of the Law 3832/2010 as in force, by Articles 8, 10 and 11(2) of the Regulation on Statistical Obligations of the agencies of the Hellenic Statistical System and by Articles 10 and 15 of the Regulation on the Operation and Administration of ELSTAT.

More precisely:

      ELSTAT disseminates the statistics in compliance with the statistical principles of the European Statistics Code of Practice and in particular with the principle of statistical confidentiality.

http://www.statistics.gr/en/statistical-confidentiality?inheritRedirect=true

11.2. Confidentiality - data treatment

ELSTAT protects and does not disseminate data it has obtained or it has access to, which enable the direct or indirect identification of the statistical units that have provided them by the disclosure of individual information directly received for statistical purposes or indirectly supplied from administrative or other sources. ELSTAT takes all appropriate preventive measures so as to render impossible the identification of individual statistical units by technical or other means that might reasonably be used by a third party. Statistical data that could potentially enable the identification of the statistical unit are disseminated by ELSTAT if and only if:


a) these data have been treated, as it is specifically set out in the Regulation on Statistical Obligations of the agencies of the Hellenic Statistical System (ELSS), in such a way that their dissemination does not prejudice statistical confidentiality or

b) the statistical unit has given its consent, without any reservations, for the disclosure of data.

  • The confidential data that are transmitted by ELSS agencies to ELSTAT are used exclusively for statistical purposes and the only persons who have the right to have access to these data are the personnel engaged in this task and appointed by an act of the President of ELSTAT.
  • ELSTAT may grant researchers conducting statistical analyses for scientific purposes access to data that enable the indirect identification of the statistical units concerned. The access is granted provided the following conditions are satisfied:

    a) an appropriate request together with a detailed research proposal in conformity with current scientific standards have been submitted;

    b) the research proposal indicates in sufficient detail the set of data to be accessed, the methods of analyzing them, and the time needed for the research;

    c) a contract specifying the conditions for access, the obligations of the researchers, the measures for respecting the confidentiality of statistical data and the sanctions in case of breach of these obligations has been signed by the individual researcher, by his/her institution, or by the organization commissioning the research, as the case may be, and by ELSTAT.
  • Issues referring to the observance of statistical confidentiality are examined by the Statistical Confidentiality Committee (SCC) operating in ELSTAT. The responsibilities of this Committee are to make recommendations to the President of ELSTAT on:
    •  the level of detail at which statistical data can be disseminated, so as the identification, either directly or indirectly, of the surveyed statistical unit is not possible;
    • the anonymization criteria for the microdata provided to users;
    •  the granting to researchers access to confidential data for scientific purposes.
  • The staff of ELSTAT, under any employment status, as well as the temporary survey workers who are employed for the collection of statistical data in statistical surveys conducted by ELSTAT, who acquire access by any means to confidential data, are bound by the principle of confidentiality and must use these data exclusively for the statistical purposes of ELSTAT. After the termination of their term of office, they are not allowed to use these data for any purpose.
  • Violation of data confidentiality and/or statistical confidentiality by any civil servant or employee of ELSTAT constitutes the disciplinary offence of violation of duty and may be punished with the penalty of final dismissal.
  • ELSTAT, by its decision, may impose a penalty amounting from ten thousand (10,000) up to two hundred thousand (200,000) euros to anyone who violates the confidentiality of data and/or statistical confidentiality. The penalty is always imposed after the hearing of the defense of the person liable for the breach, depending on the gravity and the repercussions of the violation. Any relapse constitutes an aggravating factor for the assessment of the administrative sanction.


12. Comment Top

No additional comments.


Related metadata Top


Annexes Top