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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 Institute for Health and Welfare (THL) |
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1.2. Contact organisation unit | Information Services - Statistics and Registers |
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1.5. Contact mail address | P.O. Box 30, FI-00271 Helsinki, Finland |
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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 | |||
SHA 2011 based accounts are available from 2000. |
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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: 3 - Public administrative records: 3 - Financial reports: 4 - 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. At the national level data is collected and compiled by the National Institute for Health and Welfare (THL). The data for the statistics are gathered annually by making use of various statistics and registers, research reports and financial statements. Due to the limitations and shortcomings of statistical datasets, the statistics are partly based on estimates. For instance, the expenditure on private oral health care not covered by National Health Insurance is an estimate based on several statistical data sources. |
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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:
Data are correct in so far as they have been reported correctly and accurately. The data are checked at different stages of the production process of the statistics. At the recording and reporting stage, data are compared with data from previous years using various checking procedures. In unclear cases, data providers are contacted in order to avoid errors and find causes for changes. |
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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 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
No adjusments are done. |
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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. THL takes part in the Finnish work on improving the quality of statistics, which is coordinated by the Advisory Board of the Official Statistics of Finland (OSF). http://tilastokeskus.fi/meta/svt/index_en.html |
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4.2. Quality management - assessment | |||
Overall data quality is good. Biggest uncertainty concerns breakdown of expenditure to the certain functions (ICHA-HC). Expenditure data is often received at level which does not correspond to classification of SHA 2011 health care functions (ICHA-HC). Upcoming reform to the Local governments finances statistics will help as data will be collected at more detailed level from the statistical year 2020 onwards. |
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5.1. Relevance - User Needs | |||
The main users of the SHA data in Finland are Ministries (especially The Ministry of Social Affairs and Health) and other authorities. Statistics is also targeted at decision-makers, planning officials, researchers and students in the field of social and health care and all others who need basic information on trends in health expenditure and financing and related statistics nationally and internationally. Unmet user needs relate mostly to the timeliness and promptness of published data. |
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5.2. Relevance - User Satisfaction | |||
National level users’ satisfaction survey has not been done. There is regular unofficial conversation with the Ministry of Health and Social Affairs concerning national reporting of health care expenditure. |
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5.3. Completeness | |||
For HF, HC and HP classifications there are no deviations from SHA definitions. Data for HC.6.5 and HC.6.6 are missing due to lack of available data sources. |
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5.3.1. Data completeness - rate | |||
100% |
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6.1. Accuracy - overall | |||
Overall data accuracy is good as expenditure data is gained mainly from financial reports and public administrative records. Errors in the base data lead also to errors in Health Expenditure Accounts data. Only Household Budget Survey together with national accounts private comsumption expenditures is used to estimate households’ expenditure in HC. 5.2.1 and HC.5.2.3. |
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6.2. Sampling error | |||
In households' consumption survey the relative standard error is 2.5 % concerning C06 – Health. |
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6.2.1. Sampling error - indicators | |||
2.5 % |
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6.3. Non-sampling error | |||
Not relevant. |
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6.3.1. Coverage error | |||
There should not exist any double counting in SHA figures. If noticed that double counting has been occurred, it will be eliminated and the figures will be revised. Informal care is not included, although it should not exist in Finland. Medicines purchased outside the National Health Insurance scheme, e.g. bought from the internet, are not included. |
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6.3.1.1. Over-coverage - rate | |||
There shouldn’t be an over- or under- coverage of eligible units. |
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6.3.1.2. Common units - proportion | |||
None. |
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6.3.2. Measurement error | |||
Unknown. |
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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 | |||
The main sources of processing errors are typing errors for data entry and typing/logical errors in the programming code as calculation for SHA are made in SAS system. At the recording and reporting stage, the data are compared with data from previous years using various checking procedures which help detecting the errors. |
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6.3.4.1. Imputation - rate | |||
Not applicable. |
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6.3.5. Model assumption error | |||
Not relevant. |
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6.4. Seasonal adjustment | |||
Not applicable. |
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6.5. Data revision - policy | |||
Data will be revised when relevant at the time of the submission of Joint OECD, Eurostat and WHO Health Accounts data (JHAQ). |
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6.6. Data revision - practice | |||
Years 2015 - 2016 have been revised due to revision on the data sources (e.g. Production and generation of income accounts). Administration cost of voluntary insurance has been estimated and added to the sum of CHE for the years 2015 -2017. Private insurance has been reclassified between compulsory and voluntary schemes for the years 2000-2017. |
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6.6.1. Data revision - average size | |||
For all HC average size of revision between 2018 JHAQ and 2019 JHAQ was -0,5 percent. |
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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. Aim for T-2 data is 31st March year T. Estimates for the T-1, available only at HC x HF – level, are aimed to be provided by the end of May year T. |
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7.1.1. Time lag - first result | |||
Finland does not publish first results. |
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7.1.2. Time lag - final result | |||
Final results are aimed to be published by the end of March T+2. |
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7.2. Punctuality | |||
Commission Regulation 359/2015 transmission deadlines were not respected during 2017 JHAQ concerning reference year 2015 figures. This was due the changes made in the statistics used as background data. Implementation of these changes to SHA calculations took more time than expected. There were no deviations from Commission Regulation 359/2015 transmission deadlines for other reference years. |
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7.2.1. Punctuality - delivery and publication | |||
According to the Commission Regulation 359/2015 transmission deadlines. |
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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 | |||||||||||||||
From 2015. |
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8.3. Coherence - cross domain | |||||||||||||||
SHA and ESSPROS are not comparable since ESSPROS includes also cash benefits and LTC-expenditures more broadly, also valuating of services are different. In SHA the value of the good or service is measured as equal to the sum of its production costs. In ESSPROS expenditure are more like net costs. |
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8.4. Coherence - sub annual and annual statistics | |||||||||||||||
Not applicable. |
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8.5. Coherence - National Accounts | |||||||||||||||
There is a link between some SHA figures and National Accounts local government sector (S1313) income and production accounts. Otherwise, no other relevant coherence with National Accounts exists. |
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8.6. Coherence - internal | |||||||||||||||
Atypical entries:
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9.1. Dissemination format - News release | |||
Every year, THL publish a statistical report called Health Expenditure and Financing. The report is published in Finnish, Swedish and in English and can be retrieved here. |
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9.2. Dissemination format - Publications | |||
Recent and earlier publications can be found in PDF format here. Appendix tables in Excel-format can be found from the statistics home page of the latest statistical year. |
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9.3. Dissemination format - online database | |||
Currently there is no online database available in Finland. |
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9.3.1. Data tables - consultations | |||
Data is not available. |
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9.4. Dissemination format - microdata access | |||
Not applicable. |
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9.5. Dissemination format - other | |||
Health care expenditures are also reported in Statistics Finland’s Statistical year book. |
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9.6. Documentation on methodology | |||
Background information concerning methodology can be found on the statistics home page. |
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9.7. Quality management - documentation | |||
National quality description for Health Expenditure and Financing can be found here. NB: Special issues concerning the 2017 statistics will be updated during autumn 2019. |
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9.7.1. Metadata completeness - rate | |||
Unknown. |
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9.7.2. Metadata - consultations | |||
Unknown. |
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Information concerning cost associated with the collection and production of a statistical product and burden on respondents is not available. |
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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. Guidelines for THL's statistics can be found here. Otherwise, Statistics Finland data protection guidelines can be found here. |
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11.2. Confidentiality - data treatment | |||
Since only expenditure data from public databases and reports are used, no additional confidentiality rules are applied. |
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None. |
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