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For any question on data and metadata, please contact: Eurostat user support |
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1.1. Contact organisation | Statistics Poland |
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1.2. Contact organisation unit | Social Surveys Department – Health Statistics Division |
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1.5. Contact mail address | Niepodległości 208 Av. 00-925 Warsaw, Poland |
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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. 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). One of the important factors concerning SHA2011 data collection is the fact that Statistics Poland is using the cash method. |
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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 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. |
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2.8. Coverage - Time | |||
Detailed data according to SHA 2011 is available from 2013-2016 for Poland. Main aggregates are also available for 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: 3 (household budget survey, module survey “Health care in households”, non-profit institutions survey) - Public administrative records: 9 - Financial reports: 1 - Other: 0
Public administrative records
Financial reports
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3.2. Frequency of data collection | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Annual. |
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3.3. Data collection | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Annual records on activity of ministries (Ministry of Health, Ministry of National Defence, Ministry of Justice, Ministry of Social Policy, Ministry of the Interior) and other institutions (National Health Fund, Social Insurance Institution, Agricultural Social Insurance Fund, National Fund for Rehabilitation of Disabled) are submitted annually in a standardized format to Statistics Poland. Rb-28 Annual report on realization of state budget expenditure plan, Rb-28s Annual report on realization of territorial self-government budgetary units’ expenditure plan is obtained from Statistics Poland Macroeconomic Studies and Finance Department. Expert estimations on the basis of the yearly conducted household budget survey and the module survey “Health care in households” carried out every 3 years. Expert estimations on the basis of the non-profit institutions' survey (SOF). Expert estimations on the basis of the number and price of the preventive medical examinations of working persons. (MZ-35A) |
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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:
In addition to the validation features provided by the JHAQ, Statistics Poland carries out several other steps to check and validate its SHA data. Time series for each data source/calculation step are analyzed for trends, growth rates and anomalies. Growth of aggregate data is decomposed in its single elements to detect possible miscalculations. New entries and revisions are double-checked and analyzed in detail. Consistency between dimensions is achieved as every single calculation is coded with all three corresponding dimensions. Results of years that are not re-transmitted/re-published are also calculated even if there is no change and these results are compared with calculations in previous years to secure consistency of the calculation methods over time. |
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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 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Statistics Poland publishes data at the national level according to international SHA 2011 methodology without changes. |
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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. Law on official statistics imposes the obligation to look after quality under the Code of Practice: Art. 25a. The President of Statistics Poland performs tasks specified in the Act, follows the principles of professional independence, impartiality, reliability and responsibility for the high quality of national and international statistics, under the European Statistics Code of Practice referred to in art. 11 of Regulation (EC) No 223/2009 of the European Parliament and of the Council of 11 March 2009 on European statistics and repealing Regulation (EC, Euratom) No 1101/2008 of the European Parliament and of the Council on the transmission of statistical data to the Statistical Office of the European Communities subject to the principle of confidentiality, Council Regulation (EC) No 322/97 on Community Statistics and Council Decision 89/382 / EEC, Euratom establishing a Committee for the Statistical Programs of the European Communities (OJ L 87/3131, 31.03.2009, page 164), "Regulation No. 223/2009". SHA was introduced as a survey for the annual program of statistical surveys approved by Prime Minister's Office and imposes an obligation to provide data (within a given scope and structure) for the purposes of JHAQ. |
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4.2. Quality management - assessment | |||
The best-developed classification is HF.1 public / compulsory expenditure schemes because Health Statistics Division uses detailed reports of financing agents based on reports on implementing material and financial plans, reports on implementing the state budget (RB-28), reports on implementing the budget of local government units (RB-28s). Health Statistics Division works closely with the largest financing agent (National Health Fund) to maximize the precision of classifying individual expenditure. The greatest difficulty is estimating by private health expenditure, including cost sharing. |
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5.1. Relevance - User Needs | |||
The main recipients of data from NRZ are financing agents, i.e. ministries, Social Insurance Institution, Agricultural Social Insurance Fund, etc. Data recipients are also media, institutions conducting scientific, educational and analytical activities and students. Some disadvantage for data users is a two-year delay in the publication of data, which makes data become potentially less attractive for users who want the latest data. Another problem could be a complex methodology (e.g. ICHA-HF) that requires a lot of time to understand its nuances. |
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5.2. Relevance - User Satisfaction | |||
Account's results included in Statistics Poland publications, always including a wide methodological and analytical commentary. Due to the complexity of the invoice and various purposes of using its results by users of data, Health Statistics Division are open to direct consultations, which happens several times a year.
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5.3. Completeness | |||
HF.4 is unavailable due to the lack of data sources. |
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5.3.1. Data completeness - rate | |||
Almost 100% of mandatory variables of the three dimensions according to Commission Regulation 359/2015 that are relevant/occurring in the Polish health system (for exceptions see 5.3). |
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6.1. Accuracy - overall | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||
The overall accuracy of Polish SHA data can be considered to be quite good. In many cases we avoid double counting, e.g. data provided by Ministry of Family, Work and Social Protection coincides with RB-28 report, non-profit expenditure coincides with NFZ expenditure, etc. Health Statistics Division compares the expenditure of ministries and other institutions with the reports on the use of the state budget. |
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6.2. Sampling error | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Not applicable. |
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6.2.1. Sampling error - indicators | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||
There is a sampling error in Household budget surveys used as a basis for the calculation of OOP expenditure. However, the HBS data undergoes further calculation for the NHA purpose. In the table below: selected
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6.3. Non-sampling error | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Household budget surveys, or homeless people, for example, as part of the Population Census 2011. These people are covered by general health insurance, just like the rest of society, however, some differences in the use of health care services cannot be excluded in relation to private household members.
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6.3.1. Coverage error | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Household budget surveys, serving as the main source of data for estimation of OOP expenditure do not include people in collective accommodation establishments (about 1% according to Population Census 2011), neither homeless. These people have common health insurance, just like the rest of society, however, differences in the use of health care services cannot be ruled out.
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6.3.1.1. Over-coverage - rate | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||
All cases of double counting of expenditure are eliminated. An example can be non-profit expenditure and NFZ expenditure, which partly overlap. Other examples are local governments and subsidies on particular levels of local governments are also excluded. We take into account only the final financing agents. |
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6.3.1.2. Common units - proportion | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Not applicable. |
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6.3.2. Measurement error | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Health Statistics Division is not aware of any measurement errors. |
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6.3.3. Non response error | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||
In HBS, 2017 response rate amounted to 37,7%. |
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6.3.3.1. Unit non-response - rate | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||
In HBS, 2017 response rate amounted to 37,7%. |
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6.3.3.2. Item non-response - rate | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Not applicable. |
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6.3.4. Processing error | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||
No such errors. |
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6.3.4.1. Imputation - rate | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||
No such errors. |
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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 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Generally, when calculating national health account for each subsequent year, the categories of expenditure are compared with previous periods and checked for their accuracy and coherence due to current knowledge. In justified cases and, as far as possible, data for previous years are revised in order to achieve comparability of data over time. |
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6.6. Data revision - practice | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Generally, when calculating national health accounts for each subsequent year, the categories of expenditure are compared with previous periods and checked for their accuracy and coherence due to current knowledge. In justified cases and, as far as possible, data for previous years are revised in order to achieve comparability of data over time. |
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6.6.1. Data revision - average size | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Difficult to calculate. |
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7.1. Timeliness | |||
There were no deviations from deadlines in the reference period. |
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7.1.1. Time lag - first result | |||
Thirteen months. |
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7.1.2. Time lag - final result | |||
Statistics Poland transmits SHA2011 data for t-2 and estimations t-1 annually via EDAMIS by end of April year t. The national publication takes place at the end of June for t-2. |
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7.2. Punctuality | |||
There were no deviations from deadlines in the reference period. |
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7.2.1. Punctuality - delivery and publication | |||
Not applicable. |
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8.1. Comparability - geographical | ||||||||||||||||||||||||
Polish National Health Account is developed from the side of agents, which expenditure covers the whole area of Poland. There are no regional accounts because of the lack of regional data. https://stats.oecd.org/ (OECD) http://apps.who.int/nha/database/Select/Indicators/en (WHO) https://ec.europa.eu/eurostat/data/database (Eurostat) |
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8.1.1. Asymmetry for mirror flow statistics - coefficient | ||||||||||||||||||||||||
Not applicable. |
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8.2. Comparability - over time | ||||||||||||||||||||||||
Data according to SHA 1 is available from 2004 to 2012 and is comparable in such timeframe. Data according to SHA2011 is available and comparable in the 2013-2017 timeframe. Breaks in time series resulting from methodological changes (SHA1.0 to SHA2011 transition)
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8.2.1. Length of comparable time series | ||||||||||||||||||||||||
Definitive break in the series was caused by the implementation of SHA 2011 revision. |
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8.3. Coherence - cross domain | ||||||||||||||||||||||||
SHA and ESSPROS cannot be mapped from one to another, however, some SHA data referring to LTC is used for ESSPROS calculation. |
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8.4. Coherence - sub annual and annual statistics | ||||||||||||||||||||||||
Not applicable. |
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8.5. Coherence - National Accounts | ||||||||||||||||||||||||
NHA is calculated from the side of financing agents, no detailed analyses have been conducted so far concerning coherence with National Accounts.
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8.6. Coherence - internal | ||||||||||||||||||||||||
SHA2011 working tables in addition to the ICHA-HC, ICHA-HP, and ICHA-HF also include financing agents (ICHA-FA operating often in various financing schemes). Financing agent data is added up for each classification (the sums must, of course, be equal) and the individual values and totals are compared with previous years. The HCxHF, HCxHP and HPxHF tables are summed up taking into account classifications at the level of one digit but also at the level of two digits. These sums must also be equal between the individual tables.
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9.1. Dissemination format - News release | |||
Statistics Poland publishes the President's announcement regarding the most important NHA aggregates: |
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9.2. Dissemination format - Publications | |||
Health and health care in 2017: https://stat.gov.pl/obszary-tematyczne/zdrowie/zdrowie/zdrowie-i-ochrona-zdrowia-w-2017-r-,1,8.html |
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9.3. Dissemination format - online database | |||
No online database at the national level. |
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9.3.1. Data tables - consultations | |||
Restricted from publication. |
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9.4. Dissemination format - microdata access | |||
Microdata is not disseminated. |
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9.5. Dissemination format - other | |||
Not applicable. |
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9.6. Documentation on methodology | |||
The methodology is described, quite generally, in an information note: More detail in the publication Health and health care in 2017: https://stat.gov.pl/obszary-tematyczne/zdrowie/zdrowie/zdrowie-i-ochrona-zdrowia-w-2017-r-,1,8.html |
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9.7. Quality management - documentation | |||
Not available. |
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9.7.1. Metadata completeness - rate | |||
Not available. |
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9.7.2. Metadata - consultations | |||
Not available. |
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The cost incurred by Statistics Poland associated with the development of NHA is estimated annually, based on labor consumption, as part of work at the Program Of Public Statistic Surveys (PBSSP). It does not include costs incurred by our respondents - data providers.
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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 | |||
Data on individual financing agents are not distributed.
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No further comments. |
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