Reference metadata describe statistical concepts and methodologies used for the collection and generation of data. They provide information on data quality and, since they are strongly content-oriented, assist users in interpreting the data. Reference metadata, unlike structural metadata, can be decoupled from the data.
Demography, Health, Culture and Justitice Statistics Office - Department of Studies, Demographic Projections and Population Census
1.3. Contact name
Confidential because of GDPR
1.4. Contact person function
Confidential because of GDPR
1.5. Contact mail address
National Institute of Statistics (INS), 16 Libertatii avenue, district 5, 050706, Bucharest, Romania
1.6. Contact email address
Confidential because of GDPR
1.7. Contact phone number
Confidential because of GDPR
1.8. Contact fax number
Confidential because of GDPR
2.1. Metadata last certified
4 June 2024
2.2. Metadata last posted
4 June 2024
2.3. Metadata last update
4 June 2024
3.1. 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).
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.
3.3. 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
3.4. 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.
The classifications and definitions presented in the SHA 2011 manual are to be followed. Additional guidelines and material useful for compilers are also available at this address.
3.5. Statistical unit
Commission Regulation (EU) 2021/1901, and Commission Regulation (EU) 2015/359 previously in force, concern 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 (EU) 2021/1901 and (prior Commission Regulation (EU) 2015/359) limits its scope to the collection of data on the expenditure of health care financing schemes.
3.6. 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).
3.7. 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.
3.8. Coverage - Time
Data is available, under the SHA 2011 methodology, for the period 2011-2022.
3.9. Base period
Not applicable.
Current expenditure data are presented according to following units:
expenditure amount in millions of euro
expenditure amount in millions of national currency
expenditure amount in millions of PPS
percentage of GDP
amount in euro per capita
amount in national currency per capita
amount in PPS per capita
percentage of current health expenditure (CHE)
Health care expenditure data are annual data, corresponding to the calendar year.
This quality report covers the following reference years: 2018-2022.
6.1. Institutional Mandate - legal acts and other agreements
Countries submit data to Eurostat on the basis of Commission Regulations (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, until the reference year 2020
2021/1901 of 29 October 2021 implementing Regulation (EC) No 1338/2008 of the European Parliament and of the Council as regards statistics on health care expenditure and financing, for which the first reference year will be in 2021.
The implementing Regulations specify the areas and the level of aggregation to be submitted by EU Member States and EEA countries (see Annex II of the Regulation).
6.2. Institutional Mandate - data sharing
Data collection takes place in agreement with the World Health Organization (WHO) and the Organization of Economic Co-operation and Development (OECD).
The Health Expenditure Accounts uses aggregated and public available data (healthcare units and survey data) and no personal information is used thus no confidentiality procedures are applied.
8.1. Release calendar
At national level, begining with 2024, SHA data will be disseminated through a press release and a publication at the end of august (most recent data for reference year 2022). Also SHA data will be available on the INS online database, TEMPO, at the end of september.
In line with the Community legal framework and the European Statistics Code of Practice Eurostat disseminates European statistics on Eurostat's website (see item 10 - 'Accessibility and clarity') respecting professional independence and in an objective, professional and transparent manner in which all users are treated equitably. The detailed arrangements are governed by the Eurostat protocol on impartial access to Eurostat data for users.
Annual
10.1. Dissemination format - News release
August 30th - first time news release for reference year 2022
end of December - first time release in 2024 will be available on the INS online database TEMPO online (A.9 HEALTH)
10.4. Dissemination format - microdata access
Not applicable.
10.5. Dissemination format - other
SHA indicators are released for data requests from policy makers, institutions and organisations, researchers and private users.
10.6. Documentation on methodology
Methodological description of the compilation of SHA data is included in the annual publication "The System of Health Accounts in Romania" - INSEE sistemul conturilor (romanian) INSEE Sistemul conturilor.
10.7. Quality management - documentation
Specifications on data sources, data management are available in the publication "The System of Health Accounts in Romania"and in the metadata available on Eurostat database.
11.1. Quality assurance
Authorities responsible for SHA data collection work 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.
11.2. Quality management - assessment
INS Romania compiles the data starting from healthcare unit or ministry level which are validated either by INS (in the case of surveys) or by institutions providing administrative data. Using non-expenditure data or average costs can lead to over-estimation or under-estimation of some indicators where data are missing, but the base data used has a degree of reliability that we are expecting a good quality of the data resulted. As there is still no unified health care data at national level, INS is making efforts to identify new high quality data sources and introduce SHA methodology in the national statistics in order to provide quality data.
12.1. Relevance - User Needs
The main users of health care expenditure data are policy makers, research institutes, media, and students.
12.2. Relevance - User Satisfaction
Currently there is no specific user satisfaction accounting, but NIS is providing methodological suport and specifications to all users that are requesting the data.
12.3. Completeness
Below are the information regarding the completeness of Romania SHA data.
ICHA Code
Description
Deviations from SHA definitions or missing data
Explanations
HF.1.2.2
Compulsory private insurance schemes
Category does not exist
HF.1.3
Compulsory Medical Savings Accounts (CMSA)
Category does not exist
HF.2.1
Voluntary health insurance schemes
…
Administration costs for health private insurance could not be identified.
HF.2.2
NPISH financing schemes
…
Data are underestimated, included are expenditure of the main non-profit organisations for which public financial and non-financial reports were available giving the posibility of identiffying health care related data. Data for non-profit hospitals included in the scheme are collected through the NIS annual exhaustive survey on the activity of sanitary units. Data included represent expenditure from donations, patients, and other revenues. Although the hospitals are also financed through the health insurance fund, these expenditures were not included in the NPISH scheme.
HF.2.3
Enterprise financing schemes
…
Expenditures of medical offices established by corporations for their employees (in the energy, industry sectors) included in the survey Activity of Sanitary Units.
HF.3.2
Cost-sharing with third-party payers
Partially missing (data is partially not available)
Cost-sharing with private insurance included in HF.3.1
HF.4
Rest of the world financing schemes (non-resident)
Missing (data not available)
No medical services identified that are financed directly by a non-resident
HC.1.2
Day curative care
Missing (category reported elsewhere)
HF.1.1 and HF.3 category included in HC.1.1
HC.1.3.2
Dental outpatient curative care
…
HF.1.1; Expenditures of school dental offices, financed by the Ministry of Health, are included in HC.1.3.1.
HC.1.3.3
Specialised outpatient curative care
…
HF.3-includes orthodontic specialists services; HF.1.2-includes a small share of general medical outpatient services provided in hospitals
HC.1.3.9
All other outpatient curative care
…
Included in HC.2.3
HC.1.4
Home-based curative care
…
For missing: included in HC.1.1 or HC.1.3; For "0" Category doesn't exist
HC.2.1
Inpatient rehabilitative care
Missing (category reported elsewhere)
HF.3 category included in HC.1.1
HC.2.2
Day rehabilitative care
Missing (category reported elsewhere)
For missing, category is included in HC.1.1 or HC.2.1
HC.2.3
Outpatient rehabilitative care
…
HF.3; in 2016 include renting of medical equipment and household expenditure for transport of medical personnel (other than ambulance services offerd by hospitals); begining with 2016 a new category of health care services (phisiotherapy, speech therapy, chiropractics, optometry, acupuncture) was introduced following a change in the COICOP-HBS classification
HC.2.4
Home-based rehabilitative care
…
For missing: included in HC.2.1 or HC.2.3; For "0" Category doesn't exist
HC.3.2
Day long-term care (health)
Missing (category reported elsewhere)
Included in HC.1 for HF.1.2; Included in HC.3.1 for HP.1 for HF.2.1 and HF.3
HC.3.3
Outpatient long-term care (health)
Missing (category reported elsewhere)
Included in HC.3.1 for HP.1, for HF.2.1 and HF.3
HC.3.4
Home-based long-term care (health)
Missing (category reported elsewhere)
Included in HC.3.1 for HP.1, included in HP.3.1/HP.3.2/HP.3.4 for HP.2; for HF.2.1 and HF.3
HC.4
Ancillary services (non-specified by function)
…
HC.4 in HP.3 is included in HP.4
HC.4.1
Laboratory services
Missing (category reported elsewhere)
for HF.1.1
HC.4.2
Imaging services
Missing (category reported elsewhere)
HF.3; included in HC.4.1
HC.5.2
Therapeutic appliances and other medical durable goods
Missing (category reported elsewhere)
included in HC.1, HC.2 or HC.3 for HF.1.1, HF.2.3
HC.6
Preventive care
Category does not exist
for HF.2.1.
HC.6.6
Preparing for disaster and emergency response programmes
Missing (data not available)
Data on this services is agreggated together with other emergency response programmes other than the ones with a health objective and so far couldn't be identified and separated.
HC.7
Governance and health system and financing administration
…
Not applicable: HF.2, HF.3, HF.4
HP.3.3
Other health care practitioners
…
HF.3; begining with 2016 a new category of health care services (phisiotherapy, speech therapy, chiropractics, optometry, acupuncture) was introduced following a change in the COICOP-HBS classification
HP.3.4
Ambulatory health care centres
…
HF.3; in 2016 include renting of medical equipment and household expenditure for transport of medical personnel (other than ambulance services offerd by hospitals)
HP.5.1
Pharmacies
Missing (category reported elsewhere)
Medicines covered by the social health insurance curative programs providedprovided to outpatients in the curative national programs through independent pharmacies (other than hospital pharmacies) are included in HP.1.1/HC.5.1.1
HP.7
Providers of health care system administration and financing
…
Not applicable for HF.3
HP.7.3
Private health insurance administration agencies
Missing (data not available)
HP.7.9
Other administration agencies
Category does not exist
HP.9
Rest of the world
Missing (category reported elsewhere)
For HF.1.1 - included in HP.1, HP.2, HP.3
13.1. Accuracy - overall
The sources to compile the data on health care expenditure are mainly administrative and register-based data, only a small percentage of the figures come from surveys or other means. Accordingly, for the health care expenditure data collection, accuracy deals with problems of coverage as the main possible source of errors.
13.2. Sampling error
Not applicable.
13.3. Non-sampling error
Non-resident expenditure are excluded. SHA data does not cover informal payments.
14.1. Timeliness
Member States were required to transmit their data to Eurostat in compliance with the Commission Regulation (EU) 2015/359 transmission deadlines, until reference year 2020. As of reference year 2021, data are transmitted pursuant to Commission Regulation (EU) 2021/1901. Data and reference metadata for the reference year T should be transmitted to Eurostat by 30 April T+2.
14.2. Punctuality
The National Institute of Romania complied with the Commission Regulation 359/2015 and Commission Regulation 1901/2022 transmission deadlines.
Beginning with 2020, new categories were introduced in the national Household Budget Survey COICOP-HBS classification
15.3. Coherence - cross domain
ESSPROS - Although SHA and ESSPROS data intersect in respect to the data sources used (allowances for persons accompanying the severe visual impairment, general government and social health insurance scheme, expenditure in the elderly persons residential homes and residential units for persons with disabilities), the compilation of the two are different. The health related services provided in the social care sector (combined health and social care) are difficult to estimate but INS is working with the Ministry of Labor in order to identify residential units that employ health personel and provide health care in order to improve the SHA estimates.
National Accounts - The SHA and National Accounts data are mostly comparable regarding COFOG total expenditure, differences appear in the COFOG structures as SHA is compiled (for HF.1.1 and HF.1.2) in a bottom-up approach. This leads to some differences in the distribution in COFOG categories. SHA data and SNA data are still under analysis in order to identify the inconsistencies between the two datasets. Other differences comes from the broader scope of the SHA leading to the inclusion of health related expenditure in social residential institutions, of occupational healthcare expenditure.
15.4. Coherence - internal
The aproach for compiling SHA data is from the bottom-up thus ensuring a better control of the disaggregation by schemes, providers and services. For example, the public healthcare networks (local administration network, ministries with own healthcare network, Ministry of health network) are analysed separately regarding the 3 dimensions of SHA. In order to insure a better coherence in the coding process, the type of financing schemes for each network, the types of providers it has and types of services they provide are coded based on a broad categorisation at national level. For example, these procedures follow the coding of public and private hospitals by type of hospital (HP1) based on common criteria or of healthcare services (e.g. covered by social and private insurance) coded by type of HC.
Health Expenditure Accounts are compiled by 2 experts. Health data systems, especially financial data, are compiled by different owners and are not correlated thus the work of compiling and identifying useful data (especially local administration data) is time consuming and depends on the availability of data providers and the quality of their database. Although steps have been made in the health system to improve transparency, health data at type of service and type of providers are difficult to identify, especially for the private sector and those outside the health insurance system.
17.1. Data revision - policy
According to NIS revision policy, revisions for previously transmitted data are sent together with data for the reporting year. Revisions are performed if new data sources are identified, previous aggregated data can be separated by categories that more closely follow the definitions, recoding of items or revisions are performed in the source data.
17.2. Data revision - practice
According to NIS revision policy, revisions for previously transmitted data are sent together with data for the reporting year. Last significant data revision was performed in 2020, for 2015-2017 data, and was related to a misscategorisation of OOP expenditures for long-term care.
18.1. Source data
Source name
Brief description of source (e.g. coverage, reference year, etc)
Type of data 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 (e.g monthly, quarterly, annual, irregular)
Processing (e.g. brief description of any adjustments, correction or distribution applied to the original data sources)
Minstry of Finace
- Budgetary executions accounts (from the state budget or from own revenues) of the ministries with own health network: Ministry of Health, Ministry of Defence, Minstry of Internal Affairs, the Romanian Academy and other special health care networks;
Financial reports
2018-2022
12 months
annual
- the current expenditures from the ministries budget reports are allocated to SHA items and distributed either to a single HC or a single HP, or to several HC or HP according with the sanitary units under their administration and with the health activities that each ministry finance. '- MoF is collecting financial budget execution data from public institutions through a web portal at COFOG3 level. These data are public and are used for SHA compilation for the health care units subordinated to ministries with own health network and for health care units subordinated to the local administration.
Transfers from the Ministry of Health to sanitary units from their own health care network and from local administration network are consolidated.
Ministry of Health
- public hospitals financial data collected through the online monitoring programme (the reports are based on the budgetary classifications distributed by sources of financing: transfers from the state budget, local budget, contracts with the national social health insurance and other revenues from own sources;
Public administrative records
2018-2022
monthly
monthly
The database is available at unit level thus permiting the distribution of expenditures by type of hospital (general, mental health, specialised). Because there is no national hospital classification by these types of hospitals, NIS attributes codes to every hospital in order to obtain the expenditures by type of hospital.
Ministry of Health
- financial data on the programmes developed through the Annual National Health Program
approved sums for reimbursements, average price or number of services were used to estimate expenditure by type of hospitals
the National Authority for Persons with Disabilities
records regarding expenditures for long-term or day care centres.
Public administrative records
HF.1.1 financing HC.2, HC.3 and HC.R.1 provided by HP.2
2018-2022
12 months
annual
Estimations are made based on the provision of medical services and the presence of medical staff in the centre (based on information collected through the exhaustive survey Activity of Sanitary Units and the expenditure data callected by the Labour Ministry from elderly residential units
the Ministry of Labour, Family, Social Protection and Elderly - activity and financial reports of the nursing homes for the elderly
total expenditure by financing source (government, NGOs and households)
Public administrative records
2018-2022
annual
the statistical buletins of the Labour Ministry include total expenditures for the nursing homes for the elderly under the local administration and NGOs administration and include information on sources of financing, number of beds in the facility and the average monthly number of beneficiares.
Statistics of the Ministry of Labour, Family, Social Protection and Elderly
- allowance for attendants of persons with severe visual disabilities - expenditure for balneary treatment for retired persons founded from the State Social Security Budget
Financial reports
HF.1.2 financing HC.3.4 HF.1.2 financing HC.2.3
2018-2022
12 months
annual
- balneary treatment expenditure include also sums for accomodation and meal which cannot be separated
National Institute of Statistics - National Accounts Department
annual data regarding aggregated budget execution accounts (for the health domain) of the central administration and local administration, the social security funds - from the state budget or from own revenues; Data is received from the Ministry of Finance
Public administrative records
2018-2022
12 months
annual
- the current expenditures from the budget reports are consolidated and allocated to SHA items and distributed either to a single HC or a single HP, or to several HC or HP using estimations on the basis of data from other sources
National Institute of Statistics - "Activity of Sanitary Units"
- Non-financial and financial data collected through the exhaustive survey "the Activity of Sanitary Units".
Surveys/censuses
HF.2.2 financing HP.1.3 and HP.2.1 HF.2.3 financing HP.8.2 HF.1.1 financing HP.2 and HC.3
2018-2022
6 months
annual
Financial and non-financial information is used in order to separate health and social care expenditure (for residential homes for the elderly and residential units for persons with disabilities), expenditures of the medical offices organised by corporations (energy, industry sectors) for their employees - HF23, and to estimate rehabilitation and long-term services in hospitals; data source for HF22 (residential units managed by non-profit organisations)
The Financial Supervisory Authority - Insurance Supervisory Commission
- data collected through a questionnaire developed in colaboration with the National Institute of Statistics on the basis of ICHA function and providers, sent to private insurance companies.
Financial reports
2018-2022
12 months
annual
- the data is collected through the common questionnaire is extended to the total amount reimbursed by the insurance companies directly to the insured or to the health care providers. The Financial Supervisory Authority - Insurance Supervisory Commission included the questionnaire in the regular financial data colected from the private insurance companies.
National Institute of Statistics - Household Budget Survey
- monthly collected data regarding households income, expenditures and consumption
Surveys/censuses
2018-2022
12 months
annual
- annual household health related expenditure is obtain on the basis of average monthly household expenditure by HBS clasification
National School of Public Health, Management and Professional Development (NSPHMPD)
- data regarding the amounts for validated and proposed for reimbursment cases (by type of hospital and type of service:inpatient and day care) sent to the National House of Health Insurance for services provided to foreigners based on the european card, european forms and international accords. The amounts will be reimbursed to Romania by the countries of origin.
2018-2022
18.2. Frequency of data collection
Annual.
18.3. Data collection
Data are collected through the joint health accounts questionnaire (JHAQ) that is submitted 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). Data are submitted to Eurostat based on 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, until reference year 2020. As of reference year 2021 onwards Commission Regulation (EU) 2021/1901 of 29 October 2021 implementing Regulation (EC) No 1338/2008, is in force.
18.4. Data validation
The 2023 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)
18.5. 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.
SHA variable(s)
Main method
Brief description of methodology
HP.1/HF.1.1 - splitting HP.1.1/HP.1.2/HP.1.3
Other
Total hospital current expenditure from the budget reports for every ministry with its own health care network was allocated by type of hospitals (general, mental health, speciality) using financial data from the Ministry of Health hospital financial monitoring programme and from the NIS Annual Exhaustive survey on sanitary units .The monitoring programme collects monthly non-financial and financial data from every public sanitary unit with beds, the financial data refering to the budgetary execution of revenues and expenditures by source of financing (state budget transfers, local administration funds, own funds from the social health insurance contracts or other sources). Hospitals are analised in regard to specialities covered in every hospitals (according to the SHA methodology) and coded for the type of hospital. The NIS survey collects data on type of hospital and services provided.
HC.1.3 - splitting HP.1.1/HP.1.2/HP.1.3
Interpolation/Extrapolation
Estimations on outpatient care in hospitals (by type of hospitals) were made using the number of outpatient consultations in the ambulatory departments that function as part of the organisational structure of hospitals and the value of a consultation used for reimbursement by the social health insuranc. For type of hospitals estimation were made based on NIS annual survey data for this information.
HP.6/HF.1.1 - splitting HP.6.1-HP.6.5
Other
Preventive care is covered in the government annual health programme by immunization, screenning, monitoring or surveillance programmes. Preventive care financed by the Ministry of health was estimated based on the reports collected by the Ministry of Health. The preventive care financed by the health insurance fund was estimated based on the contracted services and on the reimbusements of some preventive services in familiy doctor offices and other ambulatory medical office. Preventive care expenditure by services and providers is provided by the Ministry of Health based on administrative records.
HF.1.2 - splitting HC.1.1/ HC.1.2/HC.3.1 by HP.1.1/HP.1.2/HP.1.3
Other
NIS annual survey collects data regarding the type of hospital. This information is used for every financial data accesible on unit level. The expenditures by type of hospital and by type of service (inpatient curative care, day care and long term care) were estimated using reimbursed sums for DRG, acute care, chronic conditions care, palliative care in hospitals.
HF.1.1 - splitting HC.6/HC.3.3
Interpolation/Extrapolation
Preventive services and outpatient long term services were estimated using the number of services provided and reimbursed for family planning,epidemiological surveillance,healthy condition monitoring, early diseases detection and regular check-ups for persons with chronic diseases in family doctors offices and offices of medical specialists, the number of points (the reference used for reimbursements in primary care and in ambulatory specialist care) allocated for these types of services and the average value of the point (in RON) set quartely by the NHIH.
HF.2.1
Other
Amounts spent for covering health care provided to persons insured through private health insurance were available only in aggregated form, as total reimbursements directly to patients or to the providers of health care. The split by functions and providers was made using data collected from the private insurance companies through a questionnaire which combined types of services and providers according with the main risks covered by the insurance policies. The response rate being again low, an extrapolation was made in order to cover all companies, using the share of services and providers reported in the questionnaire.
HF.3.1
Pro-rating/Utilisation key
Data available from the Household Budget Survey refered to average monthly spending of a household for services and products related to health. SHA items were calculated using the average monthly spending and the estimated total number of households.
HF.3.1/HF.3.2 - HC.5.1.1/HC.5.1.2
Interpolation/Extrapolation
Households expenditure for prescribed medicines (cost-sharing) and for OTC medicines are estimated using the reimbursement sums payed by the social health insurance by percent of coverage (there are 3 lists of medicines covered by the social health insurance by 100%, 90% and 50%). Sums payed by the households for prescribed medicines are extrapolated as being the rest representing 10% and 50% of the total costs for medicines. Expenditures for the OTC medicines represent the difference between the total amount spend by households for medicines and the estimated sum for households cost-sharing for prescribed medicines.
HF.1.1- splitting HC.2.1 and HC.3.1
Pro-rating/Utilisation key
Financial and non-financial data are collected through the NIS exhaustive survey Activity of Sanitary Units. The number of rehabilitation beds and beds for chronically ill patients are used for estimating expenditure for rehabilitation and long term services provided in general hospitals.The average cost per rehabilitation and long term beds are calculated using the number of beds and expenditure in rehabilitation hospitals and hospitals for chronically ill.
HF.1.1/HF.3.1/HF.3.2 - splitting HC.3.1 and HCR.1
Pro-rating/Utilisation key
Financial and non-financial data are collected through the NIS exhaustive survey Activity of Sanitary Units for nursing homes for the elderly which provide medical services and employ health care personel. These data are substracted from the total expenditure for the nursing home for the elderly (by source of financing: central and local budget, own revenues and beneficiares contribution) and included in the health care expenditure, the remaning expenditure is included as LTC.
HF.1.1 - splitting HC.2.1/HC.3 and HCR.1
Pro-rating/Utilisation key
Expenditure for consultations performed by medical personel in the residential centres for disabled persons are collected through the exhaustive survey Activity of Sanitary Units. These expenditure are extracted from the total current expenditure of the residential centres for persons with disabilities (by type of centres) provided by the National Authority for Persons with Disabilities and included in the health care expenditure, the remaning amount being included in the HCR by type of residential unit that provides the services.
Due to lack of data sources for health care expenditures of the local budget, other than for hospitals, data was estimated based on legislation stipulations on the type of services financed by the local administations and on transfers from the state budget to the local budget.
HF.1.2 - splitting HC.1.1//HC1.2/HC.1.3.1/HC1.4/HC.6 to extract ependiture of non-residents
The NSPHMPD collects data from hospitals based on a national legislation and validates the data sent by the hospitals in order for the health providers to obtain the financing.Data collected refers also to non-residents that were treated in Romania for which the national health insurance institution will be reimburesd by the insurer in the country of residence.These expenditures were extracted from the National Health Insurance House.
18.6. Adjustment
At national level, the ICHA is not used for classifying services and providers. INS allocates ICHA codes for the national types of sanitary units. For hospitals, INS collected in the annual "Activity of Sanitary Units" codes for the types of hospitals of ICHA, these information for each hospital in Romania is used for estimating expenditure the data from the Ministry of Health, the National House of Health Insurance and the Ministry of Finance.
Some underestimations are encountered: enterprise financing schemes are underestimated: included are medical offices established by corporations (in the energy, industry sectors) included in the survey Activity of Sanitary Units. Data sources for expenditures of employers for the regular medical check-ups of employees could not be identified; NPISH financing schemes are underestimated, expenditures included represent funds reported by non-profit organisations (fundations and asociations) which conduct health activities in Romania; informal payments are not identified.
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).
4 June 2024
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.
The classifications and definitions presented in the SHA 2011 manual are to be followed. Additional guidelines and material useful for compilers are also available at this address.
Commission Regulation (EU) 2021/1901, and Commission Regulation (EU) 2015/359 previously in force, concern 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 (EU) 2021/1901 and (prior Commission Regulation (EU) 2015/359) limits its scope to the collection of data on the expenditure of health care financing schemes.
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).
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.
Health care expenditure data are annual data, corresponding to the calendar year.
This quality report covers the following reference years: 2018-2022.
The sources to compile the data on health care expenditure are mainly administrative and register-based data, only a small percentage of the figures come from surveys or other means. Accordingly, for the health care expenditure data collection, accuracy deals with problems of coverage as the main possible source of errors.
Current expenditure data are presented according to following units:
expenditure amount in millions of euro
expenditure amount in millions of national currency
expenditure amount in millions of PPS
percentage of GDP
amount in euro per capita
amount in national currency per capita
amount in PPS per capita
percentage of current health expenditure (CHE)
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.
SHA variable(s)
Main method
Brief description of methodology
HP.1/HF.1.1 - splitting HP.1.1/HP.1.2/HP.1.3
Other
Total hospital current expenditure from the budget reports for every ministry with its own health care network was allocated by type of hospitals (general, mental health, speciality) using financial data from the Ministry of Health hospital financial monitoring programme and from the NIS Annual Exhaustive survey on sanitary units .The monitoring programme collects monthly non-financial and financial data from every public sanitary unit with beds, the financial data refering to the budgetary execution of revenues and expenditures by source of financing (state budget transfers, local administration funds, own funds from the social health insurance contracts or other sources). Hospitals are analised in regard to specialities covered in every hospitals (according to the SHA methodology) and coded for the type of hospital. The NIS survey collects data on type of hospital and services provided.
HC.1.3 - splitting HP.1.1/HP.1.2/HP.1.3
Interpolation/Extrapolation
Estimations on outpatient care in hospitals (by type of hospitals) were made using the number of outpatient consultations in the ambulatory departments that function as part of the organisational structure of hospitals and the value of a consultation used for reimbursement by the social health insuranc. For type of hospitals estimation were made based on NIS annual survey data for this information.
HP.6/HF.1.1 - splitting HP.6.1-HP.6.5
Other
Preventive care is covered in the government annual health programme by immunization, screenning, monitoring or surveillance programmes. Preventive care financed by the Ministry of health was estimated based on the reports collected by the Ministry of Health. The preventive care financed by the health insurance fund was estimated based on the contracted services and on the reimbusements of some preventive services in familiy doctor offices and other ambulatory medical office. Preventive care expenditure by services and providers is provided by the Ministry of Health based on administrative records.
HF.1.2 - splitting HC.1.1/ HC.1.2/HC.3.1 by HP.1.1/HP.1.2/HP.1.3
Other
NIS annual survey collects data regarding the type of hospital. This information is used for every financial data accesible on unit level. The expenditures by type of hospital and by type of service (inpatient curative care, day care and long term care) were estimated using reimbursed sums for DRG, acute care, chronic conditions care, palliative care in hospitals.
HF.1.1 - splitting HC.6/HC.3.3
Interpolation/Extrapolation
Preventive services and outpatient long term services were estimated using the number of services provided and reimbursed for family planning,epidemiological surveillance,healthy condition monitoring, early diseases detection and regular check-ups for persons with chronic diseases in family doctors offices and offices of medical specialists, the number of points (the reference used for reimbursements in primary care and in ambulatory specialist care) allocated for these types of services and the average value of the point (in RON) set quartely by the NHIH.
HF.2.1
Other
Amounts spent for covering health care provided to persons insured through private health insurance were available only in aggregated form, as total reimbursements directly to patients or to the providers of health care. The split by functions and providers was made using data collected from the private insurance companies through a questionnaire which combined types of services and providers according with the main risks covered by the insurance policies. The response rate being again low, an extrapolation was made in order to cover all companies, using the share of services and providers reported in the questionnaire.
HF.3.1
Pro-rating/Utilisation key
Data available from the Household Budget Survey refered to average monthly spending of a household for services and products related to health. SHA items were calculated using the average monthly spending and the estimated total number of households.
HF.3.1/HF.3.2 - HC.5.1.1/HC.5.1.2
Interpolation/Extrapolation
Households expenditure for prescribed medicines (cost-sharing) and for OTC medicines are estimated using the reimbursement sums payed by the social health insurance by percent of coverage (there are 3 lists of medicines covered by the social health insurance by 100%, 90% and 50%). Sums payed by the households for prescribed medicines are extrapolated as being the rest representing 10% and 50% of the total costs for medicines. Expenditures for the OTC medicines represent the difference between the total amount spend by households for medicines and the estimated sum for households cost-sharing for prescribed medicines.
HF.1.1- splitting HC.2.1 and HC.3.1
Pro-rating/Utilisation key
Financial and non-financial data are collected through the NIS exhaustive survey Activity of Sanitary Units. The number of rehabilitation beds and beds for chronically ill patients are used for estimating expenditure for rehabilitation and long term services provided in general hospitals.The average cost per rehabilitation and long term beds are calculated using the number of beds and expenditure in rehabilitation hospitals and hospitals for chronically ill.
HF.1.1/HF.3.1/HF.3.2 - splitting HC.3.1 and HCR.1
Pro-rating/Utilisation key
Financial and non-financial data are collected through the NIS exhaustive survey Activity of Sanitary Units for nursing homes for the elderly which provide medical services and employ health care personel. These data are substracted from the total expenditure for the nursing home for the elderly (by source of financing: central and local budget, own revenues and beneficiares contribution) and included in the health care expenditure, the remaning expenditure is included as LTC.
HF.1.1 - splitting HC.2.1/HC.3 and HCR.1
Pro-rating/Utilisation key
Expenditure for consultations performed by medical personel in the residential centres for disabled persons are collected through the exhaustive survey Activity of Sanitary Units. These expenditure are extracted from the total current expenditure of the residential centres for persons with disabilities (by type of centres) provided by the National Authority for Persons with Disabilities and included in the health care expenditure, the remaning amount being included in the HCR by type of residential unit that provides the services.
Due to lack of data sources for health care expenditures of the local budget, other than for hospitals, data was estimated based on legislation stipulations on the type of services financed by the local administations and on transfers from the state budget to the local budget.
HF.1.2 - splitting HC.1.1//HC1.2/HC.1.3.1/HC1.4/HC.6 to extract ependiture of non-residents
The NSPHMPD collects data from hospitals based on a national legislation and validates the data sent by the hospitals in order for the health providers to obtain the financing.Data collected refers also to non-residents that were treated in Romania for which the national health insurance institution will be reimburesd by the insurer in the country of residence.These expenditures were extracted from the National Health Insurance House.
Source name
Brief description of source (e.g. coverage, reference year, etc)
Type of data 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 (e.g monthly, quarterly, annual, irregular)
Processing (e.g. brief description of any adjustments, correction or distribution applied to the original data sources)
Minstry of Finace
- Budgetary executions accounts (from the state budget or from own revenues) of the ministries with own health network: Ministry of Health, Ministry of Defence, Minstry of Internal Affairs, the Romanian Academy and other special health care networks;
Financial reports
2018-2022
12 months
annual
- the current expenditures from the ministries budget reports are allocated to SHA items and distributed either to a single HC or a single HP, or to several HC or HP according with the sanitary units under their administration and with the health activities that each ministry finance. '- MoF is collecting financial budget execution data from public institutions through a web portal at COFOG3 level. These data are public and are used for SHA compilation for the health care units subordinated to ministries with own health network and for health care units subordinated to the local administration.
Transfers from the Ministry of Health to sanitary units from their own health care network and from local administration network are consolidated.
Ministry of Health
- public hospitals financial data collected through the online monitoring programme (the reports are based on the budgetary classifications distributed by sources of financing: transfers from the state budget, local budget, contracts with the national social health insurance and other revenues from own sources;
Public administrative records
2018-2022
monthly
monthly
The database is available at unit level thus permiting the distribution of expenditures by type of hospital (general, mental health, specialised). Because there is no national hospital classification by these types of hospitals, NIS attributes codes to every hospital in order to obtain the expenditures by type of hospital.
Ministry of Health
- financial data on the programmes developed through the Annual National Health Program
approved sums for reimbursements, average price or number of services were used to estimate expenditure by type of hospitals
the National Authority for Persons with Disabilities
records regarding expenditures for long-term or day care centres.
Public administrative records
HF.1.1 financing HC.2, HC.3 and HC.R.1 provided by HP.2
2018-2022
12 months
annual
Estimations are made based on the provision of medical services and the presence of medical staff in the centre (based on information collected through the exhaustive survey Activity of Sanitary Units and the expenditure data callected by the Labour Ministry from elderly residential units
the Ministry of Labour, Family, Social Protection and Elderly - activity and financial reports of the nursing homes for the elderly
total expenditure by financing source (government, NGOs and households)
Public administrative records
2018-2022
annual
the statistical buletins of the Labour Ministry include total expenditures for the nursing homes for the elderly under the local administration and NGOs administration and include information on sources of financing, number of beds in the facility and the average monthly number of beneficiares.
Statistics of the Ministry of Labour, Family, Social Protection and Elderly
- allowance for attendants of persons with severe visual disabilities - expenditure for balneary treatment for retired persons founded from the State Social Security Budget
Financial reports
HF.1.2 financing HC.3.4 HF.1.2 financing HC.2.3
2018-2022
12 months
annual
- balneary treatment expenditure include also sums for accomodation and meal which cannot be separated
National Institute of Statistics - National Accounts Department
annual data regarding aggregated budget execution accounts (for the health domain) of the central administration and local administration, the social security funds - from the state budget or from own revenues; Data is received from the Ministry of Finance
Public administrative records
2018-2022
12 months
annual
- the current expenditures from the budget reports are consolidated and allocated to SHA items and distributed either to a single HC or a single HP, or to several HC or HP using estimations on the basis of data from other sources
National Institute of Statistics - "Activity of Sanitary Units"
- Non-financial and financial data collected through the exhaustive survey "the Activity of Sanitary Units".
Surveys/censuses
HF.2.2 financing HP.1.3 and HP.2.1 HF.2.3 financing HP.8.2 HF.1.1 financing HP.2 and HC.3
2018-2022
6 months
annual
Financial and non-financial information is used in order to separate health and social care expenditure (for residential homes for the elderly and residential units for persons with disabilities), expenditures of the medical offices organised by corporations (energy, industry sectors) for their employees - HF23, and to estimate rehabilitation and long-term services in hospitals; data source for HF22 (residential units managed by non-profit organisations)
The Financial Supervisory Authority - Insurance Supervisory Commission
- data collected through a questionnaire developed in colaboration with the National Institute of Statistics on the basis of ICHA function and providers, sent to private insurance companies.
Financial reports
2018-2022
12 months
annual
- the data is collected through the common questionnaire is extended to the total amount reimbursed by the insurance companies directly to the insured or to the health care providers. The Financial Supervisory Authority - Insurance Supervisory Commission included the questionnaire in the regular financial data colected from the private insurance companies.
National Institute of Statistics - Household Budget Survey
- monthly collected data regarding households income, expenditures and consumption
Surveys/censuses
2018-2022
12 months
annual
- annual household health related expenditure is obtain on the basis of average monthly household expenditure by HBS clasification
National School of Public Health, Management and Professional Development (NSPHMPD)
- data regarding the amounts for validated and proposed for reimbursment cases (by type of hospital and type of service:inpatient and day care) sent to the National House of Health Insurance for services provided to foreigners based on the european card, european forms and international accords. The amounts will be reimbursed to Romania by the countries of origin.
2018-2022
Annual
Member States were required to transmit their data to Eurostat in compliance with the Commission Regulation (EU) 2015/359 transmission deadlines, until reference year 2020. As of reference year 2021, data are transmitted pursuant to Commission Regulation (EU) 2021/1901. Data and reference metadata for the reference year T should be transmitted to Eurostat by 30 April T+2.
