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For any question on data and metadata, please contact: Eurostat user support |
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1.1. Contact organisation | Statistik Austria |
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1.2. Contact organisation unit | Directorate Macro-Economic Statistics / Department Sector Accounts and Public Finances |
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1.5. Contact mail address | Guglgasse 13, A-1110 Wien |
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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. Accounting period: Health expenditure and financing data pertain to the calendar year (1 January to 31 December). The time coverage of this Quality report is 2004 to 2017 reference years. Statistics Austria is compiling SHA data on behalf of and on the basis of a contract with the Federal Ministry for Labour, Social Affairs, Health and Consumer Protection. Data is published on Statistics Austria’s website. A detailed methodological documentation is also published at Statistics Austria’s website (German only), a English excerpt of this documentation is published here. In addition to the core functions of SHA, Statistics Austria also calculates figures for public and private expenditure on gross fixed capital formation (HK). Additionally, Statistics Austria also compiles SHA figures on public spending for State Health Funds financed hospitals (SHF hospitals, part of HP.1) for all nine Federal States of Austria and also provides an additional table where all three SHA-dimensions (HC, HP, HF) are represented in one table. For reference year 2014, health care expenditure according to SHA 2011 by Age and Gender was also compiled.
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2.2. Classification system | |||
Healthcare expenditure is recorded in relation to the international classification for health accounts (ICHA) defining:
In addition to the mandatory classification of the Commission Regulation 2015/359, Statistik Austria calculates and partly publishes certain items of HC/HP/HF at a lower aggregation level. This is true especially for HC.1.3, HC.5.1, HC.5.2, HC.7, HP.1, HP.3, HP.4, HP.5, HP.7, HP.8, HF.1.2 and HF.3. Additionally, for the calculation on expenditure for State Health Funds financed hospitals (SHF hospitals) we also use an additional classification not included in the SHA-manual on HF.1.1.2, where we further differentiate between state/regional government schemes (HF.1.1.2.1) and local government schemes (HF.1.1.2.2). Gross capital formation is compiled by Statistik Austria as a whole but is not differentiated according to the classification of gross fixed capital formation in health systems by type of asset (chapter 11 of SHA manual). |
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2.3. Coverage - sector | |||
1. Household individual consumption, consumption of NPISH and government consumption (both for individual and collective consumption) on health with two exceptions: Additionally, Statistik Austria includes (parts of ) other NACE-groups (NACE rev.2) if they are within the scope of SHA:
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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 | |||
Detailed data according to SHA 2011 is available from 2004-2016 for Austria. 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: 4 - Public administrative records: 9 - Financial reports: 3 - Other: 9
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. Annual accounts of central, provincial and local governments as well as financial reports of public corporations and government funds (especially State Health Funds) are submitted annually to Statistik Austria (mainly for the purpose of National Accounts and GFS/EDP compilations). Data for core units of government is submitted standardised and electronically in detail, data for some public corporations and government funds is transmitted via a web-based tool. Data for social insurance funds is transmitted in a non-standardised form and is processed and coded (also SHA-coded) by Statistik Austria. Results from National Accounts as well as from several social statistics are obtained from our colleagues in Statistik Austria. Reports of the regional governments on social activity are published on their websites and taken from there. Additional data/reports/information from some ministries, the Main association of Austrian social insurances, regional/local government, the Austrian Insurance Association and the Austrian economic chambers are submitted by them after request. |
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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, Statistik Austria carries out several other steps to check and validate its SHA data. Time series for each data source / calculation step are analysed 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 analysed in detail. Consistency between dimensions is achieved as each 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 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Not applicable. |
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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. Quality criteria for Statistik Austria are also set out in the “Bundesstatistikgesetz 2000” (§14 and §24), and in the quality guidelines of Statistik Austria. Additional measures undertaken to guarantee high quality of SHA data compilation are Internal Audits carried out by Statistik Austria, annual presentation and discussion of results and methods with main user of SHA data and regular feedback dialogues with quality management of Statistik Austria, colleagues from Statistik Austria, SHA data users and experts on methodological and quality aspects. |
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4.2. Quality management - assessment | |||
The quality of SHA figures from Statistik Austria can be considered to be quite high. Areas where data is not fully in line with SHA guidelines or are partially missing are outlined under 5.3 and 6.3.1. |
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5.1. Relevance - User Needs | |||
Main users of SHA data in Austria are Federal Ministries (especially Ministry for Labour, Social Affairs, Health and Consumer Protection), regional and local governments and the social insurance funds as well as the Court of Audit for policy making and policy evaluation purposes. SHA data is e.g. the basis for the monitoring of the effects of the most recent health reform in Austria (especially for public expenditure). Social partners also use the data for informing their opinion on policy issues. Research institutions like WIFO, IHS, Gesundheit Österreich etc. use SHA data for research projects and studies. Media, education institutions like universities, other research institutions, students and the general public also are requesting SHA data on an ad-hoc basis depending on the question they are dealing with. Key indicators that are often requested are health expenditure in general, public and private expenditure, expenditure on long-term care, expenditure on a wide range of functions of health care, expenditure on hospitals etc. We observed unmet user needs (due to insufficient data on these topics) especially in questions on health expenditure on specific diseases, total pharmaceuticals expenditure (HC.RI.1) and regional break-downs of health expenditure. The latter is done only for State Health Funds financed hospitals but not for other parts of the health care sector. |
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5.2. Relevance - User Satisfaction | |||
User satisfaction is discussed annually when presenting and discussing main results and methods of SHA with main users in a designated meeting. Also, there are regular feedback dialogues with quality management of Statistik Austria, colleagues from Statisitk Austria, SHA data users and experts on methodological and quality aspects. Feedback from main users is incorporated in the compilation of SHA figures if feasible and possible. |
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5.3. Completeness | |||
Overall, SHA data for Austria can be considered almost complete. One slight deviation from SHA-definition occurs in HF.3, were Household out-of-pocket payment is in large parts calculated according to the domestic concept (including exports, excluding imports health goods and services) and not for all residents, irrespective of the location of transaction. As a consequence, data for HP.9 (Rest of the world) is partially missing as it is not yet possible to identify all Out-of-Pocket Payments of Household for several medical services abroad. Other items were data is partially missing are HP.7.1 (Government health administration agencies) where it is not possible to identify all health-related administration costs of ministries apart from the former Ministry of Health (now included in the Federal Ministry for Labour, Social Affairs, Health and Consumer Protection) and of regional government administration, for OOP-expenditure for HC.4.3 (transportation in conventional vehicles (e.g. taxi)), for medicines purchased via internet and illegally purchased medicines in HC.5.1 and for occupational health care expenditure for the entire public administration as well as for hospitals, medical practices and residential long-term care facilities in. However, these topics all can be considered relatively minor in terms of the volume of expenditure. Within the categories of the three SHA-dimensions, there are also some minor topics where a clear distinction between SHA categories is not always possible:
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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 Austrian health system (for exceptions see 5.3). |
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6.1. Accuracy - overall | |||
Overall accuracy of Austrian SHA data can be considered to be quite good. Known under-coverages are explained in detail under 5.3 and 6.3.1. |
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6.2. Sampling error | |||
Not applicable as we do not use any surveys directly for the compilation of SHA data. However, some of our data sources (e.g. from National Accounts) are based on results of surveys (e.g. consumer survey). |
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6.2.1. Sampling error - indicators | |||
Not applicable. |
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6.3. Non-sampling error | |||
Not applicable as we do not use any surveys directly for the compilation of SHA data. However, some of our data sources (e.g. from National Accounts) are based on results of surveys (e.g. consumer survey). |
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6.3.1. Coverage error | |||
We are not aware of any double-counting of expenditure items in our SHA figures at the moment. However, if double-counting of expenditure is detected, it is removed and consolidated. A known under-coverage exists in OOP payments for HP.9 (rest of world, see 5.3) although we were able to include expenditure for dental services in Hungary in our last data submission, which is the major case were medical services are consumed by Austrian residents abroad. Other known under-coverages are laid out in detail under 5.3, although the effect of these under-coverages can all be considered to be relatively minor in terms of the volume of health expenditure. Underground/informal/illegal health services and goods are in large part included. Only for illegally purchased medicines and the “shadow” economy for nursing care data is (partly) missing. |
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6.3.1.1. Over-coverage - rate | |||
Not applicable. |
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6.3.1.2. Common units - proportion | |||
Not applicable. |
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6.3.2. Measurement error | |||
We are not aware of any measurement errors. |
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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 | |||
We are not aware of any processing errors. |
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6.3.4.1. Imputation - rate | |||
Not applicable. |
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6.3.5. Model assumption error | |||
Not applicable. |
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6.4. Seasonal adjustment | |||
Not applicable. |
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6.5. Data revision - policy | |||
Data are routinely revised annually for the latest 2-3 years, as all data are expected to be final at that time. Data are often revised for longer or even for the whole time-series, if fundamental changes in methodology take place (e.g. ESA 2010 implementation, implementation of SHA 2011). Data for the most recent year are preliminary. |
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6.6. Data revision - practice | |||
In general, with each data submission t-2 was newly compiled and the two previous data years were revised. Additionally, in 2016 a major revision was undertaken to implement SHA 2011 for data years 2011-2014. In 2018, another major revision was carried out to compile data according to SHA 2011 also for data years 2004-2010 and to also revise data for 2011-2015 due to some new insights gained by compiling the whole time-series 2004-2016. |
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6.6.1. Data revision - average size | |||
The magnitude of revision amounted to 0.5% -1.5% of current health care in the last years depending on the kind of revision. |
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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. Statistik Austria transmits SHA data for t-2 annually to EUROSTAT by March 31st latest in line with the deadline set out by OECD for the JHAQ. National publication takes place in Mid-February for t-2. A flash estimate of (highly aggregated) SHA-data for t-1 is published nationally and transmitted to OECD/EUROSTAT/WHO end of June since 2018. |
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7.1.1. Time lag - first result | |||
Around 6 months (national publication of flash estimate of main aggregates). |
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7.1.2. Time lag - final result | |||
Around 13 months (national publication of preliminary results of detailed SHA data, can be revised – see 6.5 and 6.6). |
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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 | ||||||
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 | ||||||
Data according to SHA 2011 is available from 2004-2016 (and main aggregates for 2017) for Austria and comparable over this time frame with one minor exemption, a minor break between 2007 and 2008 (see below). Breaks in time series resulting from methodological changes
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8.2.1. Length of comparable time series | ||||||
14 years (2004-2017) for SHA 2011 data (2017 only main aggregates published so far, minor break 2007-2008 – see 8.2). |
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8.3. Coherence - cross domain | ||||||
SHA and ESSPROS are based on different underlying concepts as e.g. SHA is based on final consumption whereas ESSPROS is based on total expenditure. Also, e.g. in the domain of LTC SHA core variables are only focusing on health-related LTC whereas ESSPROS takes into account also the social aspects of LTC. A full coherence between these different approaches is therefore not feasible. In addition, compilation methods for SHA and ESSPROS are different in Statistik Austria and therefore data cannot be mapped from one approach to the other. |
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8.4. Coherence - sub annual and annual statistics | ||||||
Not applicable. |
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8.5. Coherence - National Accounts | ||||||
Generally speaking, the approach for compiling SHA data is at large in line with the approach of National accounts and a great amount of SHA data is directly taken (and sometimes modified/pro-rated to fit within the SHA-boundaries) from National Accounts or Government Finance Statistics (e.g. household consumption according to COICOP, government expenditure according to COFOG, supply-use tables, gross-fixed capital formation,…). However, for some spending items (e.g. public spending in hospitals) direct data from financial reports is used and the compilation of these figures is not always fully in line with the concept of final consumption. The starting point of compiling public spending in hospitals is data from the State health funds (serving as intermediates that distribute government transfers to state-owned hospitals and other transfers to hospitals owned by NPISH) and not data from hospitals themselves on their cost structure. This is mainly done as an assignment to the different financing schemes contributing to the State Health Funds would not be possible if using data from the hospitals. Also, for health providers owned by the social insurance, the transfers (D.73) of the social insurance funds to these providers are accounted instead of compiling the final consumption of these providers as these providers are now classified inside the government sector in National Accounts. Nevertheless, these approaches lead to around the same overall figures than an approach by final consumption (we have compared both approaches for internal validation purposes in the past). Two major differences of SHA in comparison to National accounts should also be mentioned (see also SHA 2011 manual):
Underground/informal/illegal health care goods and services are included in SHA figures but there are some exceptions covered under 6.3.1. The treatment of imports/exports under SHA is outlined under 5.3 and 6.3.1. |
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8.6. Coherence - internal | ||||||
Internal coherence of SHA tables is achieved. For consistency checks and validation methods see 3.4. |
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9.1. Dissemination format - News release | |||
National publication of SHA results of t-2 in Mid-February is accompanied by a press release (last in German and English from February 2018) by Statistics Austria. |
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9.2. Dissemination format - Publications | |||
Results on health care expenditure on aggregates as well as in the three SHA-dimensions and figures for public spending for State Health Funds financed hospitals are published in Mid-February for t-2 on Statistik Austria's website together with explanatory texts and alongside a press release. Public expenditure for State Health Funds financed hospitals are also published end of September for t-1. The figures of the flash estimation for t-1 are published at the end of June. In addition, SHA data are published in Statistik Austria's yearly publication "Statistisches Jahrbuch Österreichs" (last edition: Statistik Austria (2017): Statistisches Jahrbuch Österreichs 2018) which can be ordered on Statistik Austria's website. Another publication of Statistics Austria including SHA data is the yearly publication "Jahrbuch der Gesundheitsstatistik" (last edition: Statistik Austria (2018): Jahrbuch der Gesundheitsstatistik 2016) which also can be ordered on Statistik Austria's website. In addition, several articles on SHA or containing SHA data were published in Statistik Austria’s monthly publication “Statistische Nachrichten”. The most recent articles were:
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9.3. Dissemination format - online database | |||
On the national level, we currently do not use an on-line database for the dissemination of SHA data but we provide EXCEL files with main aggregates as well as the three cross-classification tables, one table were all three dimensions are represented and one table were public spending for State Health Funds financed hospitals per Federal State is presented on Statistics Austria’s website. Data can also be obtained at the health-databases of OECD, EUROSTAT and WHO. |
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9.3.1. Data tables - consultations | |||
Restricted from publication | |||
9.4. Dissemination format - microdata access | |||
Not applicable. |
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9.5. Dissemination format - other | |||
SHA data are used as a base line for evaluating the ongoing health care reform in Austria. Other major publications using/containing SHA data are e.g.: OECD (2017): Health at a Glance 2017: OECD Indicators. OECD-Publishing, Paris. Bachner, Florian et al. (2018): Austria: Health system review. Health Systems in Transition. 2018; 20(3): 1 – 256 Countless other publications, surveys, web-based texts etc. |
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9.6. Documentation on methodology | |||
A detailed methodological documentation (Statistik Austria 2016: Standard-Dokumentation Metainformationen (Definitionen, Erläuterungen, Methoden, Qualität) zu Gesundheitsausgaben nach System of Health Accounts für Österreich) is published in German at Statistik Austria’s website, an English excerpt of this documentation can also be found there. |
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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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Restricted from publication |
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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. On national level, the “Datenschutzgesetz 1999” and the “Bundesstatistikgesetz 2000” (§17 - §19), applies. At Statistik Austria, there are guidelines in place with regards to the policy on confidentiality. |
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11.2. Confidentiality - data treatment | |||
All legal requirements are met and Statistik Austria’s guidelines are followed. The publication of SHA data is done at relatively high aggregated data-level, detailed data is not published or distributed. For most data sources, already aggregated data already (partly) published elsewhere is used. If data from financial reports or other information of single units is taken into account, it is secured that a sufficient number of units are aggregated together to be able to publish the relevant HF/HC/HP combination. |
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No further comments |
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