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For any question on data and metadata, please contact: Eurostat user support |
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1.1. Contact organisation | Federal Public Service Social Security |
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1.2. Contact organisation unit | Directorate General Social policy Dept. International relations |
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1.5. Contact mail address | Kruidtuinlaan 50 1000 BRUSSELS Belgium |
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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 2014 to 2016 reference years. |
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2.2. Classification system | |||
Healthcare expenditure is recorded in relation to the international classification for health accounts (ICHA) defining:
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2.3. Coverage - sector | |||
1. Household individual consumption on health, including the collective consumption with two exceptions: 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: 2. Health care financing schemes: HF1 Government schemes and compulsory contributory health care financing schemes; HF2 -voluntary health care payment schemes; HF4 - rest of the world financing schemes, albeit that this is not applicable to Belgium. 3. NACE rev. 2, section Q, human health and social work activities. |
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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 | |||
Data are available for the period 2003-2016. |
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2.9. Base period | |||
Not applicable. |
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3.1. Source data | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Several data sources are used: - Surveys/census: 2 - Financial reports: 4 - Other: 2
Surveys/censuses
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. Data for Belgium are gathered by the Federal Public Service Social Security and treated to compile SHA accounts and cover the financing schemes of health care consumption. Social security data serve as a base to calculate keys. Double countings are eliminated from the calculations. Estimates of non-health consumption occurring by some providers are also eliminated. Estimates of health related consumption of retail sales (glasses and hearing aids) are added. |
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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:
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3.5. Data compilation | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
The Belgian social security health insurance functions on a fee-for-service basis, disposing of exhaustive information on several thousand of medical acts and services performed by the providers. This information is aggregated into some 1500 types of benefits, that get individually classifications assigned (provider and function). This data source also identifies the patient copayment amounts for all these (reimbursable) benefits. This information is used as a basis for the calculation of different keys, used for assigning financial interventions of other schemes for whom such detailed information is not available: - third party intervention in copayments by private insurance companies and other complementary insurances - distribution of out-of-pocket payments per item - reimbursement of medical care by occupational hazards social security.
Governmental accounts data and budget are used on a individual expense item basis. All expenditure items covering health and long term care are assigned a classification of provider and function. This includes also items not belonging to COFOG 7. Data are included for medical services provided by health services of the defense forces and justice department to prisoners, as well as data for general population protection (ministry of the interior) Data cover federal and all regional governments in Belgium. Estimates of final household consumption per item are used and corrected for government interventions (care allowances, reimbursements by complementary insurances, non-health consumption) and then submitted to a calculated key per item for 2nd or 3rd digit assignment of function/provider. |
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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. |
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4.2. Quality management - assessment | |||
Even if data are compiled starting from very detailed administrative data on the reimbursement of health care, the patients co-payments are calculated using keys that may not perfectly reflect the private consumption patterns, on the 2nd and 3rd digit levels. Government accounts and budget data are used and classified using the budgetary article label. This may lead to overestimation of some items and subreporting of others, which cannot be corrected in the actual state of play of information available. Nevertheless, these errors are negligible in view of the general expenditure amounts. Prior to 2006, data sources were less detailed. The classification of expenditure is therefore not entirely comparable with the data starting from 2006, causing a break in series. |
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5.1. Relevance - User Needs | |||
Policy development use in Belgium is still very limited. |
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5.2. Relevance - User Satisfaction | |||
Not tested. |
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5.3. Completeness | |||
Data are available on the requested detail requested by Eurostat for all items applicable or relevant in the situation of health and long term care delivery and consumption in Belgium. (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) |
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5.3.1. Data completeness - rate | |||
Data are available on the requested detail requested by Eurostat for all items applicable or relevant in the situation of health and long term care delivery and consumption in Belgium. (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) |
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6.1. Accuracy - overall | |||
No statistical estimation technique is used. Out of pocket expenditure is subject at the basis to the error levels generated in the estimation of final household consumption in the framework of the national accounts. Where a repartition key is used, based on administrative accounts to split some expenditure items this could lead to some 'incorrectness' on 2nd or 3rd digit level. |
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6.2. Sampling error | |||
Not applicable. |
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6.2.1. Sampling error - indicators | |||
Not applicable. |
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6.3. Non-sampling error | |||
Not applicable. |
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6.3.1. Coverage error | |||
Not applicable. |
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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 | |||
Not applicable. |
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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 | |||
Not applicable. |
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6.3.4.1. Imputation - rate | |||
See 6.3.2. |
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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 | |||
Methodological improvements applied for total time span (2003 to last year), punctual data corrections due to new/better/updated data sources for those years where needed. |
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6.6. Data revision - practice | |||
H321: elimination for entire time span (2003-2015) of a double counting between HF31 and HF11 : specific allocations not deducted before from household consumption. As these items are treated as 'transfers to households' by national accounts, they are not taken into account on the expenditure side of households (deducted), but by mistake also not deducted by us, so that double counting existed. |
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6.6.1. Data revision - average size | |||
Depends on the nature of corrections needed. |
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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. |
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7.1.1. Time lag - first result | |||
30 April T+2. |
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7.1.2. Time lag - final result | |||
30 April T+2. |
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7.2. Punctuality | |||
Data delivered following deadlines. |
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7.2.1. Punctuality - delivery and publication | |||
Deadlines respected. |
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8.1. Comparability - geographical | |||||||||
Not applicable at national level. Data cover the country. |
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8.1.1. Asymmetry for mirror flow statistics - coefficient | |||||||||
Not applicable. |
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8.2. Comparability - over time | |||||||||
Breaks in time series resulting from methodological changes
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8.2.1. Length of comparable time series | |||||||||
Except for the consequences of the series breaks, all data items are fully comparable and consistent over the 2003-2016 period on all levels. |
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8.3. Coherence - cross domain | |||||||||
Not applicable: SHA is an estimation of final consumption expenditure. With regards to national accounts, sectoral subdivisions differ. (SHA public expenditure is larger than COFOG7 - complementary insurance interventions are lifted out of the financial sector) In SHA, corrections are applied for non-health services consumed in the hospital sector. |
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8.4. Coherence - sub annual and annual statistics | |||||||||
Not applicable. |
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8.5. Coherence - National Accounts | |||||||||
Coherence in accounting principles exist. However, as scope differences exist between national accounts in the health classification in COFOG, COICOP, etc.. a full coherence in 'scope' is as such not applicable. Differences with national accounts will be found in: - governement 'health' expenditure (larger than COFOG 7) - private insurance expenditure - corrections of final household consumption for non-health services in hospitals and pharmacies, addition of health related items from retail sale in national accounts. |
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8.6. Coherence - internal | |||||||||
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9.1. Dissemination format - News release | |||
Defined by Eurostat. |
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9.2. Dissemination format - Publications | |||
Defined by Eurostat. |
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9.3. Dissemination format - online database | |||
National data can be accessed here: |
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9.3.1. Data tables - consultations | |||
Not available. |
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9.4. Dissemination format - microdata access | |||
Not applicable. |
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9.5. Dissemination format - other | |||
Defined by Eurostat. |
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9.6. Documentation on methodology | |||
A full methodological manual on national level is under development. |
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9.7. Quality management - documentation | |||
Not applicable. |
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9.7.1. Metadata completeness - rate | |||
100% |
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9.7.2. Metadata - consultations | |||
Not applicable. |
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Cost of production is estimated on 2FTE and 300.000 EUR/year This does not include production of the source data (accounts, reports) by data providers. |
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11.1. Confidentiality - policy | |||
The Regulation (EC) No 223/2009 on European statistics (recitals 23-27, 31-32 and Articles 20-26) applies. |
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11.2. Confidentiality - data treatment | |||
Not applicable. |
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If data are internally coherent, consistent and calculated on known basis, this is not a guarantee for international comparability (where, as known, issues still exist). |
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