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For any question on data and metadata, please contact: Eurostat user support |
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1.1. Contact organisation | Statistical Service of Cyprus |
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1.2. Contact organisation unit | Health Unit - Demography, Social Statistics and Tourism Department |
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1.5. Contact mail address | Michael Karaolis Str.
1444 Nicosia CYPRUS
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2.1. Data description | |||
Health care expenditure quantifies the economic resources dedicated to health functions, excluding capital investment. Healthcare expenditure concerns itself primarily with healthcare goods and services that are consumed by resident units, irrespective of where that consumption takes place (it may be in the rest of the world) or who is paying for it. As such, exports of healthcare goods and services (to non-resident units) are excluded, whereas imports of healthcare goods and services for final use are included. It provides a set of revised classifications of health care functions, providers of health care goods and services and financing schemes. The SHA is currently used as a basis for a joint data collection by OECD, Eurostat and WHO on health care expenditure. The manual sets out in more detail the boundaries, the definitions and the concepts of health accounting – responding to health care systems around the globe with very different organisational and financing arrangements. Accounting period: Health expenditure and financing data pertain to the calendar year (1 January to 31 December). |
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2.2. Classification system | |||
Healthcare expenditure is recorded in relation to the international classification for health accounts (ICHA) defining:
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2.3. Coverage - sector | |||
1. Household individual consumption on health, including the collective consumption with two exceptions: |
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2.4. Statistical concepts and definitions | |||
SHA concept is the consumption of health care goods and services. Summary tables provide data on:
Cross-classification tables refer to:
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2.5. Statistical unit | |||
Commission Regulation 2015/359 concerns the collection of data on "current expenditure on healthcare" which is defined as the "final consumption expenditure of resident units on health care goods and services". |
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2.6. Statistical population | |||
SHA focuses on the consumption of health care goods and services by the resident population irrespective of where this takes place. This implies the inclusion of imports (from non-resident providers) and the exclusion of exports (health care goods and services provided to non-residents). |
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2.7. Reference area | |||
The data aims at providing a complete overview of expenditure on health care goods and services consumption of services and goods by the resident population on the national territory of a country. |
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2.8. Coverage - Time | |||
Detailed data according to SHA2011 is available for the period 2010-2017 for Cyprus. |
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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 2019): - Surveys/census: 3 - Public administrative records: 5 - Financial reports: 3 - Other: 0
Surveys/censuses
Public administrative records
Financial reports
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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. |
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3.4. Data validation | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
The 2019 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 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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. No data is published at national level using different methodology than SHA2011. |
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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. The quality of statistics in CYSTAT is managed in the framework of the European Statistics Code of Practice which sets the standards for developing, producing and disseminating European Statistics as well as the ESS Quality Assurance Framework (QAF). CYSTAT endorses the Quality Declaration of the European Statistical System. In addition, CYSTAT is guided by the requirements provided for in Article 12 of the Statistics Law No. 15(I) of 2000 as well as Article 12 of Regulation (EC) No 223/2009 on European statistics, which sets out the quality criteria to be applied in the development, production and dissemination of European statistics. European Statistics Code of Practice: https://ec.europa.eu/eurostat/documents/4031688/8971242/KS-02-18-142-EN-N.pdf/e7f85f07-91db-4312-8118-f729c75878c7 ESS Quality Assurance Framework (QAF): http://ec.europa.eu/eurostat/documents/64157/4392716/ESS-QAF-V1-2final.pdf/bbf5970c-1adf-46c8-afc3-58ce177a0646 Quality Declaration of the European Statistical System: http://ec.europa.eu/eurostat/documents/4031688/8188985/KS0217428ENN_corr.pdf/116f7c85-cd3e-4bff-b695-4a8e71385fd4 Statistics Law No. 15(I) of 2000: http://www.mof.gov.cy/mof/cystat/statistics.nsf/legislation_en/legislation_en?OpenDocument Regulation (EC) No 223/2009 on European statistics (consolidated text): http://eur-lex.europa.eu/legal-content/EN/TXT/PDF/?uri=CELEX:02009R0223-20150608&qid=1504858409240&from=EN |
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4.2. Quality management - assessment | |||
The overall quality of SHA data for the case of Cyprus is considered to be quite good. The main weakness is the lack of information for specific topics. These issues are outlined under points 5.3 and 6.3.1 of this report. |
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5.1. Relevance - User Needs | |||
The main users of SHA data in Cyprus are the several ministries, i.e. Ministry of Health and the Ministry of Finance, as well as other bodies such as the National Health Insurance Organisation. Moreover, several other users are interested for SHA data, i.e. researchers, students, journalists.
Key indicators that are often included in the requests are: the current health expenditure in total, as well as the current health expenditure of the public sector as a percentage of the GDP and the respective figure for the private sector.
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5.2. Relevance - User Satisfaction | |||
CYSTAT always remains on the disposal of the SHA users for any suggestions for improvement. Any feedback from main users is considered accordingly and if it is feasible it is incorporated in the compilation of SHA. |
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5.3. Completeness | |||
Data is complete as far as the Commission regulation is applicable. The only scheme for which data is not available from reference years 2016 onwards is "HF.4 Rest of the world financing schemes", due to lack of data source. However that fact does not lead to underestimation of the total health expenditure, since this expenditure is included in other HF items of the private sector. |
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5.3.1. Data completeness - rate | |||
As regards the completeness of the data according to the Regulation, it is estimated to be almost full, 100%. |
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6.1. Accuracy - overall | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Since the SHA tables are the result of integrating different data sources into a given methodology, as well as the application of several estimations in order to result in the detailed SHA categories, the outcome is inevitably not 100% accurate. |
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6.2. Sampling error | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Not applicable since no surveys are used directly for the compilation of SHA data. |
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6.2.1. Sampling error - indicators | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Not applicable. |
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6.3. Non-sampling error | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
See point 6.3.1 below. |
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6.3.1. Coverage error | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Βelow is the table with the variables deviating from SHA definitions or missing data. Health care goods and services by non-residents are excluded from domestic provider revenues and underground/informal/illegal health care goods and services are in large part included. Only illegally purchased medicines are 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 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
As regards the Private Sector, since the data for the reference year are always preliminary, they are revised during the next year's submission. |
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6.6. Data revision - practice | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Data for reference years 2010-2015 have been revised according to Eurostat's feedback during the validation procedure for the JQ2018. Specifically, the distribution of the expenditure reported under HF.1.1, HF.2.3, HF4 and HF.2.1 has been revised as described below: - Part of the expenditure of foreign companies having branches in Cyprus (FOE) has been reclassified under HF.2.1, instead of HF.4 as was the case. - The expenditure concerning medical funds for local government employees has been shifted from HF.1.1 that was the case, to HF.2.1. - The expenditure concerning enterprises having their own medical funds has been shifted from HF.2.3 to HF.2.1. Data for reference year 2016 have been revised according to the following parameters: - Revised figures obtained from the National Accounts division as regards the individual consumption expenditure by households (HF.3.1 and HF.3.2), has been applied in the compilation of the data. - Data referring to HF2.1 (Local Government Schemes, Enterprises having their own funds, as well as Bank and Union funds) that were preliminary, have been revised according to the actual data obtained from ESSPROS. As regards the submitted data for 2017, it should be noted that the data referring to the Private Sector, as well as the depreciation for the Public Sector are preliminary.
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6.6.1. Data revision - average size | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
The revisions done every year do not lead to any significant differences in the total current health expenditure. It should be noted that the latest revisions performed for reference year 2016, resulted in an increase in the total current health expenditure by 0.1%, compared to the figures before the revisions. |
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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. The Statistical Service of Cyprus annually transmits SHA data to EUROSTAT for reference year t by 31st March t+2. |
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7.1.1. Time lag - first result | |||
First results for year t are published in May of year t+2. |
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7.1.2. Time lag - final result | |||
Final results for year t are published in May of year t+3. |
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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 | ||||||||||||||||||||||||
Breaks in time series resulting from methodological changes
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8.2.1. Length of comparable time series | ||||||||||||||||||||||||
2010-2017 |
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8.3. Coherence - cross domain | ||||||||||||||||||||||||
Coherence is not applicable, since data from other sources, such as the National Account Data and ESSPROS data are applied to SHA2011 methodology in order to compile SHA. |
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8.4. Coherence - sub annual and annual statistics | ||||||||||||||||||||||||
Not applicable. |
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8.5. Coherence - National Accounts | ||||||||||||||||||||||||
The National Accounts Division of the Statistical Service of Cyprus extrapolates the results of the Household Budget Survey (HBS) in order to estimate the health expenditure by type of service.
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8.6. Coherence - internal | ||||||||||||||||||||||||
Consistency checks are embedded in the cross tables in advance, so CYSTAT performes these checks before submitting the data to Eurostat. No other internal consistency check are performed. |
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9.1. Dissemination format - News release | |||
No specific news release for the dissemination of SHA data is announced. Aggregated SHA data as well as cross tables are published through the annual report “Health and Hospital Statistics”, for which an announcement is uploaded in CYSTAT’s website informing the users of the new publication. |
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9.2. Dissemination format - Publications | |||
The annual report mentioned in the previous point is usually published in April-May year t with reference year t-2, including amongst others aggregated SHA data, as well as cross tables. The publication can be downloaded for free from CYSTAT’s website, following the link below: http://www.cystat.gov.cy/mof/cystat/statistics.nsf/populationcondition_23main_gr/populationcondition_23main_gr?OpenForm&sub=3&sel=4 and Part G regards to SHA results for year t-2. |
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9.3. Dissemination format - online database | |||
At national level, SHA data are not disseminated through an on-line database. |
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9.3.1. Data tables - consultations | |||
Information not available. |
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9.4. Dissemination format - microdata access | |||
Not applicable. |
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9.5. Dissemination format - other | |||
None |
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9.6. Documentation on methodology | |||
The only methodological document available is the SHA 2011 manual, as well as the Metadata document submitted to Eurostat via eDamis during the data submission process. |
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9.7. Quality management - documentation | |||
Not available. |
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9.7.1. Metadata completeness - rate | |||
Not available. |
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9.7.2. Metadata - consultations | |||
Not available. |
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The data sources used for the compilation of SHA data are administrative data, as well as information obtained from other surveys that are not conducted for the needs of SHA, but their results also serve SHA purposes. Therefore, the burden on the providers and the respondents is not reflected on SHA. |
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11.1. Confidentiality - policy | |||
Official statistics are released in accordance to all confidentiality provisions of the following:
http://www.mof.gov.cy/mof/cystat/statistics.nsf/legislation_en/legislation_en?OpenDocument
http://www.mof.gov.cy/mof/cystat/statistics.nsf/dmlquality_en/dmlquality_en?OpenDocument |
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11.2. Confidentiality - data treatment | |||
Official statistics are released in accordance to all confidentiality provisions of the following: National Statistics Law No. 15(I) of 2000 (especially Article 13 on statistical confidentiality). http://www.mof.gov.cy/mof/cystat/statistics.nsf/legislation_en/legislation_en?OpenDocument
The treatment of confidential data is regulated by CYSTAT's Code of Practice for the Collection, Publication and Storage of Statistical Data. http://www.mof.gov.cy/mof/cystat/statistics.nsf/dmlquality_en/dmlquality_en?OpenDocument |
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None |
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Annex 4.1 Cystat's Policy |