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For any question on data and metadata, please contact: Eurostat user support |
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1.1. Contact organisation | Ministère des solidarités et de la Santé - DREES (Direction de la recherche, des études, de l’évaluation et des statistiques) |
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1.2. Contact organisation unit | Ministère des solidarités et de la Santé - DREES (Direction de la recherche, des études, de l’évaluation et des statistiques) - BACS (Bureau de l'analyse des comptes sociaux) |
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1.5. Contact mail address | Directorate of Research Analysis, Studies, Evaluation and Statistics (DREES) |
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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). Nonetheless, this assumption is not perfectly verified (see 6.3.1). |
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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 2006 to 2017 reference years. |
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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: 0 - Public administrative records: 4 - Financial reports: 0 - Other: 5
Public administrative records
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. |
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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 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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. |
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4.2. Quality management - assessment | |||
Not available. |
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5.1. Relevance - User Needs | |||
Users are: French Ministry of Health, academics, health organization, international organization etc. |
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5.2. Relevance - User Satisfaction | |||
There is no satisfaction surveys or consultations to determine user satisfaction on SHA data. Nonetheless, French health national accounts are annualy presented in a Committee ("Commission des comptes de la santé") gathering about 50 different stakeholders from all part - Ministry of Health, public authorities, health professionals, academics, social partners, industries, etc. - with many very positive feedbacks. Press relay is also very good. |
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5.3. Completeness | |||
See 5.3.1. |
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5.3.1. Data completeness - rate | |||
Information concerning total pharmaceutical expenditure is not available: SHA is based on French health accounts (comptes nationaux de la santé or CNS). In CNS, we are not able to isolate medication use at hospital (due to a highly aggregate data source). |
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6.1. Accuracy - overall | |||
No comment. |
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6.2. Sampling error | |||
The only sampling technique is used to compute over-the-counter medicines, which represents around 1% of total health expenditure. About 3 different sampling techniques have been tested, which provided very similar results. Quality assessments indicated an accuracy of around 0,1%. |
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6.2.1. Sampling error - indicators | |||
See 6.2. |
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6.3. Non-sampling error | |||
See below. |
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6.3.1. Coverage error | |||
SHA data are base on French health national accounts which are centered on consumption in the French territory. This means that the consumption by French residents abroad is excluded; and conversely that the consumption by non-residents on the French territory is included. Customs data are not sufficiently detailed on this specific topic to provide an accurate estimation to be used in SHA, but qualitative assessments indicate that the amounts strictly concerning health consumption should be very limited, which also limits the coverage error. |
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6.3.1.1. Over-coverage - rate | |||
See 6.3.1. |
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6.3.1.2. Common units - proportion | |||
Not applicable: there is no overlapping between the unique survey (on over-the-counter medicines) and all the administrative data. |
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6.3.2. Measurement error | |||
There is almost no measurement error: the few ones are corrected through a careful automatized process (for instance: typing error in the data source reporting euros instead of million of euros in administrative data). |
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6.3.3. Non response error | |||
There is a small non-response error regarding complementary schemes' data: the coverage is higher than 97% in market shares. This non-response is corrected using sampling techniques. |
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6.3.3.1. Unit non-response - rate | |||
See 6.3.3. |
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6.3.3.2. Item non-response - rate | |||
See 6.3.3. |
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6.3.4. Processing error | |||
The main processing error is reported in section 6.3.2. |
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6.3.4.1. Imputation - rate | |||
See 6.3.4. |
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6.3.5. Model assumption error | |||
Not applicable: there is no modeling in the computation of French health accounts. |
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6.4. Seasonal adjustment | |||
Not applicable. |
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6.5. Data revision - policy | |||
Data are revised each year, according to our methological improvements. Concerning public hospital, data can also be revised because of national accounts base year change. Data are revised from year 2006 on, so that no breaks in time series will be introduced. |
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6.6. Data revision - practice | |||
Futher methodological improvements have been made: -In 2017, over the counter medicines consumption was revised. Now the estimates are based on more detailed data : pharmacies' turnovers (including taxes - retail price) [IQVIA data]. |
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6.6.1. Data revision - average size | |||
Health accounts are revised each year, according to methological improvements and also thanks to more recent data. Data are revised from year 2006 on, so that no breaks in time series will be introduced. In this edition, the methodology for estimating over-the-counter medicines has been improved thanks to more detailed data regarding pharmacies’ turnovers. This translates into a slightly upward revision in 2006 and downward revisions between 2007 and 2016 (which reaches a maximum of 1.3 billion euros in 2016). Concerning public hospital, data can also be revised because of national accounts base year change or updated data by the French national statistical institute (INSEE): in this edition, public hospital data has been revised by - 430 million euros in 2016. |
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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 | |||
Not applicable. |
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7.1.2. Time lag - final result | |||
Definite figures for year T-3 are published in September of the year T. |
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7.2. Punctuality | |||
See 7.2.1. |
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7.2.1. Punctuality - delivery and publication | |||
There were no deviations from deadlines in the reference period. |
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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 | |||
There are no breaks in 2006-2017 series. |
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8.2.1. Length of comparable time series | |||
There are no breaks in 2006-2017 series. |
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8.3. Coherence - cross domain | |||
SHA and ESSPROS are based on different concepts as 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. |
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8.4. Coherence - sub annual and annual statistics | |||
Not applicable. |
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8.5. Coherence - National Accounts | |||
SHA is based on final consumption. The concept of "consumption" comes from national accounts SEC10. |
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8.6. Coherence - internal | |||
No comment. |
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9.1. Dissemination format - News release | |||
DREES website |
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9.2. Dissemination format - Publications | |||
DREES website |
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9.3. Dissemination format - online database | |||
DREES website |
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9.3.1. Data tables - consultations | |||
DREES website |
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9.4. Dissemination format - microdata access | |||
Not applicable. |
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9.5. Dissemination format - other | |||
Not applicable. |
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9.6. Documentation on methodology | |||
The results of the French national health accounts on which SHA relies are presented in « Les dépenses de santé en 2017, résultats des comptes de la santé – édition 2018 », Panoramas de la Drees-Santé, septembre 2018 (in French only). See in particular annex 1, annex 2 and annex 5 for more details about the methodology of French national health accounts. |
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9.7. Quality management - documentation | |||
The results of the French national health accounts on which SHA relies are presented in « Les dépenses de santé en 2017, résultats des comptes de la santé – édition 2018 », Panoramas de la Drees-Santé, septembre 2018 (in French only). See in particular annex 1, annex 2 and annex 5 for more details about the methodology of French national health accounts. |
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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. |
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11.2. Confidentiality - data treatment | |||
Le secret statistique est défini par la loi n° 51-711 du 7 juin 1951 modifiée sur l'obligation, la coordination et le secret en matière de statistiques. Il interdit, pendant une durée de soixante-quinze ans, toute communication de données ayant trait à la vie personnelle et familiale, et plus généralement, aux faits et comportements d'ordre privé recueillies au moyen d'une enquête statistique. Des dérogations peuvent néanmoins être accordées, sur avis du Comité du secret statistique, exclusivement en réponse à des besoins dont la finalité relève de la statistique publique ou de la recherche scientifique ou historique. Pour leur part, les renseignements d'ordre économique ou financier ne peuvent être communiqués pendant une durée de vingt-cinq ans, sauf dérogation accordée après avis du Comité du secret statistique, pour des finalités excluant strictement toute utilisation de ces informations à des fins de contrôle fiscal ou de répression économique. Toutes les personnes ayant accès aux données collectées (enquêteurs, agents recenseurs, statisticiens, chercheurs autorisés) sont astreintes au secret statistique. Comme tous les fonctionnaires et agents de l'État, les personnels de la Statistique publique sont de plus soumis aux règles législatives et réglementaires sur le secret professionnel et l'obligation de réserve, qui s'appliquent aux dossiers et informations dont ils ont connaissance dans leur travail. |
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Further methodological improvements have been conducted this year, leading to revise some estimates. |
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