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For any question on data and metadata, please contact: Eurostat user support |
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1.1. Contact organisation | Inspection générale de la sécurité sociale |
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1.2. Contact organisation unit | Service études et analyses |
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1.5. Contact mail address | 26, rue Zithe . L-2763 Luxembourg |
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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 | |||
2013-2017. |
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2.9. Base period | |||
Not applicable. |
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3.1. Source data | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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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. Social security data serve as a base to calculate most keys. Double counting are eliminated from calculations. Non-health consumption are eliminated as much as possible. |
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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 | |||
Goverment accounts are classified based on budgetary article label. This may lead to overestimation or underestimation of some items. Subsidies or programs on local level are excluded. Out-of-pocket payments for glasses are only partly included and thus do not perfectly reflect private consumption patterns. It is not always evident to include/exclude consumption of residents abroad and consumption of non-residents in Luxembourg, as Luxembourg is faced with a lot of cross-border activity. |
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5.1. Relevance - User Needs | |||
Not applicable. |
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5.2. Relevance - User Satisfaction | |||
Not applicable. |
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5.3. Completeness | |||
HF4 Data are incomplete, but this is only marginal. |
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5.3.1. Data completeness - rate | |||
Not available. |
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6.1. Accuracy - overall | |||
Most data are based on financial statements and administrative data and should thus be accurate. OOP data, OTC drug data are estimates, HF4 is partially missing. |
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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 | |||
See coverage error. |
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6.3.1. Coverage error | |||
Double counting has been excluded this year, we are not aware of any double-counting at the moment. OTC medicines (HC.5.1.2) are estimated based on the proportion of turnover/sales of pharmacies subject to the reduced VAT rate (3%). This might include "non pharmaceuticals" sold by pharmacies also subject to the reduced VAT rate (such as food,..). No data available on (OTC) pharmaceutical sales to non-residents. No data available on pharmaceuticals bought by residents abroad and/or in shops other than pharmacies (supermarkets,..). An under-coverage exists in OOP-payments for HP.9 and HC.5.2, as well as HF4. Mental hospitals are included in specialised hospitals. |
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6.3.1.1. Over-coverage - rate | |||
OTC medicines (HC.5.1.2) are estimated based on the proportion of turnover/sales of pharmacies subject to the reduced VAT rate (3%). This might include "non pharmaceuticals" sold by pharmacies also subject to the reduced VAT rate (such as food,..). No data available on (OTC) pharmaceutical sales to non residents. No data available on phramaceuticals bought by residents abroad and/or in shops other than pharmacies (supermarkets,..). |
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6.3.1.2. Common units - proportion | |||
Not applicable. |
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6.3.2. Measurement error | |||
Not available, mainly administrative data/financial statement data. |
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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 available, mainly administrative data/financial statement data. |
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6.3.3.2. Item non-response - rate | |||
Not available, mainly administrative data/financial statement data. |
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6.3.4. Processing error | |||
Typing errors can always occur, clerical work means risk of random and systematic measurement error. |
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6.3.4.1. Imputation - rate | |||
Not available. |
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6.3.5. Model assumption error | |||
No model is used. |
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6.4. Seasonal adjustment | |||
Not applicable. |
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6.5. Data revision - policy | |||
No data revision policy is in place, as data are considered stable. |
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6.6. Data revision - practice | |||
Data will be revised if variations in the social security data occur. This may be due to wrong estimations or more data becomes available. |
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6.6.1. Data revision - average size | |||
Not available. |
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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 | |||
As no t-1 data is published, no first results are published. |
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7.1.2. Time lag - final result | |||
Unless revisions are produced, final results are published for t-2 in March of year t. |
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7.2. Punctuality | |||
Deadlines respected since EU regulation is in place. |
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7.2.1. Punctuality - delivery and publication | |||
Deadlines respected since EU regulation is in place. |
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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 | |||||||||||||||
Data is comparable for the period 2013-2017 (no break in time series). |
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8.3. Coherence - cross domain | |||||||||||||||
ESSPROS is compiled using a different method than SHA and cannot be mapped. |
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8.4. Coherence - sub annual and annual statistics | |||||||||||||||
Not applicable. |
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8.5. Coherence - National Accounts | |||||||||||||||
National accounts are compiled using a different method than SHA and cannot be mapped. |
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8.6. Coherence - internal | |||||||||||||||
Atypical entries:
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9.1. Dissemination format - News release | |||
SHA data are not disseminated on national level. |
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9.2. Dissemination format - Publications | |||
SHA data are not disseminated on national level. |
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9.3. Dissemination format - online database | |||
SHA data are not disseminated on national level. |
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9.3.1. Data tables - consultations | |||
SHA data are not disseminated on national level. |
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9.4. Dissemination format - microdata access | |||
Not applicable. |
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9.5. Dissemination format - other | |||
SHA data are not disseminated on national level. |
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9.6. Documentation on methodology | |||
SHA data are not disseminated on national level. |
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9.7. Quality management - documentation | |||
SHA data are not disseminated on national level. |
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9.7.1. Metadata completeness - rate | |||
SHA data are not disseminated on national level. |
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9.7.2. Metadata - consultations | |||
SHA data are not disseminated on national level. |
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Cannot be estimated. |
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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 | |||
The health expenditure data only uses aggregated data or data without direct personal reference. Otherwise, the European GDPR applies. |
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No further comment. |
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