Statistics Explained

Government expenditure on health


Data extracted in February 2022

Planned article update: 28 February 2023

Highlights

General government expenditure in the EU on health amounted to € 1 073 billion or 8.0 % of GDP in 2020.


Total general government expenditure on health, 2020 (% of GDP) - Source: Eurostat (gov_10a_exp)

This article analyses data on general government total expenditure on 'health' (according to the Classification of the Functions of Government - COFOG). It is part of a set of statistical articles based on Government expenditure by function.

Eurostat collects data on general government expenditure by economic function according to the international Classification of the Functions of Government (COFOG) in the framework of the European System of National Accounts (ESA 2010).

Full article

Expenditure on 'health'

In 2020 at the level of the EU, 'health' expenditure remained the second largest item of general government expenditure after expenditure on 'social protection'. In 2020 in the EU, total expenditure of general governments on 'health' amounted to € 1 073 billion or 8.0 % of GDP.

Table 1: Total general government expenditure on health, 2020 (% of GDP) - Source: Eurostat (gov_10a_exp)

Looking at a more detailed breakdown for the EU in 2020, 'hospital services' accounted for 3.4 % of GDP, 'outpatient services' for 2.5 % of GDP and 'medical products, appliances and equipment' for 1.2 % of GDP.

The largest amount of government expenditure on health was reported by Czechia and Austria (9.2 % of GDP), France (9.0 % of GDP), Denmark (8.9 % of GDP) and Belgium (8.8 % of GDP). Among the EFTA countries, Norway reported the largest amount (9.6 % of GDP). The smallest amounts were reported by Latvia (4.8 % of GDP) as well as Poland and Ireland (5.4 % of GDP). Switzerland reported the smallest amount among the reporting EU and EFTA countries (2.5% of GDP). In some countries, the health care is organised by the private sector, while other countries have government schemes.

Evolution of general government 'health' expenditure

At the level of the EU, general government 'health' expenditure increased relatively smoothly between 1995 and 2020, amounting to 11.1 % of total expenditure in 1995 and 15.1% in 2020. As a ratio to GDP, EU government health expenditure amounted to 5.9 % of GDP in 1995 and 8.0 % of GDP in 2020. In 2020, the ratio to GDP increased by one percentage point as compared to 2019 resulting in the highest ratio in the available time series. The high amount reported in 2020 is due to both a decrease in nominal GDP and an increase in government expenditure on health (increase of + €95 billion compared to 2019) related to the COVID-19 pandemic.

GeneralGovernmentExpenditureEN 2020.jpg

Source data for tables and graphs

The detailed tables Microsoft Excel 2010 Logo.png are available here.

Data sources and availability

Reporting of data to Eurostat

Annual government finance statistics (GFS) data are collected by Eurostat on the basis of the European System of Accounts (ESA 2010) transmission programme. Member States are requested to transmit, among other tables, table 1100, 'Expenditure of general government by function' twelve months after the end of the reference period. Table 1100 provides information about expenditure of the general government sector divided into main COFOG functions and ESA 2010 categories. The transmission of the COFOG I level breakdown (divisions) is compulsory for the years 1995 onwards, whereas information on the COFOG II level (COFOG groups) is provided on a compulsory basis for the reference years 2001 onwards. The main reference year used in this publication is 2020 as the latest year available at EU-27 level.

Data was extracted on 22 February 2022.

Provisional data

While a significant effort was undertaken to harmonise the recording of government measures to mitigate the economic and social impact of the COVID-19 pandemic, a full harmonisation of data for the reference year 2020 was not yet achieved. The likelihood of future revisions is thus higher than usual and EU and euro area data is provisional.

Data for Germany (2018-2020), Spain (2020), France (2019-2020), Italy (2020) and Portugal (2020) is provisional.

Definition of general government and its subsectors

The data relate to the general government sector of the economy, as defined in ESA 2010, paragraph 2.111: 'The general government sector (S.13) consists of institutional units which are non-market producers whose output is intended for individual and collective consumption, and are financed by compulsory payments made by units belonging to other sectors, and institutional units principally engaged in the redistribution of national income and wealth’.

Classification of functional expenditure of government

The Classification of the Functions of Government (COFOG) classifies government expenditure into ten main categories (divisions known as the 'COFOG I level' breakdown): general public services; defence; public order and safety; economic affairs; environmental protection; housing and community affairs; health; recreation, culture and religion; education; social protection. These divisions are further broken down into 'groups' (COFOG II level).

For 'health', the groups are

  • 'medical products, appliances and equipment',
  • 'outpatient services',
  • 'hospital services',
  • 'public health services',
  • 'R&D health',
  • 'health n.e.c.'

Further information is available in the Eurostat Manual on sources and methods for the compilation of COFOG Statistics.

COFOG level II data

The provision of COFOG level II data has become compulsory with the introduction of ESA 2010. The development of COFOG level II data is not completed in many Member States and data needs to be looked at with this in consideration.

Satellite accounts

Administrative expenditure data is additionally collected in so-called satellite accounts. In general, the amount of expenditure recorded in satellite accounts is expected to exceed the expenditure recorded under the respective COFOG division. More details on the comparability of COFOG data with satellite accounts data can be found in the COFOG manual.

Definition of general government total expenditure

Government total expenditure is defined in ESA 2010, paragraph 8.100 by using as reference a list of ESA 2010 categories.

Government total expenditure comprises the following categories:

  • P.2, 'intermediate consumption': the purchase of goods and services by government;
  • P.5, 'gross capital formation' consists of: (a) gross fixed capital formation (P.51g); (b) changes in inventories (P.52); (c) acquisitions less disposals of valuables (P.53); where
  • P.51g, 'gross fixed capital formation': consists of acquisitions, less disposals, of fixed assets during a given period plus certain additions to the value of non-produced assets realised by the productive activity of producer or institutional units. Fixed assets are tangible or intangible assets produced as outputs from processes of production that are themselves used repeatedly, or continuously, in processes of production for more than one year;
  • D.1, 'compensation of employees': the wages of government employees plus non-wage costs such as social contributions;
  • D.29, 'other taxes on production, payable',
  • D.3, 'subsidies, payable',
  • D.4, 'property income, payable', consists of : (a) 'interest, payable' (D.41) and (b) 'other property income, payable' (D.42+D.43+D.44+D.45), where
  • D.41, 'interest': excludes settlements under swaps and forward rate arrangements, as these are treated as financial transactions in the ESA 2010;
  • D.5, 'current taxes on income, wealth, etc, payable';
  • D.62, social payments: cover social benefits and pensions paid in cash;
  • D.632, 'social transfers in kind - purchased market production';
  • D.7, 'other current transfers, payable';
  • D.8, 'adjustments for the change in pension entitlements'
  • D.9, 'capital transfers payable'
  • NP, 'acquisitions less disposals of non-financial non-produced assets': public investment spending. Non-financial non-produced assets consist of land and other tangible non-produced assets that may be used in the production of goods and services, and intangible non-produced assets.
  • Capital investments includes P.5 and NP.
  • Other current expenditure includes D.29, D.5 and D.8.

Gross Domestic Product

Throughout this publication, the nominal GDP, i.e. GDP at current prices is used. The latest GDP available at time of publication is used.

Time of recording & symbol

In the ESA 2010 system, recording is in principle on an accrual basis, that is, when ‘economic value is created, transformed or extinguished, or when claims and obligations arise, are transformed or are cancelled.'

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"pp" percentage points

More data and information

For more country-specific notes, e.g. on missing data, please refer to the metadata published on Eurobase. The authors can be contacted at ESTAT-GFS@ec.europa.eu

Context

In the framework of the European System of National Accounts (ESA 2010), Eurostat collects data on general government expenditure by economic function according to the international Classification of the Functions of Government (COFOG) – see methodological note.

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Government statistics (t_gov)
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Government statistics (gov)
Government finance statistics (EDP and ESA2010) (gov_gfs10)
Annual government finance statistics (gov_10a)
Government revenue, expenditure and main aggregates (gov_10a_main)
General government expenditure by function (COFOG) (gov_10a_exp)
Main national accounts tax aggregates (gov_10a_tax_ag)