Developments in UK Health Accounts

OECD Meeting of Experts in National Health Accounts 27-28 October 2003

Gavin WallisHealth Accounts Team

Office for National Statistics

Outline

• Introduction

• Total UK Health Expenditure

• UK Health Accounts

• Results

• Next Steps

• Conclusions

• Questions / Discussion

Introduction to UK Health Accounts

• Stimulating debate

• Previous releases

• Next releases

• Project Board

• Key users identified

• Use of National Accounts

• Major deviations dealt with:

(i) Nursing Care not funded by NHS

(ii) Research and Development

(iii) education and training

• Charities, religious organisations, prisons, armed forces

Total UK Health Expenditure sources

Total UK Health Expenditure issues

• Private finance most problematic

• Conformity with SHA:

(i) Household production of health care services

(ii) Occupational health care

• Further deviations: using National Accounts

UK Health Accounts sources

• Health administrations

(i) Main source activity costs

(ii) Budgetary information

(iii) Double counting?

• Household expenditure based on National Accounts

• Nursing care

• Public / private split

UK Health Accounts issues

• Reasonable first estimate

• Some "top-down" methods

• Exclusion of Household production & Occupational health care

• NPISH, prisons, armed forces not fully cross-classified

• Financial year basis

• No time series

• Health related functions?

Results: UK Health Accounts 1999/2000

Total current expenditure on health by function, UK, 1999/2000

HC.1-267%

HC.36%

HC.41%

HC.518%

HC.73%

NPISH2%

Prisons and armed forces

1%HC.62%

HC.1-2. Cure/rehabilitationHC.3. LT nursingHC.4. Ancillary servicesHC.5. Goods (and related services) to outpatientsHC.6. Prevention & publicHC.7. Administration

Total current expenditure on health by provider, UK, 1999/2000

HP.1 HospitalsHP.2 Nursing facilitiesHP.3 Ambulatory facilitiesHP.4 Retailers of goodsHP.5 Providers of public healthHP.6 AdministrationHP.9 Rest of the world (imports)

HP.158%

HP.23%

HP.316%

Prisons and armed forces

1%

HP.90%

HP.50%

NPISH2%

HP.418%

HP.62%

Next Steps

• Household production of health services

• Further investigation into sources and methods

• Primary data sources (“bottom-up”)

• Function and provider for NPISH, prisons, armed forces?

• Calendar year basis

• Time series

Conclusions

• Reasonable first estimate

• Some documented deviations from SHA

• Improvements in pipeline

• Growing user demand

• Publication on 16 December 2003

Questions / Discussion