英文_OECD_巴西卫生账户制度化_方法_数据和政策相关性综述_83页_3mb

Institutionalising Health Accounts in Brazil: A Review of Methods, Data and Policy Relevance

Executive Summary

Health accounts are a vital tool to obtain comprehensive and internationally comparable data on health expenditure and financing. This report reviews Brazil's efforts to institutionalise national health accounts aligned with international standards, assesses the methodologies and data sources used, and provides recommendations for regular production and enhanced policy impact.

Introduction and Methodology

The review assesses Brazil's comprehensive approach to construct health accounts, analysing the identified financing schemes, data sources, and methodologies. It benchmarks these against OECD countries and provides insights on institutionalisation and future scope expansions.

National Health Accounts – Tool for Tracking Health Spending

Health accounts track health spending through three axes: financing, service use, and provider perspectives. Based on the 2011 OECD/WHO health accounts framework, Brazil's approach aligns sufficiently with international practices for comparability.

Data Sources and Methodologies in Health Accounts

Brazil relies on various data sources to estimate health spending, including federal budget data (SIAFI), intergovernmental transfers (SIOPS), health information systems (SIA, SIH), and private sector data (ANS). The methodologies have produced results comparable to other OECD countries, though some refinement is needed for accuracy.

Brazil's Health Spending in an International Context

Current health spending in Brazil is lower per capita than OECD countries but accounts for a similar proportion of GDP. The financing architecture differs significantly, with voluntary insurance playing a larger role and public coverage being more limited.

Expanding Health Accounts Scope

Future work could include mapping health spending to providers, identifying revenue sources, tracking regional variations, and breaking down spending by disease and demographics, enhancing health accounts' analytical potential.

Strengthening Institutionalisation and Governance

Institutionalisation requires a dedicated team, legal mandate, strong data partnerships, and expert advisory groups. Institutional memory through proper documentation is crucial for sustainability.

Dissemination for Greater Policy Impact

Brazil should adopt comprehensive dissemination strategies with varied outputs for different audiences, similar to successful examples in other OECD countries.

Annex A: Key Classifications

The report includes the detailed classifications central to the System of Health Accounts 2011 framework used in the analysis.