2015年-世界发展银行全球_National_Health_Accounts_Data_from_1996_to_2010___A_Systematic_Review_15页_1mb

Summary of "National health accounts data from 1996 to 2010: a systematic review"

Core Content

This study systematically reviewed and compiled national health accounts (NHA) data from 1996 to 2010 across 117 countries. The goal was to evaluate the completeness and quality of publicly available NHA reports and to make the data accessible through an online visualization tool.

Main Objectives

• Collect and evaluate NHA reports globally from 1996 to 2010.
• Compile and standardize data across four key financial data types: financing source, financing agent, health function, and health provider.
• Make the data publicly available for cross-country comparisons and research purposes.

Key Findings

• Total Data Collected: 872 NHA reports from 117 countries, containing 2936 matrices or tables.
• Data Completeness: Only 252 of the 872 reports contained data in all four types, indicating that most countries did not provide complete health expenditure data.
• Not-Specified-by-Kind (NSK) Expenditure:
  • In some countries, NSK expenditure accounted for more than 75% of the total in financing source matrices.
  • The generated NSK component was the largest in financing source and health provider matrices.
  • For 46% of countries, the generated NSK component made up at least 50% of the total NSK component.
  • For all OECD countries, NSK was often necessary to account for discrepancies in the data.
• Quality Issues:
  • Year-on-year changes in health expenditure were sometimes substantial and likely due to data generation processes.
  • Some countries reported over- or under-reporting at the item level, as reflected in the NSK components.
• Geographic and Income Disparities:
  • High-income OECD countries produced the most NHA reports, with a median of 100% report availability and 98% matrix availability.
  • Non-OECD, high-income countries produced very few reports.
  • Lower-middle and low-income countries had the lowest report availability, with the median number of tables reported being zero for these groups.
• Data Sources:
  • NHA reports were collected from the WHO global health expenditure database, OECD StatExtracts, and direct contacts with countries and Abt Associates.
  • Data were formatted to conform with the OECD SHA 2000 framework.
• Public Access:
  • All study data are publicly available via the online visualization tool at http://vizhub.healthdata.org/nha/.

Key Information

• Data Types:
  • (i) Financing source: identifies where health resources come from.
  • (ii) Financing agent: identifies who manages health spending.
  • (iii) Health function: identifies what goods and services are purchased.
  • (iv) Health provider: identifies who provides health services.
• NSK Categories:
  • Given NSK: Expenditure not clearly categorized under SHA categories.
  • Generated NSK: Adjusted values to make up for discrepancies between the sum of categories and the total reported expenditure.
• Challenges:
  • Many countries did not follow the SHA framework, reducing data comparability.
  • There is a lack of transparency regarding the data and methods used to impute missing values.
  • Data collection lags, particularly for 2010, may affect the availability of up-to-date information.

Conclusion

The study highlights the importance of comprehensive and standardized health expenditure data for policy-making and research. It also underscores the current limitations in data availability and quality, particularly in non-OECD and low-income countries. Improved data collection and reporting would enhance the ability of health systems to allocate resources effectively and enable more accurate international comparisons.

Methodology Highlights

• Search and Collection:
  • Reports were obtained from WHO, OECD, and direct sources.
  • Data were extracted and formatted according to the SHA 2000 framework.
• Data Aggregation:
  • Data were aggregated into broader categories, and NSK components were used to account for discrepancies.
• Visualization Tool:
  • An interactive tool was developed to make the data accessible and usable for analysis.
• Data Availability:
  • Data were converted to US dollars at 2010 values for consistency.
  • The maximum number of reports per country was 15 (one per year from 1996 to 2010).
  • The maximum number of matrices per country was 60 (four per year for 15 years).

Implications

• The lack of complete and standardized data limits the ability to make accurate comparisons and informed policy decisions.
• The study provides a valuable resource for researchers, policymakers, and health administrators to understand global health expenditure patterns.