Orestis Tsigkas ESTAT-F5 JHAQ 2015 Data collection & 3rd pilot collection based on SHA 2011 Item 7.1 of the agenda Orestis Tsigkas ESTAT-F5 26-27 November 2015 Working Group Public Health

Working Group Public Health JHAQ 2015 Data collection 26-27 November 2015 Working Group Public Health

Working Group Public Health JHAQ 2015 Common effort of EUROSTAT, OECD and WHO 10 rounds of JHAQ since 2005 Evolution and improvement of the JHAQ JHAQ package: Launched in January 2015 Excel files with data and Excel file for metadata, explanatory notes, Technical guidance 26-27 November 2015 Working Group Public Health

SHA 2011 methodology Calendar for the transition JHAQ 2015: Only SHA 2011 data are published 26-27 November 2015 Working Group Public Health

Working Group Public Health JHAQ 2015 Results 31 "Eurostat" countries submitted the JHAQ 2015 SHA 2011: 24 countries (18 MSs, 4 EEA/EFTA countries and 2 candidate countries)  13 of them submitted also the SHA 1.0 JHAQ SHA 1.0 (only): 7 countries Liechtenstein submitted SHA 2011 for the first time Bosnia & Herzegovina continued submissions at detailed level Republic of Kosovo, Serbia and Turkey: submitted data at various level of aggregation 26-27 November 2015 Working Group Public Health

Working Group Public Health JHAQ 2015 Results Non-reporting countries: Luxembourg, Malta & Italy did not submit the JHAQ Ireland compiled SHA 2011 data and submitted them as confidential to the IHAT United Kingdom: aggregates only 20 "Eurostat" countries used eDAMIS for transmitting their data 26-27 November 2015 Working Group Public Health

Dissemination of JHAQ 2015 Results 6 new Tables on Eurobase for SHA 2011 data Time-series for 2003-2012 (SHA 1.0) retained  13 Tables that have been used up to now JHAQ 2015: Only SHA 2011 data are published Data for 10 countries have been uploaded on Eurobase up to now 26-27 November 2015 Working Group Public Health

Working Group Public Health Conclusions The Working Group is invited to: take note of the work performed to process data collected in the framework of JHAQ 2015 Countries that have still not submitted data in the framework of the JHAQ 2015 data collection exercise are invited to clarify their intention to send data for the reference year 2013. Countries, for which the validation has not been finalised, are invited to respond to the messages sent by the IHAT as soon as possible and not later than 4 December 2015. 26-27 November 2015 Working Group Public Health

Final Report of the SHA 2011 pilot TESTING 26-27 November 2015 Working Group Public Health

Working Group Public Health Pilot testing of SHA 2011 BACKGROUND 2012: decision for pilot testing of SHA Tables based on SHA 2011 2013: 1st pilot testing of SHA 2011 9 countries submitted data 2014: 2nd pilot testing of SHA 2011 16 countries submitted data 2015: 3rd pilot testing of SHA 2011 29 countries submitted data 23 countries officially submitted SHA 2011 Tables for the JHAQ 2015 exercise 6 countries submitted SHA 2011 Tables as part of the pilot exercise 26-27 November 2015 Working Group Public Health

Working Group Public Health Timetable 26-27 November 2015 Working Group Public Health

Working Group Public Health SHA 2011 submissions 2013-2015 26-27 November 2015 Working Group Public Health

Working Group Public Health 1st Pilot - Outcome Reporting SHA 2011 variables is feasible, but a number of challenges are still to be addressed: not only specific to SHA 2011 reporting requirements mostly regarding the disaggregation at lower digit level Overall consistency between SHA 1.0 and SHA 2011 categories at the 1st-digit level There was a particular focus on: the new categories of prevention (HC.6) the alignment of long-term care (HC.3) any shift in the structure of financing with the change in concept to financing schemes (HF) in the SHA 2011 framework. 26-27 November 2015 Working Group Public Health

Working Group Public Health 2nd Pilot - Outcome The outcomes of the first pilot were corroborated Observations on challenges towards the transition to the SHA 2011 methodology were reinforced Existing time series preserved, particularly at the first-digit level, for the majority of categories Implementation of SHA 2011 is not a one-step process For the majority of countries, a lengthier period of refinement and revision of data sources, classifications and estimations could be expected 26-27 November 2015 Working Group Public Health

Working Group Public Health 2nd Pilot - Outcome The impact of these revisions, in terms of volume and scope, has to be monitored carefully. Improvements due to: work in the methodological field improved definitions and criteria for inclusion and exclusion of the SHA 2011 manual. Certain areas (i.e. split between modes of provision) where further work was required to increase the international comparability of data. In most cases, existing issues that were not specific to a shift from SHA 1.0 to SHA 2011 26-27 November 2015 Working Group Public Health

Working Group Public Health 3rd Pilot Data Collection according to SHA 2011 29 countries compiled and submitted data according to the SHA 2011 methodology. The majority of the 23 countries that officially submitted the SHA 2011 questionnaire had already participated in one of the pilot exercises. 7 countries that submitted the SHA 2011 questionnaire had not previously submitted comparable SHA 1.0 tables  In these cases, a direct comparison of SHA 2011 and SHA 1.0 estimates has not been possible. 26-27 November 2015 Working Group Public Health

Working Group Public Health Country Submissions 26-27 November 2015 Working Group Public Health

3rd Pilot Data Collection according to SHA 2011 All countries  3 main tables cross-classifying the dimensions (HC, HF, HP) 7 countries  financing (HF) by revenues (FS) 3 countries  factors of provision (HPxFP) 10 countries  some information on capital spending (HKxHP) In many cases, multiple years were submitted

Working Group Public Health Production of the SHA 2011 Tables 2 approaches for compiling data 1st approach: mapping of SHA 1.0 categories onto SHA 2011 ones, (mainly) by using the default correspondence Tables Refinements on a case-by-case basis 2nd approach: direct allocation of expenditures recorded in national health account system to SHA 2011 categories 26-27 November 2015 Working Group Public Health

Factors for observed changes in SHA 2011 a. Change of boundaries of specific categories under SHA 2011 b. Availability of new data sources c. Reclassifications due to: new information on existing data sources better guidance of the SHA 2011 manual in-depth revision of existing classifications changes introduced during discussions with data providers, stakeholders in the data collection and national accountants d. New estimation methods for specific items or refinement of existing estimation methods

Current Expenditure on Health Observed changes due to: decreases  spending on preventive care more detailed definitions changes in reported long-term care spending

Working Group Public Health Health Care Functions Continuity of reporting without breaks for: HC.1;HC.2 Services of curative and rehabilitative care Disaggregating HC.1;HC.2 into modes of provision still challenging HC.4 Ancillary services to health care HC.5 Medical goods dispensed to out-patients Attention to the split between HC.5.1.1 and HC.5.1.2 HC.7 Governance and health system and financing administration Attention to the split between HC.7.1 and HC.7.2 26-27 November 2015 Working Group Public Health

Working Group Public Health Long-Term Care (HC.3) 26-27 November 2015 Working Group Public Health

Working Group Public Health Prevention (HC.6) 26-27 November 2015 Working Group Public Health

Working Group Public Health Health Care Financing Schemes Public/private vs Compulsory/voluntary  Minimal impact One-to-one mapping for household out-of-pocket payments, HF.2.3 (SHA 1.0) to HF.3 (SHA 2011) One-to-one mapping for “HF.2.5 Corporations” (SHA 1.0) to “HF.2.3 Enterprise financing schemes” (SHA 2011) Working Group Public Health

Compilation Issues HC.1.3.9 All other outpatient curative care n.e.c. Long-term care (HC.3 + HCR.1) HC.4 Ancillary services (non-specified by function) HC.5.1 Pharmaceuticals and other medical non-durable goods HC.6 Preventive care HC.7 Governance, and health system and financing administration HP.8.9 Other industries n.e.c.

Working Group Public Health Overview Outcomes of the 1st and 2nd pilots were validated Current time series preserved, particularly at the first-digit level The implementation of SHA 2011 is not a one-step process long-lasting refinement and revision of data sources, classifications and estimations can be expected 26-27 November 2015 Working Group Public Health

Working Group Public Health Overview Challenges Split between modes of provision Realign long-term care spending with the better defined definitions in SHA 2011 Prevention  identifying appropriate data sources and allocation rules Review of classification methodologies to ensure a proper accounting rather than relying on a one-to-one mapping 26-27 November 2015 Working Group Public Health

Working Group Public Health SHA 2011 Grants 6 countries received grants for implementing the SHA 2011 methodology Actions expected to be finalised by end of November 2015 for 5 countries and end of March 2016 for one country 26-27 November 2015 Working Group Public Health

Working Group Public Health Conclusions The Working Group is invited: comment on the results and conclusions of the pilot-testing exercise indicate possible difficulties in migrating to SHA 2011 reporting in 2016 26-27 November 2015 Working Group Public Health