1. National Health Accounts in the Czech Republic
OECD meeting of experts in NHA, October 2003, Paris
National Health Accounts in the Czech Republic
Present state
and implementation of
the System of Health Accounts methodology
Institute of Health Information and Statistics of the Czech Republic

2. Present information systems covering area of health
National Health Information System (IHIS)
Government Finance Statistics (Ministry of Finance)
International databases (OECD, WHO)
National Accounts (Czech Statistical Office)
Institute of Health Information and Statistics of the Czech Republic

3. Activities related to implementation of SHA
Translation of SHA manual and conversion of national classifications to ICHA
Monitoring of available data sources
Modifications of statements of health insurance companies, collection and analysis of new data
Preparation of data collecting and methods of expenditures estimation from other sources
Institute of Health Information and Statistics of the Czech Republic

4. Expenditures monitored by current sources
Source of funding
Source covers mainly area of:
Share in total
General government
- collective health care services
- capital formation
- health related functions
10%
Social Security Funds
- personal health care services
80%
Private household o-o-p expenditure
pharmaceuticals
therapeutic appliances
services of dental care
Institute of Health Information and Statistics of the Czech Republic

5. Main data sources Government expenditure Social security funds
HF.1 → functions of budget (HP.x/HC.x)
Social security funds
HF.1.2 → segments of care (HP.x/HC.x)
Household out-of-pocket expenditure (Family Accounts Statistics)
HF.2.3 → COICOP (HC.x)
Institute of Health Information and Statistics of the Czech Republic

6. Supplementary data sources
Economics of health establishments - assets and debts, costs (by type of care) and returns (by source) of health establishments
HF.x → HP.x → type of care
Health employment: HP.x → occup.&wages
Economic data on pharmacies (revenues)
HF.x → HP.4 → HC.5
Drug consumption by ATC: HC.5
Health care for foreigners: HF.x → HP.1
Institute of Health Information and Statistics of the Czech Republic

7. Potential data sources
Long-term nursing care in social establishments: HP.2 → HC.3
National accounts - sector accounts and branches production accounts (HF.2.4)
Occupational health care financed by corporations: HF.2.5 → HC.6.5
Private health insurance (HF.2.2)
Institute of Health Information and Statistics of the Czech Republic

8. Problems and challenges Functions of health care
Determination of boundaries for health care, health-related care and non-health care.
included: education and research
excluded: long-term nursing care in social care establishments
Differences in definitions of functions
modes of production: day care not defined
types of episode of care: data not available or in different structure
Institute of Health Information and Statistics of the Czech Republic

9. Problems and challenges Providers of health care
Boundaries for health care industries
problem of different sources of data
Type of provider reporting data
legal subjects (used at present) x units of homogenous production
Institute of Health Information and Statistics of the Czech Republic

10. Problems and challenges Financiers of health care
Not all groups of financiers are included → involving other financiers
Real allocation of all resources (a concrete purpose of use) needn’t be known when collecting data from financiers
→ broader use of data from providers
Institute of Health Information and Statistics of the Czech Republic

11. Forthcoming plans
To publish first estimates of health expenditures by SHA structure
To continually solve appropriate evaluation of types of health care according to ICHA-HC
To join expenditure data with non-monetary health data from other sources (e.g. length of stay and number of hospitalisations by age, sex and ICD)
To review ICHA consistency when combining data from different sources
Institute of Health Information and Statistics of the Czech Republic

12. Contact Institute of Health Information and Statistics (www.uzis.cz)
Jakub Hrkal
Czech Statistical Office (
Jiří Papánek
Institute of Health Information and Statistics of the Czech Republic