1. Hungarian National Health Accounts, 1998 - 2000
Separation of expenditure by function within hospitals
Maria Goschi MANNO
Maria Mihalyne HAJDU
10-11 October 2002
OECD Paris

2. Hungarian National Health Accounts, 1998 - 2000
Topics
Completed SHA and other tables
Raw databases
SHA: Table 2. calculations
Estimations
Importance of Sector of Hospital
Problems to be solved in the future
October 2002
OECD Paris

3. Hungarian National Health Accounts, 1998 - 2000
Completed SHA tables
SHA Table 2. (= HNHA table 5)
Total current health expenditures by functions of health care and types of service providers
SHA Table 3. (= HNHA table 9)
Total current health expenditures by types of service providers and financing agents
SHA Table 4. (= HNHA table 7)
Total current health expenditures by functions of health care and financing agents
October 2002
OECD Paris

4. Hungarian National Health Accounts, 1998 - 2000
Completed other tables
HNHA Table 1: Health expenditures by financing agents
HNHA Table 2: Development of health expenditures as percentage of GDP
HNHA Table 3: Real value of health expenditures
HNHA Table 4: Current health expenditures by functions of health care and types of service providers
HNHA Table 6: Current health public expenditures by functions of health care and types of service providers
HNHA Table 8: National Health Insurance expenditures by functions of health care
HNHA Table 10: Total current health expenditures by type and form of service providers and by financing agents
October 2002
OECD Paris

5. Hungarian National Health Accounts, 1998 - 2000
Raw databases
Annual reports of the budgetary institutions
Financing data of the National Health Insurance Fund
Hungarian Central Statistical Office (HCSO): Household statistics
HCSO: Non-profit organisations
HCSO: National Accounts
HCSO: Investment statistics
Tax Finance and Control Office (TFCO): Self-employed
TFCO: Enterprises
Private Health Insurance Fund - surveying
Enterprises: - at an estimations
October 2002
OECD Paris

6. Hungarian National Health Accounts, 1998 - 2000
SHA: Table 2. calculations – Step 1
Sort of the budgetary institutions
Sort of functions of budgetary institutions
Individual classification to four groups by three Hungarian legal rules.
Breakdown to eight main categories on the basis of codes of so-called „special tasks”. The first main group is the group of healthcare functions.
Within the healthcare group the functions were primarily collated with the SHA functions.
Results:
Separation of non-health care functions of healthcare institutions.
Elaboration of SHA table of the budgetary institutions
(Version 1).
October 2002
OECD Paris

7. Hungarian National Health Accounts, 1998 - 2000
SHA: Table 2. calculations – Step 1
Breakdown of current health expenditures by functions
Summary of breakdown of current expenditures
October 2002
OECD Paris

8. Hungarian National Health Accounts, 1998 - 2000
SHA: Table 2. calculations – Step 2 - 3
Correction with financing data of the National Health Insurance Fund
Functional separation
Separation of one-day care from inpatient care
Separation from inpatient service
Clinical laboratory services
Diagnostic imaging services
Kidney dialysis
Home special care
Result: a functional classifications is identical with of OECD SHA
(Version 2)
NHIF payments to private institutions
All cells in the SHA 2. (Version 2) table were increased by NHIF payments to private sector
Result: SHA 2. (Version 3)
SHA 2. (Version 3) =
SHA 2. (Version 2) + NHIF to private
October 2002
OECD Paris

9. Hungarian National Health Accounts, 1998 - 2000
SHA: Table 2. calculations – Step 4
Correction with data of private sector
Incomes of private hospitals from private sector
The value of paying from private sector is decreased by item to budgetary institutions.
These results were added to the data of the SHA 2. (Version 3)
Supposition: the total expenditure of private hospitals are allocated to inpatient services.
Result: Final SHA 2.
SHA 2 = SHA 2 (Version 3) + private sector
October 2002
OECD Paris

10. Hungarian National Health Accounts, 1998 - 2000
SHA: Table 2. calculations - outcome
October 2002
OECD Paris

11. Hungarian National Health Accounts, 1998 - 2000
Estimations – 1 (Screening overlaps)
Representative collection of „unspecified” income data of the budgetary hospitals
„Unspecified” income amounted to 10% of the total revenues of the hospitals
Result:
Elimination of cumulated data
About 30% of the „unspecified” income was eliminated
October 2002
OECD Paris

12. Hungarian National Health Accounts, 1998 - 2000
Estimations -2 (Universities of medical sciences)
The three main tasks of Universities of medical sciences
Education
Research
Health care services
Integration of Universities
In 1998 and 1999 years:
independent institutions
From 2000 year:
integrated institutions
Separation of Universities of medical sciences
„Clinical” institution
This data appears in SHA tables
„Education and research” institution
SHA tables were not included.
October 2002
OECD Paris

13. Hungarian National Health Accounts, 1998 - 2000
Estimations -2 (Universities of medical sciences)
Distribution of expenditures of universities of medical sciences
October 2002
OECD Paris

14. Hungarian National Health Accounts, 1998 - 2000
Role and weight of the hospital sector - 1
Breakdown of total current health expenditure by types of service providers
Almost 40% of health care expenditures is dedicated to hospitals activities.
The objective of healthcare policy: decrease the rate.
October 2002
OECD Paris

15. Hungarian National Health Accounts, 1998 - 2000
Role and weight of the hospital sector - 2
Breakdown the total health expenditures by functions health care
The total health expenditures realised
31 % to inpatient care
39 % to medical goods
16 % to outpatient care
OECD Paris

16. Hungarian National Health Accounts, 1998 - 2000
Role and weight of the hospital sector – 3 (general hospitals)
Breakdown of health expenditures of general hospitals by functions of health care
General hospitals
„Clinical” institutions
Out of hospitals’ health expenditures almost 80 % is dedicated to inpatient services.
The diagnostic services rendered to inpatients are recorded under inpatient function. (These expenses are included in DRG.)
October 2002
OECD Paris

17. Hungarian National Health Accounts, 1998 - 2000
Role and weight of the hospital sector – 4 (The hospitals in outpatient services)
Breakdown of expenditures of outpatient services by types of service providers
Within outpatient services hospitals represent a significant proportion.
The expenditures realised at the hospitals:
73% of the total outpatient rehabilitative care
59 % of the total specialised outpatient care (HC.1.3.3)
28 % of the total outpatient care
October 2002
OECD Paris

18. Hungarian National Health Accounts, 1998 - 2000
Problems to be solved in the future
Studying of functional structure of healthcare expenditure in private sector.
Completion of the Non-profit statistics.
Indirect calculation from data of the Household statistics.
Elaboration the rest SHA tables.
Development of IT system.
Elaboration of regional accounts.
October 2002
OECD Paris

19. Hungarian National Health Accounts, 1998 - 2000
Thank you for all your attention.
Lunch break
October 2002
OECD Paris