1. 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

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

3. 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

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

5. 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

6. 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

7. Dissemination of JHAQ 2015 Results
6 new Tables on Eurobase for SHA 2011 data
Time-series for (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

8. 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

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

10. 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

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

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

13. 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

14. 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

15. 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

16. 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

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

18. 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

19. 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

20. 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

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

22. 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 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

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

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

25. 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

26. 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.

27. 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

28. 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

29. 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

30. 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