1. Methodological improvements of SHA: Examples of good practice Markus Schneider Bruxelles, ONSS, Place Victor Horta, 20-21 septembre 2007 Organisé par Service public fédéral Sécurité sociale - SPP Politique scientifique - HIVA Katholieke Universiteit Leuven

2. Outline Concept of SHA1.0 + PG Criteria of good practice and improvements Examples: NL, PT, D, CZ, F Tools Requests on SHA2.0

3. Concept of SHA1.0

4. Concept of SHA1.0+PG

5. Actors, Activities, Inputs SHA1.0+PG ActorsProviders: ICHA-HP Financing agents: ICHA-HF, FS Consumers: Age, Gender, Diseases, BOD ActivitiesExpenditures: ICHA-HC, ICHA-HC.R Volumes Prices InputsHealth personnel (Health, Non-Health), Resources Costs (RC)

6. Criteria of good practice SHA1.0 Principles: –Comprehensiveness, Consistency (internal, over-time), Compatibility Organisation of statistical process: Input, Throughput, Output (Metainformation, National Manual) Transparency (Metainformation, Reporting Standards, National Manuals) International comparability (external consistency)

7. Methodological Improvements Related to the compilation of the SHA Cube Health care and non health care production (Netherlands) Integration of human resources and cost of illness (Germany, Czech Republic) Related to the compatibility of SHA Co-ordination with sectors of SNA (Portugal) Related to international comparability Concept of relative unit cost, EUCOMP AC/CC, TOSHA Related to the concept of SHA Value-added concept, Health-added concept, Financing concept

8. Example: NL Objectives: internal consistency with other accounts SNA, ESSPROS, multiple use, Responsibility: CBS, Health Statistics Approach: Provider side (HC, HCR, NHC), reconsiliation with financing side, Including Social Care Comprehensiveness: SHA Cube, Pilot compilations of Health personnel and Prices, Cost of Illness accounts (RIVM) Timeliness: 1998-2005 Issues: International comparability HF2.3, HC.3, HC5.2, Transparency (Non-health care),

9. Example: PT Objectives: internal consistency with SNA, Responsibility: INE, SNA department Approach: Reconsiliation SNA + Provider side + reconsiliation financing side Comprehensiveness: SHA Cube, Pilot compilations of Prices Timeliness: 2000-2005 Issues: International comparability: Outpatient care, Transparency of private provision, health consumption of tourists

10. PT: Consolidation with SNA Source: INE 2006

11. Example: DE Objectives: indepence of other accounts, limited links with other accounts SNA, ESSPROS, Responsibility: StBA, Health Statistics Approach: Financing side + reconsiliation providers side Comprehensiveness: SHA Cube, HLA account incl. Health Industries, Cost of Illness accounts, Timeliness: SHA 1992-2005, HLA 1995-2005, COI 2000, 2002, 2004 Issues: International comparability HF2.3, Transparency (press brochures instead comprehensive tables)

12. DE: Linking German Health Accounting Systems NHA HLACOIAProviders CFHMS-HP international ICHA-HP EuComp (Actors ) national WZ03 Source: Cordes 2004, StBA

13. Example: CZ Objectives: indepence of other accounts, limited links with SNA, Responsibility: CZSU, Health Statistics Approach: Financing side (Individual accounts) + reconsiliation providers side Comprehensiveness: SHA Cube and Cost of Illness accounts, Timeliness: SHA 2000-2005, COI 2000-2005 Issues: International comparability HF2.3, HC.3; Transparency ?

14. Results page - database

15. Summary of examples NLPTDECZ SHA Cubeyyyy Health Personnelyy Pricesy(y) Cost of Illnessyyy Financing Sources(y)

16. Tools Inventories: Actors, Activities and costing, Prices, Data Software Metadata: EUCOMP: HP Actors, HLA 1 Accounts (linked to EUCOMP) Software Accounts: TOSHA: SHA Cube, HLA 2 Accounts (linked to EUCOMP) COI: Disease List, Age classification

17. IHAT Common Questionnaire TOSHA Output TOSHA Throughput TOSHA Input National Database Flexibility, Confidentiality, Interfaces SHA 1.0 Software, License

18. Key assignment page

19. Compilation page

20. EUCOMP-ACC: International reconciliation

21. International Reconciliation: Relative unit costs

22. International Reconciliation: Relative unit costs of hospital care