1. II National Meeting of Producers and Users of Social, Economic and Territorial Information Rio de Janeiro, August 21- 25, 2006 V National Conference on Statistics IV National Conference on Geography and Cartography Health Satellite Accounts: Diagnostic of the Health Accounts Methodologies in Latin America and the Caribbean August 23, 2006 Ruben M. Suarez Berenguela Suarezru@paho.org Regional Advisor Health Economics and Financing

2. Health Satellite Accounts: Diagnostic of the Health Accounts Methodologies in Latin America and the Caribbean Health Accounts Methodologies: Non-SNA: –National Health Accounts - NHA –System of Health Accounts – National Health Accounts SNA - Based: –National Health Expenditure Accounts -NHEA –Health in the System of National Accounts –Health Satellite Accounts: Health Sector/System Satellite Accounts Household Sector Satellite Accounts: Gender & Health Populations’ Health Satellite Accounts

3. Health Satellite Accounts: Diagnostic of the Health Accounts Methodologies in Latin America and the Caribbean Health Accounts Methodologies: Non-SNA: –National Health Accounts - NHA –System of Health Accounts – National Health Accounts SNA - Based: –National Health Expenditure Accounts -NHEA –Health in the System of National Accounts -SNA –Health Satellite Accounts: Health Sector/System Satellite Accounts Household Sector Satellite Accounts: Gender & Health Populations’ Health Satellite Accounts Methodologies: –Concepts –Classifications –Boundaries –Data Sources/Estimation Procedures Results: –National Health Expenditures - Gross –Final Consumption Expenditure

4. National Health Expenditure Accounts - NHEA (Expenditure and Flows of Funds - NHA *) Health Accounts: Approaches National Health Expenditure Accounts -NHEA (Expenditure and Sources of Financing/Revenues) Health in the System of National Accounts -SNA Satellite Accounts - Health Health Satellite Accounts: Diagnostic of the Health Accounts Methodologies in Latin America and the Caribbean

5. System of Health Accounts OECD's SHA Health Expenditure and Financing Flows (NHA*) NHA Harvard PHR Plus USAID National Health Expenditure Accounts -NHEA (Expenditure and Flows of Funds - NHA *) NHA* Producers Guide; USAID/World Bank/WHO Health Satellite Accounts: Diagnostic of the Health Accounts Methodologies in Latin America and the Caribbean Non SNA:

6. Health Accounts Approaches National Health Expenditure Accounts –(NHEA) National Health Expenditure and Sources of Financing/Rev enues PAHO NHEA (NHExp Data Base) UN/SNA: Functional Classifications Health Satellite Accounts: Diagnostic of the Health Accounts Methodologies in Latin America and the Caribbean SNA Based:

7. Health Satellite Accounts: Diagnostic of the Health Accounts Methodologies in Latin America and the Caribbean

14. Health Accounts Methodologies: Non-SNA: –National Health Accounts - NHA –System of Health Accounts – National Health Accounts SNA - Based: –National Health Expenditure Accounts -NHEA –Health in the System of National Accounts -SNA –Health Satellite Accounts: Health Sector/System Satellite Accounts Household Sector Satellite Accounts: Gender & Health Populations’ Health Satellite Accounts Methodologies: Convergence to work within the SNA framework Correspondance or Satellite Accounts Results: ? We know how much is being spent (NHExp); We do not know how much is being produced and how much is being used as Final Consumption Expenditures

15. National Health Expenditure Accounts - NHEA (Expenditure and Sources of Financing/Revenues) National Health Expenditure and Sources of Financing PAHO NHEA (NHExp**) -UN's Functional Classifications Health Accounts Approaches Health in the System of National Accounts - SNA Health and Health Sector Economic and Financial Indicators Supply and Uses Tables SUT -Health Health Satellite Accounts: Diagnostic of the Health Accounts Methodologies in Latin America and the Caribbean SNA Based:

16. Tabelas de Usos de bens e serviços - Demanda e Valor Adicionado A =B 1 +B2 C

17. Health in the System of National Accounts -SNA Health Services Sector/ System Satellite Accounts Health Accounts Approaches Health Satellite Accounts HAS Health and Health Sector Economic and Financial Indicators Household Sector Satellite Accounts: Gender and Health Populations' Health Satellite Accounts (Health Outcomes) Health Satellite Accounts: Diagnostic of the Health Accounts Methodologies in Latin America and the Caribbean SNA Based:

18. Household Sector Satellite Accounts: Gender & Health Actions: Making visible women’s contributions to health and development : Household sector accounts – complement to HSA & SNA The burden of under-funded public health care systems “cost shifting”/ invisible costs of cost containment/adjustment policies The impact of demographic and epidemiologic changes Women’s contribution to human development potential & poverty reduction Health Satellite Accounts: Diagnostic of the Health Accounts Methodologies in Latin America and the Caribbean

23. Heaalth Accounts Approaches Concepts ClassificationsBoundaries Data Sources/Estimation Methods System of Health Accounts OECD's SHA Agents: Providers, Sources of Funding, Resident Units Functional: (Activities, Products, Purposes) HICHA Financial/Administrative Data NHA Harvard PHR Plus USAID Agents, Providers, Financial Intermediaries Ad-hoc Financial/Administrative Data NHA* Producers Guide; USAID/World Bank/WHO Agents, Actors, Provider Agents, Financing Agents Functional: (Activities, Products, Purposes) HICHA Financial/Administrative Data PAHO NHEA (NHExp**) -UN's Functional Classifications Insitutional Units and Sector -SNA (5) + Rest of the World Classification of Expenditures by Functions or Purposes CEF/CEP: COFOG, COICOP, COPNI, COOP Financial/Administrative Data Health Satellite Accounts: Diagnostic of the Health Accounts Methodologies in Latin America and the Caribbean SNA Based:

24. Heaalth Accounts Approaches Concepts ClassificationsBoundaries Data Sources/Estimation Methods PAHO NHEA (NHExp**) -UN's Functional Classifications Insitutional Units and Sector -SNA (5) + Rest of the World Classification of Expenditures by Functions or Purposes CEF/CEP: COFOG, COICOP, COPNI, COOP Financial/Administrative Data Supply and Uses Tables SUT -Health Insitutional Units and Sector -SNA (5) + Rest of the World Activities -ISIC; Products, CPC; Expenditure by Functions or Purposes CEF/CEP) Economic and Financial Indicators Health Satellite Accounts: Diagnostic of the Health Accounts Methodologies in Latin America and the Caribbean SNA Based:

25. Heaalth Accounts Approaches Concepts ClassificationsBoundaries Data Sources/Estimation Methods Health Services Sector/ System Satellite Accounts Insitutional Units and Sector - SNA (5) + Rest of the World Activities -ISIC; Products, CPC; Expenditure by Functions or Purposes CEF/CEP) Institutions, Activities, or Products & Services Economic and Financial Indicators Household Sector Satellite Accounts: Gender and Health Insitutional Units and Sector - SNA (5) + Rest of the World Activities -ISIC; Products, CPC; Functional by Purposes; ICATUS Activities, or Products Economic and Financial Indicators Populations' Health Satellite Accounts (Health Outcomes) Insitutional Units and Sector - SNA (5) + Rest of the World Activities -ISIC; Products, CPC; Functional by Purposes; ICATUS, Human Development HD* ?Economic and Financial Indicators SNA Based: