National health accounts

• National Health Accounts (NHA) document and characterize the flow of resources in a country's health sector
• Health spending includes all expenses for activities aimed at restoring, improving, and maintaining health
• NHA describes the sources, uses, and channels for all funds used in the production and consumption of healthcare goods and services
• NHA can be used to confirm or support data from other sources, track outcomes of health sector reforms, compare trends in expenditure across countries, and measure performance against international benchmarks
• NHA in relation to universal health coverage is designed to facilitate the implementation of health system goals by policymakers
• NHA focuses on actual expenditure in the health sector from all sources (government, private, and external donors)
• NHA is important for planning processes as it traces how resources are mobilized and managed, who pays for healthcare, and how much is paid
• SHA model provides a structure for estimating health expenditure for international, sub-national, and sub-accounts comparisons
• NHA tracks who provides goods and services, how resources are distributed, and provides information for policy dialogue in health financing
• NHA aims to improve the health of the population and protect families from unfair financial burden
• Indicators in the National Health Accounts report include Annual total health expenditure (THE), Current health expenditure (CHE), and Capital spending (HK)
• NHA monitors the flow of money in the health sector and is an international accounting framework for tracking health spending
• NHAs are designed to answer questions such as where health resources come from, who pays for healthcare, what goods and services are purchased, where resources go, how resources are mobilized and managed, who uses goods and services, and who benefits from the spendings
• NHA data is useful for evidence-based policy making, guiding health financing decisions, influencing budget allocations, and advocating for more funds for Universal Health Coverage (UHC)
• The core accounting framework of the System of Health Accounts (SHA) is organized around classifications of the functions of health care, health care provision, and financing schemes
• The framework defines the boundaries of health care activities to include all spending activities aimed at improving, maintaining, and preventing the deterioration of health status
• The National Health Accounts process involves a team consisting of representatives from the national statistical office, ministries of health and finance, and academic and research institutions
• Benefits of NHA include facilitating the implementation of health system goals, providing optimal goods and services, protecting from financial burden, identifying areas of resource wastage, guiding future policies, promoting policy dialogue, and enabling cross-country comparisons
• Sources of data for NHA include government budgets, ministries of health, donors and NGOs, insurance providers, enterprises, and households
• NHA can inform health reforms, track expenditures for accountability, prioritize resources effectively, and guide evidence-based policy making
• Limitations and challenges of NHA include the time-consuming process of data collection and analysis, contextualizing the framework to fit a country's health system, challenges in data quality, and the financial approach to costs rather than economic costs
• Data quality challenges include difficulties in obtaining actual disbursement data, unwillingness of donors and the private sector to provide necessary data, and the exclusion of costs associated with time off work to access health services