Quality Report for the Statistics on Health Expenditure
and Financing
Relevance of statistical data
Health Expenditure and Financing is a national statistical account
of health expenditure and financing in Finland that was brought
into use in 2008 as a result of a statistical reform. The data are
based on the concepts and classifications of the OECD System of
Health Accounts (SHA) and are available from 1995 onwards. The
statistical reform was carried out at STAKES between 2006 and 2007
to create a new statistical accounting system for health
expenditure and financing in order to meet both national and
international reporting needs. For the purposes of national
reporting, a set of reporting tables have been produced on the
basis of the data content of the SHA while also taking into account
national special features. More accurate data are reported
nationally on, for example, expenditure on care for the elderly and
medicines. Internationally, THL follows the data contents and
structures of a common data collection procedure, as specified by
the OECD, the European Statistical Office (Eurostat) and the World
Health Organisation (WHO).
The purpose of the statistics is to support decision-making and
guidance in social and health policy especially at the national
level. The statistics are targeted at decision-makers, planning
officials, researchers and students in the field of social and
health care and all others who need basic information on trends in
health expenditure and financing and related statistics nationally
and internationally.
Description of methods
The statistics are based on the System of Health Accounts (SHA),
which is a statistical framework that cross-tabulates data by
health care function, service provider and source of funding. The
system allows national health systems to be examined from a
perspective consistent with the national accounts. The
tri-dimensional system for recording health expenditure is based on
the International Classification for Health Accounts (ICHA). The
system divides health care functions into services provided
directly to individual persons and collective health care services.
The accounting system also distinguishes between the core functions
of health care and health-related functions.
The data for the statistics are gathered annually by making use
of various statistics and registers, research reports and financial
statements. Due to the limitations and shortcomings of statistical
datasets, the statistics are partly based on estimates.
The SHA is described in detail in an OECD manual published in
2000 (1). The Finnish translations of the health care functions,
service providers and sources of funding specified in the SHA
manual, as well as the detailed national SHA data contents, sources
and methods and an assessment of their reliability, can be found in
a separate report (2).
The following indexes are used in fixing expenditure at the
prices in the statistical year:
• Travel: Consumer price index for public transport (Liikenteen
kuluttajahintaindeksi. Terveydenhuollon yksikkökustannukset
Suomessa vuonna 2002. Hujanen et al. 2004);
• Prescription medication: wholesale price index for prescription
medicines (Reseptilääkkeiden tukkuhintaindeksi, Statistics
Finland)
• Over-the-counter medication: wholesale price index for
over-the-counter medicines (Käsikauppalääkkeiden tukkuhintaindeksi,
Statistics Finland)
• Other medical non-durables: consumer price index for
pharmaceutical products (Farmaseuttisten tuotteiden
kuluttajahintaindeksi, Statistics Finland)
• Other: Price index of public expenditure, municipal health
services (Statistics Finland)
Correctness and accuracy of data
The data are correct in so far as they have been reported correctly
and accurately. The data are checked at different stages of the
production process of the statistics. At the recording and
reporting stage, the data are compared with data from previous
years using various checking procedures. In unclear cases, those
who have produced the data are contacted in order to avoid errors
and find causes for changes.
Timeliness and promptness of published data
The statistics on health expenditure and financing are produced by
THL once a year after the data needed for the accounting process
are available. The final statistical data are published annually 14
months after the end of each statistical year. Drawing on these
data, the Ministry of Social Affairs and Health produces annual
preliminary data and predictions on health expenditure and
financing. International reporting follows the timetables of the
international statistical organisations (OECD, Eurostat, WHO,
NOMESCO).
Accessibility and transparency of data
Key data on health expenditure and financing are compiled into a
Statistical Report published on the THL website. In addition, key
data are reported nationally in THL's and Statistics Finland's
statistical yearbooks. Internationally, the SHA-based data are
reported in the OECD Health Data database and in the databases and
publications of Eurostat, WHO and NOMESCO.
Comparability of statistical data
In 2008, STAKES (today THL) brought into use a national system of
accounting health expenditure and financing that uses the concepts
and classifications of the OECD System of Health Accounts (SHA).
The statistics replaced the previous statistical accounts that were
based on a statistical accounting system developed within the
Social Insurance Institution in the 1980s. From 1960 onwards, the
data were published in the Social Insurance Institution's reports
on health expenditure and financing. STAKES has had the accounting
responsibility since 2001, after which the data have been reported
annually in an online statistical summary, Health Expenditure and
Financing. The old and new statistics are not comparable.
Comparable data in accordance with the accounting system in use at
present have been produced retrospectively from 1995 onwards.
Clarity and consistency
Data on health expenditure and financing are gathered for the whole
country. The statistics and reporting that draw on the data thus
cover health expenditure and financing at the national level. In
addition, the Statistical Report that is prepared on the basis of
the statistics on health expenditure and financing contains a
SHA-based comparison of health expenditure and financing in
different OECD countries.
Special issues concerning the 2009 statistics
In the statistical report for 2008, the method for dividing up
specialised somatic health care costs between inpatient care, day
surgery and outpatient care was changed. The data for 2004-2007
were then adjusted accordingly. In connection with the statistical
report for 2009, data was adjusted going all the way back to 1995,
making the data comparable throughout the full time series.
In the 2009 statistical report, the data on outputs and
investments in the annual national accounts by Statistics Finland
have also been updated going back to 1995.
In connection with the 2009 report, the method for dividing up
pharmaceuticals costs on the different functions was changed.
Unlike previously, the costs will no longer be divided according to
their reimbursement classification under National Health Insurance.
Instead, pharmaceuticals costs will be divided into prescription
medicines in outpatient care reimbursed under National Health
Insurance and those who are not reimbursed, and into self-care
medicines in outpatient care.
The method for estimating expenditure on private oral health
care not reimbursed under National Health Insurance was also
changed. The change in calculation method will produce lower
expenditure in this category.
1. OECD. A System of Health Accounts. Paris 2000.
2. Moilanen J, Knape N, Häkkinen U, Hujanen T, Matveinen P.
(2008) Terveydenhuollon menot ja rahoitus 1995-2005. OECD:n
terveystilinpitojärjestelmän (SHA, System of Health Accounts)
käyttöönotto kansallisessa tilastoinnissa. Loppuraportti. ('Health
Expenditure and Financing 1995-2005. Implementing the SHA System of
Health Accounts in National Statistical Accounting. Final
Report.'). Stakes, Raportteja 16/2008. Helsinki
2008. |