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 ...For
Policy-Making
Health accounts represent an important tool for policymakers. A
key question that influences policy is: “How much is spent on
producing health care in this country—and how does this level of
spending compare to the past, and to other countries?” The answer to
this question, combined with other information about health and
demographic conditions, and the value placed on health by the given country, helps policymakers determine whether greater allocation of
scarce public funds to health is warranted. Health accounts information can be
used to justify and to track levels of investment in the health
sector.
Another key question that policymakers often ask is: “What health
services are being ‘purchased’ with this spending?” Health accounts
can show the proportion of spending on different types of services,
such as, for example, the proportion spent on inpatient services in comparison
with the share of total spending going toward
preventive services. While this information alone is insufficient to
guide policy choices, it represents an essential input into resource
allocation decisions.
A third question that policymakers may ask is: “What inputs are
being ‘purchased’ with this spending?” Health accounts can be used
to identify the major costs in the production of health services;
they can demonstrate, for example, how large a proportion of a
country’s total spending is dedicated to personnel, or to
pharmaceutical inputs. When viewed over time and/or in
comparison with other countries, this information can exert critical
influence over
decision-making.
A fourth question that can aid policymakers is: “Who is
benefiting from government spending?” Typically, governments
believe that much of their spending is being directed toward “public
goods”—health services that benefit the community but that
typically are not
demanded in sufficient volume by individuals acting alone.
They may also believe that a large share of public spending is benefiting families
that are too poor to pay for medical care. Health accounts (which
show spending patterns) combined with utilization data (which shows
who is using various types of services) can demonstrate which
population groups are benefiting from public health services,
and whether the above suppositions are correct at a given moment in
the development of a country’s
health system.
Many other questions are of interest to policymakers, and can be
addressed by using standard health accounts, or by conducting special studies that
can be incorporated into health accounts exercises with marginal effort and
cost. Several presentations and documents (listed below) provide some examples from the Latin America and the
Caribbean region.
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