Where can I get answers to my questions concerning health accounts?

If you have a question about how to create or use health accounts, please send us an e-mail.  Your question will be submitted to a specialist in the field of health accounts.  Please keep in mind that this is an evolving discipline, therefore we will guarantee a thoughtful response, but not necessarily one that is ¨right¨ or undisputable. 

How can I contribute to this website?

We welcome your submissions--data sources, research findings, suggestions for improving this website. Click here to contribute your ideas and materials.

Where can I obtain information regarding functions in a health system?

You can find a discussion on the issue of health system functions in the paper “La reforma de salud y la seguridad social”, written by Magdalena Rathe of the Dominican Republic. In addition, the OECD has developed classification for health care functions. 

Is it possible to obtain country specific health accounts data for one or several years?

One of the goals of the site is to answer this question and we hope to have more information about this soon. At the moment, you can find comparative data of the LAC health accounts regional network that includes Bolivia, Dominican Republic, Ecuador, El Salvador, Guatemala, México, Nicaragua, and Perú, in the article "Health care financing in eight Latin-American and Caribbean nations: the first regional NHA network", LACRSS No.16. The spreadsheets are not standard national health account matrices, but rather estimations of national health expenditures. They are produced regularly by PAHO.

The OECD methods are not realistic for my country. What do I do?

Analysts in many developing countries and transitional economies find that they must adapt the OECD methods to the realities of very limited data. Even among OECD countries, local adaptations are made to conform to the data availability and key policy questions being asked. The Guide to Producing National Health Accounts, developed with the joint support of WHO, World Bank, Harvard University, and USAID, describes the main ways in which the OECD guidelines can be adapted to low- and middle-income contexts. 

What health accounts methodology did the WHO use in its World Health Report? 

The source of data used by WHO is always official, but we do not know which institution provided it in Panama.

What are the purposes of creating health accounts?

Health accounts can be important tools for policymaking. Their main purposes are: (1) to show policymakers, program managers, development partners and citizens how public and private funds are allocated across health services, such as primary and hospital-level care, and inputs, such as personnel and medicines; and (2) to provide basic information for comparisons of spending over time and across countries.

What is the System of Health Accounts?

The System of Health Accounts (SHA) is an OECD-produced framework for collecting information on health care expenditures. Within this system, researchers, technical staff, and others can create new accounts or modify existing accounts using SHA standards. The information can help guide decisions on health care spending and other health and social economic issues.

What is the history of national health accounts activities in the Dominican Republic, and who has produced the latest estimates?

The only complete health accounts estimate in the Dominican Republic was done during 1997-98 for the year 1996. This activity was part of the Latin-American NHA regional network, with technical support from Harvard School of Public Health and financial support from USAID and PAHO. Afterwards the Central Bank has continued producing estimates for public sector health expenditures with the latest estimates available for year 1999.

What questions can be answered with health accounts data?

Analyses of health accounts data can answer many questions, including: How large is the health sector, relative to the rest of the economy? What are the relative sizes (in terms of spending) of the public and private sectors and of each public institution (such as Ministries of Health and Social Security Institutes)? What services account for the largest share of public and private health spending? Who is benefiting from public spending on health?

Why are IDB, PAHO, WB, and USAID coordinating their efforts?

IDB, PAHO, USAID and the World Bank are working together to promote the generation and use of health accounts in the Latin America and Caribbean region because all four organizations are committed to supporting good policymaking, based on solid empirical information. Each of the organizations has provided technical and financial support for health accounts in the past; now they are working together to make resources go further.

Which LAC countries have applied the OECD methodology?

Regarding countries using OECD methodology, Nicaragua is now completing a series from 1995 to 2001, with financial support from USAID. You can contact Miguel Medina, the health accounts coordinator at the Ministry of Health.