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Health Accounts- financial data for decision makers
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Subject Area="Health financing." Objective="Information for policy makers."
Details for Reform Option "Health Accounts- financial data for decision makers"
Summary

Background: Over the past 10 years, many countries have established a system of health accounts to provide policy makers with detailed, useful and appropriate financial data. Action: National health accounts (NHA) constitutes a comprehensive set of tables designed to quantify, classify and analyse the income and expenditures in the health sector (in both the public and private sector) of the country. At present, expenditures on health have been accounted only for the public sectors. The NHA will seek to integrate both these sectors so that the indicators for the health system of the country on the whole could be ascertained. NHA would, for example, give a clear picture regarding the split between health expenditures by the public and private sector. Similarly it would reveal allocations to the tertiary, secondary and primary levels of healthcare in the country. The Government of India has committed to develop NHA in the National Health Policy 2002. [see para (2.19.2.2) and para (4.19.2)] The Ministry of Health is still in the process of developing this. The issue has been discussed at at least two national workshops. Initial health accounts have been prepared in three states and a framework prepared for the preparation of NHA.

Cost
Place Studies conducted in the States of Punjab, Karnataka and Rajasthan. At the national level, the Ministry of Health is in the process of taking this agenda forward.
Time Frame Could take five to 10 years to get a fully-fledged NHA in place.
Advantages

Comprehensive: Helps to form a comprehensive information base on which policy makers can assess performance and diagnose problems with the health systems in a country and thus take action. Comparable: Allows international comparison of health financing and expenditure patterns. Analytical: Once established, health accounts produced for multiple years allow trends to be analysed.

Challanges

Time consuming: It takes several years to fully establish a system of NHA.

Prerequisites

Data from: (i) Central, state and local government budget documents and statistical abstracts. (ii) Annual reports of state-owned enterprises and health insurance companies, in particular, Employee State Insurance Scheme and Central Government Health Scheme. (iii) National Survey Sample Organisation household surveys for private health expenditures. Setting up of a task force in order to decide on the following: (i)The methodology to be used. (ii)The appropriate institutional arrangements to produce the accounts at various levels. (iii) The funding arrangements to produce health accounts. (iv) Training of key personnel in health accounts methodology. (v) Decide on how data would be used e.g. how it would be incorporated into the existing budgeting process. Setting up of a task force in order to decide on the following: 1. The methodology to be used. 2. The appropriate institutional arrangements to produce the accounts at various levels. 3. The funding arrangements to produce health accounts. 4. Training of key personnel in Health Accounts methodology. 5. Decide on how data would be used e.g. how it would be incorporated into the existing budgeting process.

Who needs to be consulted

Government officials at Centre and State level, Research Organisations, Development partners.

Risks

Sustainability

High, if the political will is there.

Chances of Replication

High.

Comments

It is difficult to put together information for such a vast country as India. Hence it is necessary that the government, as also research institutions and development partners come together to generate the necessary information.

Contact

Submitted By

Dr Matthew Jowett, Former Programme Advisor, ECTA, New Delhi. September 2003.

Status Active
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