METHODOLOGICAL INFORMATION

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1 2013 JOINT OECD, EUROSTAT AND WHO HEALTH ACCOUNTS (SHA) DATA COLLECTION ELECTRONIC QUESTIONNAIRE METHODOLOGICAL INFORMATION Country name: AUSTRALIA Year(s): 2003 to 2009 Respondent: To be returned: By: To: 31 March 2013 OECD Eurostat Who

2 I. Data sources Question I.6 on "Consumption of fixed capital" has been simplified in 2011 in that information on market providers is no longer required. Contents I.1 Public expenditure and private expenditure I.2 LTC expenditure I.3 Households out-of-pocket expenditure I.4 Prevention and Public Health I.5 Gross fixed capital formation I.1. Please provide description separately for the main sources for public expenditure and private expenditure. Public expenditure: Data is sourced from the AIHW Health Expenditure database that was used to compile Health Expenditure Australia (released October 2011). The AIHW gathers information on which to base its estimates of health expenditure from a wide range of sources. The main sources for public expenditure information are: the Department of Health and Ageing, the Commonwealth Treasury Department, the state and territory health authorities, the Australian Bureau of Statistics and the Department of Veterans Affairs. Private expenditure: Data is sourced from the AIHW Health Expenditure database that was used to compile Health Expenditure Australia (released October 2011). The AIHW gathers information on which to base its estimates of health expenditure from a wide range of sources. The main sources for private expenditure information are: the Private Health Insurance Administration Council, Comcare and the major workers compensation and compulsory third-party motor vehicle insurers in each state and territory, the Department of Health and Ageing, the Australian Bureau of Statistics and the Productivity Commission.

3 I.2. Please provide separate descriptions for the main sources for the following categories of LTC expenditure. For the boxes, please mark if the activity/service* is included in the category (Y/N). If separate information on HC.3.1, HC.3.2 and HC.3.3 can be provided then it is not necessary to complete for HC.3 also. By definition, not all the four types of services listed should be included in the categories of LTC. This question intends to clarify where the separation is not possible. HC3 Long-term nursing care Y/N HF.1 General government Expenditure on long-term nursing care (total, public, private) * Prior to the release of Health expenditure Australia , expenditure on (via payments to) residential aged care homes, in respect of a particular resident, was based on assessments of dependency under an eight-level Residential Classification Scale (RCS) for that resident. For the purpose of determining which expenditures were health or welfare, it was assumed that the major focus of services provided to residents with higher dependency levels (that is, in RCS levels 1 to 4) was for the provision of health care services. As a consequence, all expenditures for residents in RCS levels 1 to 4 were considered to be expenditure on health. Residents with dependency levels that put them into RCS levels 5 to 8 were assumed to be receiving welfare services. * All expenditure on residential aged care facilities is now classified to welfare services, in accordance with the classification practices of the Department of Finance and Administration, the Australian Bureau of Statistics, the Productivity Commission and the Department of Treasury. More recent evidence on the nature of care provided to the aged in residential aged carefacilities have informed the decision to reclassify all residential aged care facilities expenditure to welfare services. Refer to Section 6.3 of Health expenditure Australia for further details. Allocating all residential care subsidies to welfare services has had a significant impact on the total amount of expenditure designated to health and to welfare services and therefore the health expenditure and welfare services expenditure to GDP ratios. Compared with the previous allocation method, the health expenditure to GDP ratio in is lower by 0.65 percentage points and the welfare services expenditure to GDP ratio is higher by 0.65 percentage points. HC3.1 HC3.2 HC3.3 HC.R.6.1 HC3 HC3.1 HC3.2 HC3.3 HC.R.6.1 Inpatient Long-term nursing care Long-term nursing care: day care Long-term nursing care: home care Social services of Long-term care Long-term nursing care Inpatient Long-term nursing care Long-term nursing care: day care Long-term nursing care: home care Social services of Long-term care State and territory health authorities HF.2 Private sector State and territory health authorities * For full definitions, please refer to the Guidelines for estimating long-term care, available at the following website address:

4 I.3. Please provide description separately for the main sources for the following categories of households out-of-pocket expenditure*. HC1,HC2, HC4 Services of curative and rehab. care and Ancillary services HC3 Long-term nursing care HC5 Medical goods HF.2.3 Households out-of-pocket expenditure (total) The Private Health Insurance Administration Council and the Productivity Commission; Department of Health and Ageing; Australian Bureau of Statistics Over-the-counter pharmaceuticals expenditure sourced from Retail World, Retail Pharmacy, and the Pharmacy Guild of Australia; Other data sourced from the Department of Health and Ageing and the Department of Veterans Affairs HC.R.6.1 Social services of Long-term care (LTC other than HC3) HF Households out-of-pocket expenditure excluding cost-sharing HC1,HC2, HC4 HC3 HC5 Services of curative and rehab. care and Ancillary services Long-term nursing care Medical goods The Private Health Insurance Administration Council and the Productivity Commission Over-the-counter pharmaceuticals expenditure sourced from Retail World, Retail Pharmacy, and the Pharmacy Guild of Australia HC.R.6.1 HC1,HC2, HC4 HC3 HC5 HC.R.6.1 Social services of Long-term care (LTC other than HC3) HF Households out-of-pocket expenditure cost-sharing with general government Services of curative and rehab. care and Ancillary services Long-term nursing care Medical goods Department of Health and Ageing Department of Health and Ageing and the Department of Veterans Affairs Social services of Long-term care (LTC other than HC3) HF Households out-of-pocket expenditure cost-sharing with private insurance HC1,HC2, HC4 HC3 HC5 HC.R.6.1 Services of curative and rehab. care and Ancillary services Long-term nursing care Medical goods Social services of Long-term care (LTC other than HC3) Australian Bureau of Statistics * National Health Accounts. Estimation Methods: Household out-of-pocket spending in private expenditure. Draft: Sept (Rannan-Eliya, R) is available at the following website address:

5 I.4. Please provide separate descriptions for the main sources for the following categories of Prevention and Public Health. HC.6 Prevention and public health services Department of Health and Ageing; Private Health Insurance Administration Council; Public health expenditure in Australia (AIHW) ) [Note: released February 2011] HC.6.1 Maternal and child health; family planning and Department of Health and Ageing; Private Health Insurance Administration Council HC.6.2 HC.6.3 counselling School health services Prevention of communicable diseases Public health expenditure in Australia (AIHW) ) [Note: released February 2011] HC.6.4 Prevention of non-communicable diseases Public health expenditure in Australia (AIHW) ) [Note: released February 2011] HC.6.5 HC.6.9 Occupational health care All other miscellaneous public health services Public health expenditure in Australia (AIHW) ) [Note: released February 2011]

6 I.5 Gross fixed capital formation What are the main data sources used for reporting gross fixed capital formation? Australian Bureau of Statistics I.6 Consumption of fixed capital Is the consumption of fixed capital included in the estimation of current expenditure estimates on: i) the output of the non-market providers? (yes/no) If yes, what are the main data sources?

7 I. Historical information Health Expenditure and Finance Data are based on: Joint OECD-Eurostat- WHO SHA Collection SHA-consistent national health accounts Locally produced national health accounts * * 1960, 1963, 1966, 1969, National accounts estimates I.1. Notes on Data Comparability Break in time series: * There is a break in 1998, which reflects the implementation of the SHA manual. Historical data sources: Other Information:

8 II. Current state of ICHA implementation Please indicate in the following tables: 1. Any differences in your SHA-based health accounts from the definitions provided by the ICHA (or in this Methodological Note) and, by x in the last column, if an estimation procedure or adjustment was used specifically for the purpose of producing the SHA tables. Please provide separately a short description of the estimation procedure or adjustment applied at the end of this section. 2. If data are not available (but the category exists): 3. If the given category does not exist in your health system: Category not applicable Contents II.1 Current state of applying ICHA-HF II.2 Current state of applying ICHA-HC II.3 Current state of applying ICHA-HP II.4 Current state of applying Financial Sources II.5 Current state of applying Resource Costs Description of the estimation procedures and adjustments indicated by x in the tables II.1 to II.5: ICHA-HF HF.1 HF.1.1 HF.1.2 HF.2 HF HF HF HF HF HF.2.1 HF.2.2 HF.2.1-HF.2.2 HF.2.3 HF HF HF SHA Manual General government Table II.1. Current state of applying ICHA-HF Health Expenditure by Financing Agent/Schemes General government (excl. social security) = Territorial Central government Ministry of Health Other Ministries State / provincial government Local / municipal government Social security funds Private sector Private social insurance Private insurance (other than social insurance) Private insurance Private households out-ofpocket exp. Out-of-pocket excluding costsharing Cost-sharing: central government; state / provincial government; Local / municipal government; Social security funds Which deviations from ICHA are currently found in the country s SHA compilation? Category not applicable Note: Workers compensation and compulsory motor vehicle third party insurance payments are counted as a component of HF.2.5 Special estimation procedures and adjustments to the original data (marked by x ) HF HF HF HF.2.4 HF.2.5 HF.3 Cost-sharing: Private insurance All other cost-sharing Non-profit institutions serving households Corporations (other than health insurance) Rest of the world

9 Table II.2. Current state of applying ICHA-HC Health Expenditure by Function ICHA-HC HC.1 HC.1.1 HC.1.2 HC.1.3 HC HC HC HC HC.1.4 SHA Manual Services of curative care In-patient curative care Day cases of curative care Out-patient curative care Basic medical and diagnostic services Out-patient dental care All other specialised health care All other out-patient curative care Services of curative home care Which deviations from ICHA are currently found in the country s SHA compilation? Special estimation procedures and adjustments to the original data (marked by x ) HC.2 HC.2.1 HC.2.2 HC.2.3 Services of rehabilitative care In-patient rehabilitative care Day cases of rehabilitative care Out-patient rehabilitative care Not separately identified: Included in HC.2.3 HC.2.4 HC.3 HC.3.1 HC.3.2 HC.3.3 HC.4 HC.4.1 HC.4.2 HC.4.3 HC.4.9 HC.5 HC.5.1 HC HC HC HC.5.2 HC HC HC HC HC HC.6 HC.6.1 Services of rehabilitative home care Services of long-term nursing care In-patient long-term nursing Day carecases of long-term nursing care Long-term nursing care: home Ancillary care services to health care Clinical laboratory Diagnostic imaging Patient transport and All emergency other miscellaneous rescue ancillary Medical goods services dispensed to out-patients Pharmaceutical and other medical Prescribed non-durables medicines Over-the-counter medicines Other medical non-durables Therapeutic appliances and other medical durables Glasses and other vision products Orthopaedic appliances and other prosthetics Hearing aids Medico-technical devices, including wheelchairs All other miscellaneous medical durables Prevention and public health services Maternal and child health; family planning and counselling Not separately identified Included in HC Included in HC Included in HC HC.6.2 HC.6.3 HC.6.4 HC.6.5 HC.6.9 HC.7 School health services Prevention of communicable diseases Prevention of noncommunicable diseases Occupational health care All other miscellaneous public health services Health administration and health insurance Not all data available (School dental is counted in HC.1.3.9)

10 HC.7.1 HC HC HC.7.2 HC HC General government administration General government of health administration Admin., operation of health & support activities of soc. Sec. funds Health administration and health insurance: private Health administration and health insurance: social insurance Health administration and health insurance: other private HC. 9 HC.R.1 HC.R.2 HC.R.3 HC.R.4 HC.R.5 HC.R.6 HC.R.6.1 HC.R.6.9 M.1(HC) M.2(HC) M.3(HC) Not specified by kind Health related expenditures: Capital formation of health care provider institutions Education and training of health personnel Research and development in health Food, hygiene and drinking water control Environmental health Admin. and provision of social services in kind to assist living with disease and impairment Social services of LTC (LTC other than HC.3) All other services classified under HC.R.6 HC.R.7 Admin. and provision of health related cash-benefits Memorandum items: Other (Non-health care/healthrelated) pharmaceuticals goods and services and Total other medical non-durables (including in-patient and other ways of provision) Total of ancillary services (including in-patient) Includes residential aged care and Home and Community Care (HACC) The 2008 estimate excludes private hospital pharmaceuticals expenditure as this could not be separately identified.

11 Table II.3. Current state of applying ICHA-HP Health Expenditure by Provider ICHA-HP HP.1 HP.1.1 HP.1.2 HP.1.3 HP.2 Hospitals SHA Manual General hospitals Mental health and substance abuse Speciality hospitals (other then mental health and substance abuse hospitals) Nursing and residential care facilities Which deviations from ICHA are currently found in the country s SHA compilation? High-level residential aged care expenditure used to be included here but has now been excluded from this data submission for all years. It has been reclassified to welfare (social) expenditure. Refer to Chapter 6 of Health expenditure Australia for a detailed explanation for this shift in expenditure. Special estimation procedures and adjustments to the original data (marked by x ) HP.2.1 HP.2.2 HP.2.3 HP.2.9 HP.3 HP.3.1 HP.3.2 HP.3.3 HP.3.4 HP.3.5 HP.3.6 HP.3.9 HP HP HP HP.4 HP.4.1 HP.4.2 HP.4.3 HP.4.4-HP.4.9 HP.5 HP.6 Nursing care facilities Residential mental retardation, mental Community health care and facilities substance for the All other elderly residential care facilities Providers of ambulatory health care Offices of physicians Offices of dentists Offices of other health practitioners Out-patient care centres Medical and diagnostic laboratories Providers of home health care services Other providers of ambulatory health care Ambulance services Blood and organ banks Providers of all other amb. health care serv. Retail sale & other providers of medical Dispensing goods chemists = Pharmacies Retail sale and other suppliers of optical glasses and other vision products Retail sale and other suppliers of hearing aids Retail sale/other suppliers of medical appliances; All other misc. sale/other suppliers of pharma. Provision & medical admin. of goods public health programs General health administration and insurance Included in HP.4.9 HP.6.1 HP.6.2 HP.6.3 HP.6.4 HP Government administration of health Social security funds Other social insurance Other (private) insurance Providers of private insurance Category not applicable

12 HP.6.9 HP.7 HP.7.1 HP.7.2 HP.7.9 HP.9 Memorandum items: M.1(HP) All other providers of health administration Other industries (rest of the economy) Est. as providers of occupational health care services Private households as providers of home care All other ind. as secondary producers of health care Rest of the world Providers of health related goods and services

13 Table II.4. Current state of applying Financial Sources Financing sources provided by FS.1 FS.1.1 FS.1.2 FS.2 FS.2.1 FS.2.2 FS.2.3 FS.3 General government units Territorial government All other public units Private sector Corporations Households NPISH Rest of the world Which deviations from ICHA are currently found in the country s SHA compilation? Special estimation procedures and adjustments to the original data (marked by x ) Resource Costs RC.1.1 RC Table II.5. Current state of applying Resource Costs Human resources (employed and self-employed) Compensation of employees Which deviations from ICHA are currently found in the country s SHA compilation? Special estimation procedures and adjustments to the original data (marked by x ) RC , RC RC Wages and salaries Social benefits Self-employed income Data only available for Public hospitals Description of the estimation procedures and adjustments indicated by x in the tables II.1 to II.5:

14 III. Revisions and preliminary estimates III.1 Revision Practice Please provide a general description of any revision envisaged with relation to these SHA Tables. Included in this description should be whether the current data are preliminary data, any details of a time-table of revisions and reasons for the revision, if planned (i.e. due to availability of new source data, revision of associated sources, such as National Accounts, plans for revision of previous years based on new methodology employed in this year s estimates, etc.) Each entry in our health expenditure database is given a National set of codes which is used to produce data for Health expenditure Australia, as well as a set of SHA codes. In 2008, more detailed state and territory government data was requested based on a National Minimum Data Set for Government Health Expenditure. The greater detail enabled some previously aggregated codes to be correctly disaggregated into some codes which were previously unreported, for instance 'Day cases of curative care' and outpatient hospital data. Some codes may have also increased or decreased dramatically between 2007 and 2008 due to more detail from the new data returns, for instance General Government funding for All Other Specialised health care. There are often revisions that need to be made to our health expenditure data that result from either: the availability of a new data source, a revision to previously supplied estimates or a revision of previous year s data based on a new methodology employed in the latest year s estimates. Any of these changes results in a change to both our National figures and our SHA data. Each year that we compile data in the format of the joint questionnaire there will often be revisions to previously supplied estimates. We are unable to supply the latest health expenditure figures according to the SHA until the release of Health expenditure Australia (usually released around September/October each year). There is a planned revision of HP where some data will be recoded to HP 7.9 after re-evaluating the definition of OTC drug sales through supermarkets. Further information from SHA 2011 documentation indicates OTC sales through supermarkets is defined as provision through secondary producers of health care. III.2 Preliminary estimates Please provide a description of the methodology used in providing preliminary estimates of health expenditure aggregates e.g. the data sources used and/or the forecasting techniques employed. Preliminary estimates for 2010 are not yet available: This relates to our financial year data. At this stage we do not have any broad estimates for total, public or private expenditure on health. We will be able to supply 2010 health expenditure data and any revisions to old years after the release of Health expenditure Australia

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