System of Health Accounts (2011) and Health Satellite Accounts (2005): Comparison of Approaches

Resource Type: Brief
Sharon Nakhimovsky, Patricia Hernandez-Peña, Cornelius van Mosseveld, Alain Palacios
Published: June 2014

Resource Description:

Accounting data on economic and financial resource flows within the health system are critical to informing health and economic policy at both national and international levels. For the most part, institutions that produce accounting data in the health system recognize the advantages of creating methodological standards that ensure comparability over time and internationally. However, countries vary widely in their individual health accounting histories as well as the level of demand for and capacity to produce these data. As the production and use of health accounting data continue to spread, countries need to understand how the approaches fit their context and policy needs.

The purpose of this brief is to introduce non-technical policymakers and other stakeholders to two prominent health accounting approaches: the System of Health Accounts (SHA), developed by the OECD and its partners, and the Health Satellite Accounts (HSA) developed by the WHO’s Regional Office for the Americas (AMRO). The approaches are closely related to and must be understood in relation to the System of National Accounts (“National Accounts”), the international framework for analyzing economic information in a country.

This brief compares the SHA and HSA approaches to health accounting in terms of their objectives and content, standardization and scope, and data requirements. The purpose of this comparison is to communicate the main policy applications of the data each approach produces as well as the primary factors determining feasibility and data quality. The comparison is by no means exhaustive. Rather, it is intended to start a discussion to which non-experts can contribute and from which they can gain further understanding.



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