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Eurostat_OECD PPP program

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					Working Party on National
Accounts,
OECD – 4-6 November 2009

Update on PPP programme
and new data set for health
expenditure
Paul Schreyer OECD
                   Introduction
The Eurostat-OECD PPP Programme is an on-going
 programme
Purpose of this presentation:
  – Give an update on the Eurostat-OECD PPP
    programme
  – To present the latest methodological changes in the
    domains of education (implemented) and health
    (forthcoming)
     Update on the Eurostat-OECD PPP
              programme (1)
• PPPs for OECD countries are calculated every
  three years
• Preliminary results for the Round 2008 will be
  calculated end 2009. Countries which have not
  yet sent the detailed PPP national accounts
  questionnaire are invited to do it in the coming
  weeks.
• Publication of detailed results foreseen end of
  2010.
     Update on the Eurostat-OECD PPP
              Programme (2)

• Country coverage goes beyond OECD with 46
  countries participating in the Programme:
  – 37 countries (27 EU Member States, 3 Candidate
    Countries, 3 EFTA countries, 4 Western-Balkan
    countries) coordinated by Eurostat
  – 9 countries (7 OECD Member States, plus Russia
    and Israel) coordinated by OECD
  – Chile will join the Programme in 2011
    Main methodological changes for non
             market services

• The major methodological changes have been
  presented already last year.
• Final draft of handbook:
   TOWARDS MEASURING THE VOLUME OF
     HEALTH AND EDUCATION SERVICES
• Handbook will be published by the end of the year
  and we would like to thank all countries for their
  constructive comments.
  Education – output based approach to
   measure volumes of education (1)

Approach:
• Direct estimation of volumes
• Stratification by level of education
• Unit of output: pupil-hour (teaching received)
• Primary and secondary education: explicit
  quality adjustment with PISA scores, corrected
  for socio-economic variables.
   Education –output based approach to
    measure volumes of education (2)

• Substantial improvement over input cost
  approach
  – Better theoretical justification
  – More plausible results
• The method will be implemented for all OECD
  countries for the Round 2008 (for Eurostat
  countries method already implemented for two
  years)
      Education –output based approach to
       measure volumes of education (3)
200
          Per capita volume indices for Education, 2005
                          (OECD=100)
180


160


140


120


100


80


60


40


20


  0




          Output method with QA   Output method   Input method
      Education –output based approach to
       measure volumes of education (4)
300
                              )
           Per capita volume indices for GDP, 2005
                           (OECD=100)
250




200




150




100




50




  0




              Output method with QA   Input method
 Health – Toward specific PPPs for health
    based on output based approach

Progress on the work of the PPP health task force –
  presentation last year of the first results. 4th TF
  Meeting was held in October 2009.
Approach
   – Focus on hospital services
   – Disease-based approach
   – Use of secondary datasets
Study design
Current status of the project
Challenge ahead – New expenditure classification
 PPPs for hospital services – Study design

• Product identification: products are defined in terms
  of the types of services that hospitals produce (called
  “case types”. Use of Diagnosis Related Groups )
• Product measurement: case types quantities are
  measured through electronic coded information
  available at hospitalization level
• Place a value on products: a unit cost/quasi price by
  case type is estimated using available results from
  cost finding studies/price lists
PPPs for hospital services – Study design
  Case types identification -examples
  Case type    Case type       Codes              Rules
   number     description
 IM01       Acute         I21; I22         No operating room
            myocardial                     procedure         is
            infarction                     performed.
 IS02       Appendectomy 47.01; 47.09; Any            principal
                          47.11; 47.19 diagnosis code.
                                           Includes incidental
                                           appendectomy
 OS03       Cataract      13.1;      13.2; Any        principal
            surgery       13.3;      13.4; diagnosis code.
                          13.5;    13.64;
                          13.65; 13.66;
                          13.69;     13.7;
                          13.8; 13.9
        Current status of the project

• Second round of pilot studies conducted this
  year with 14 countries
• Feasibility confirmed: first set of results
  reasonable
• Still need to investigate measurement issues
  and to refine methodology (revise the list of
  case types, with a focus on inpatient services;
  identification of length of stay outliers; cost
  finding methodology)
    Proposal for a new PPP expenditure
        classification for health (1)
From prices to volume….
• Health PPPs need to be accompanied by
  consistent expenditure data
• Current expenditure information from NA not
  appropriate to deflate « new »health PPPs
      Proposal for a new PPP expenditure
          classification for health (2)
•   Expenditure classifications by purpose do not match
    disease-based approach for new health PPPs
•   Hospital services in COICOP and COFOG also
    comprise residential care and nursing homes
•   NPISH classification provides no breakdown for
    health
•   Health services directly provided by government are
    classified according to inputs
        Proposal for a new PPP expenditure
            classification for health (3)
•   New classification needed
•   Build the new classification from information
    in System of health accounts (SHA)
       SHA provides expenditure breakdown by health
        provider
       Provider-based classification HP1 – HP4
         •   Hospitals (HP1)
         •   Nursing and residential care facilities (HP2)
         •   Providers of ambulatory health care (HP3)
         •   Retail sale and other suppliers of medical goods (HP4)
         Proposal for a new PPP expenditure
             classification for health (4)
•       Close correspondence of provider classification with
        ISIC but provider classfication cuts across national
        accounts sectors
•       Proposal:
          •   Use total health expenditure from NA
          •   Apply structure of HP1 – HP4 from SHA to allocate
              expenditure
    •    Computation of Health PPPs for health as a whole
    •    Strong assumption : same structure for each sector
         but less of a problem when actual individual
         consumption is measured
                Conclusions

–   PPP 2008 Round well underway
–   New methods for education and health PPPs
    coming up
–   Thanks for providing expenditure data and
    liaising with price statisticians

				
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posted:10/24/2011
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