mesyuarat jawatankuasa pemandu mnha 2018 utama... · 2019-01-07 · seksyen malaysia nationalhealth...

Seksyen Malaysia NationalHealth Accounts (MNHA)

Cawangan Perancangan Pembiayaan, Informatik dan AkaunKesihatan

Bahagian Perancangan

Kementerian KesihatanMalaysia

MESYUARAT JAWATANKUASA PEMANDU MNHA

2018SHA 2011 MIGRATION

Seksyen MNHA, Bahagian Perancangan- 2018 1

MALAYSIA NATIONAL HEALTH ACCOUNTS

Migration to SHA 2011

Note : This presentation was prepared for the MNHA Steering Committee Meeting on 22nd November 2018.

For further information, please contact us at [email protected]

Seksyen MNHA, Bahagian Perancangan- 2018

OUTLINE

• Introduction

• Changes in SHA2011

• In i t ia l plan

• Methodology

• Outputs

• Future plans


INTRODUCTION


National HealthAccountsTri-Axial Concept

DIMENSIONS OF NATIONAL HEALTH ACCOUNTS: SHA 2000 (SHA 1.0) – TRI AXIALCONCEPT


SOURCESof

funding

Who Pays?

FUNCTIONS of Health

Care Services

For What?

PROVIDERSof

Health Care

To Whom?

SHA2011

framework

Consumer health

interface

Provision

interfaceFinancing

interface

Characteristics of beneficiaries (ICHA-HB)

(Diseases, age, gender, income,etc.)

Revenues of health

care financing schemes

(ICHA-FS)

Financing agents (ICHA-FA)

Gross capitalformation

(ICHA-HK)

Factors of provision (ICHA-FP)

External trade

Health care

financing schemes

ICHA-HF

Healthcare

Providers

ICHA-HP

DIMENSIONS OF SHA 2011 FRAMEWORK (CORE & EXTENDED)

Healthcare

functions

ICHA-HC

5

Source: IHAT for SHA 2011


• The System of Health Accounts (SHA) 2011 framework is aninternationally recognized methodology that tracks all healthspending in a given country over a defined period of timeregardless of the entity or institution that financed and managedthat spending. It ensures comparability of health expenditureacross countries and over time.

• The purpose of the SHA 2011 is to generate consistent andcomprehensive data on health spending in a country, which inturn can contribute to evidence-based policy-making in thecountry.

SHA 2011-INTRODUCTION


GLOBAL IMPLEMENTATION OF SHA2011


CHANGES IN

SHA 2011


CHANGES IN SHA 2011(1)

Revised terminologies & boundaries to addressambiguity on certain concepts,definitions

• public & private => compulsory &voluntary

• Reporting from Total Health Expenditure to Current Health Expenditure

• Total Health Expenditure = Health & Health Related Items (Capitalformation, Research & Development, And Education & Training)Current Health Expenditure = Health Expenditure Excluding HealthRelated Items (National health expenditure values will now belower)

• Capital formation is reportedseparately

Note: Health Related items includes Capital formation, Research & Development,

And Education & Training


HEALTH CAREPROVIDERS

• Minor changes - refinement of classification for better clarity

HEALTH CAREFUNCTIONS

• More complete & detailedclassifications

• HC.6 (preventive care) is completely re-categorized

• Updated HC.7 classification (governance) into 2 sub-codes - governance & health system administration (HC.7.1) and health financing administration(HC.7.2)

• Memorandum items added to track policy relevantexpenditures

• Health-related items – e.g. social component of long termcare

• Reporting Items – TCAM, Total Pharmaceutical Expenditure

HEALTH CARE FINANCING SCHEMES & REVENUESOF HEALTH CARE FINANCING SCHEMES

• Completely new classifications

CHANGES IN SHA 2011(2)


Total Vs Current Health Expenditure (SHA1)

SHA1.0Code CoreFunctions

HC.1 Services of curativecare

TotalHealth

Expenditu

re

Current

Health

Expenditu

re

HC.2 Services of rehabilitative care

HC.3 Services of long-term nursingcare

HC.4 Ancillary services to healthcare

HC.5 Medical goods dispensed to out-patients

HC.6 Prevention and public health services

HC.7 Health administration and health insurance

Code Health- RelatedFunctions

HC.R.1 Capital formation of health care providerinstitutions

HC.R.2 Education and training of healthpersonnel

HC.R.3 Research and development in health

HC.R.4 Food hygiene and drinking water control

HC.R.5 Environmental health

HC.R.6Administration and provision of social services in kind toassist

living with diseases andimpairment

HC.R.7 Administration and provision of health relatedcash-benefits

TOTAL VS CURRENT HEALTH EXPENDITURE (SHA1.0)


SHA 2011 Current HealthExpenditure

SHA2011

Code Functions

HC.1 Curative care

CurrentHealth

Expenditure

HC.2 Rehabilitative care

HC.3 Long-term care(health)

HC.4 Ancillary services (non- specified by function)

HC.5 Medical goods (non- specified by functions)

HC.6 Preventive care

HC.7 Governance, and health system and financingadministration

HC.9 Other health care services not elsewhere classified(n.e.c)

SHA 2011- CURRENT HEALTHEXPENDITURE


13

PREVENTIVE CARE FUNCTION: SHA 1.0 VS SHA2011


SHA 1.0

HC.6PREVENTION ANDPUBLIC

HEALTHSERVICES

HC.6.1 Maternal and child health,family

planning and counselling

HC.6.2 School health services

HC.6.3 Prevention ofcommunicable

diseases

HC.6.4 Prevention of noncommunicable

diseases

HC.6.5 Occupational health care

HC.6.9 All other miscellaneouspublic

health services

SHA 2011

HC.6 PREVENTIVE CARE

HC.6.1 Information, education and

counselling programmes

HC.6.2 Immunization programmes

HC.6.3 Early diseasedetection

programmes

HC.6.4 Healthy condition monitoring

programmes

HC.6.5 Epidemiological surveillanceand

risk and disease control

programmes

HC.6.6 Preparing for disasterand

emergency response programmes

INITIAL PLAN


SHA2011

framework

Consumer health

interface

Provision

interfaceFinancing

interface

Characteristics of beneficiaries (ICHA-HB)


Revenues of health


(ICHA-FS)



(ICHA-HK)


External trade

Health care

financing schemes

ICHA-HF

Healthcare

Providers

ICHA-HP

DIMENSIONS OF SHA 2011 FRAMEWORK (CORE & EXTENDED)

Healthcare

functions

ICHA-HC

15



Research & Development

Education & Training

PH components:Food

safety, drinkingwater,

fogging, etc.MNHA FRAMEWORK

SHA 1.0FRAMEWORK

NEW CHALLENGE SHA 2011MIGRATIONNEW CHALLENGES SHA 2011MIGRATION


MNHA FRAMEWORK

MNHA vs SHAFRAMEWORKS

SHA 1.0FRAMEWORK

SHA2011

Framework

NEW MNHAFRAMEWORK

SHA 1.0 vs SHA 2011FRAMEWORK


SHA2011

framework

Consumer health

interface

Provision

interfaceFinancing

interface

Characteristics of beneficiaries(ICHA-HB)


Revenues of health


(ICHA-FS)



(ICHA-HK)


External trade

Health care

financing schemes

ICHA-HF

Healthcare

Providers

ICHA-HP

SHA 2011 MIGRATION: INITIALPLAN

BY MNHA SECTION, PLANNINGDIVISION

Healthcare

functions

ICHA-HC

18



METHODOLOGY


Multiple Trainings (National andInternational)

Studied mapping SHA 1.0 versus SHA 2011

Reviewed boundaries & terminologies MNHA vs SHA2011

Early draft of MNHA 2 framework

Developed draft of MNHA2 with full mapping

TechnicalAdvisory Committee review & inputs for mapping

Planned methodology to migrate withconsultant

Pilot test the methodology

SHA 2011- METHODS OFMIGRATION



MAPPING–

MNHA 1.0

FRAMEWORK

FORMAT

SHA 1.0 FRAMEWORKSHA 2011

FRAMEWORK

MNHA 2.0

FRAMEWORK

MNHA 1.0

frk code

MNHA

1.0 label

MNHA

dtb codeSHA 1.0

frk code

SHA 1.0

label

SHA 1.0

dtb codeSHA 2011

frk code

SHA 2011

label

SHA 2011

dtb codeMNHA 2.0

frk code

MNHA

2.0 label

MNHA 2.0

dtb code

Note:

frk = framework

dtb =database

EXCEL-11DFORMAT

Internal DatabaseCode


MNHA DatabaseCode

STATA-COMBINEDATASETS


SHA 2011/ MNHA 2 (DATABASE2)


DATA OUTPUTS


For this round- Pilot study SHA 2011 migration for 3 years (2015-2017)

TABLE 1: TOTAL & Current Health Expenditure, 2015-2017

Year Current Health Expenditure(CHE)

2015 45,123

2016 46,772

2017 52,232

Current Health Expenditure,2015-2017 (RM Million, Nominal)


TABLE 1: TOTAL & Current Health Expenditure, 2015-2017Current Health Expenditure,2015-2017

(RM Million, Nominal)


Current Health Expenditure as percentageof GDP,2015-2017


Year

Current Health

Expenditure (CHE),

Nominal

(RM Million)

Current Health

Expenditure (CHE),

Nominal as %of GDP

2015 45,123 3.89

2016 46,772 3.80

2017 52,232 3.86

Current Health Expenditure as percentageof GDP,2015-2017


SHA 2011

codeHealth care financingschemes

2015 2016 2017

RM Million Percent RM Million Percent RM Million Percent

HF.1.1.1

Central governmentschemes

(e.g. MOH, MOHE, MOD, Other federal

agencies)23,159 51.33 22,777 48.7 25,536 48.89

HF.3.1 Out-of-pocket excludingcost-sharing 16,009 35.48 17,584 37.6 19,821 37.95

HF.2.1.2

Complementary/supplementary

insuranceschemes(e.g. Private Insurance & PrivateMCO)

4,353 9.65 4,738 10.13 5,069 9.70

HF.2.3Enterprise financingschemes

(e.g. All corps)684 1.52 702 1.5 799 1.53

HF.1.1.2State/regional/

local governmentschemes538 1.20 520 1.11 560 1.08

HF.1.2.1Social health insuranceschemes

(e.g. SOCSO)261 0.58 310 0.66 329 0.63

HF.2.2NPISH financingschemes

(e.g. NGO)67 0.15 84 0.18 60 0.11

HF.1.3

Compulsory Medical SavingAccounts

(CMSA)(e.g. EPF)

52 0.11 56 0.12 58 0.11

Total 45,123 100 46,772 100 52,232 100

Current Health Expenditure by Health CareFinancing Schemes,2015-2017


Current Health Expenditure by HealthCare Financing Schemes,2017


Year

GeneralGovernment

Health Expenditure

(GGHE)

(RM Million)

GeneralGovernment

Expenditure (GGE)-

Operating*

(RM Million)

GGHE as % GGE-Op

2015 24,010 243,302 9.87

2016 23,663 238,569 9.92

2017 26,483 248,202 10.67

GGHE aspercentage of GGE-Operating , 2015-2017 (Current)


Source: *Treasury Malaysia website Economy Report 2016/2017

GGHE as percentage of GGE-Op, 2015-2017 (Current)


Current Health Expenditure to Providers of Health Care, 2015-2017


SHA2011

codeProviders of healthcare

2015 2016 2017

RM Million Percent RM Million Percent RM Million Percent

HP.1 Hospital 26,031 57.69 27,652 59.12 30,953 59.26

HP.3Providers ofambulatory

healthcare10,220 22.65 10,717 22.91 11,614 22.24

HP.5

Retailers andother

providers ofmedicalgoods

3,365 7.46 3,635 7.77 3,886 7.44

HP.7

Providers of healthcare

system administrationand

financing3,571 7.91 2,715 5.81 3,791 7.26

HP.6Providers ofpreventive

care1,509 3.34 1,674 3.58 1,581 3.03

HP.4Providers ofancillary

services267 0.59 211 0.45 235 0.45

HP.8 Rest ofeconomy 144 0.32 152 0.33 160 0.31

HP.9 Rest of theworld 15 0.03 11 0.02 11 0.02

HP.2Residential long termcarefacilities

1 0.00 5 0.01 2 0.00

Total 45,123 100 46,772 100 52,232 100

Current Health Expenditure to Providers of Health Care,2017

Hospital

59%

Providers of

ambulatory healthcare

22%

Retail sale andother

providers ofmedical

goods

8%

Providers ofhealth

care system

administrationand

financing

7%

Providers ofpreventive

care

3%

Providers ofancillary

services

1%

All otherproviders

<1%


SHA

201

1

code

Functions of healthcare

2015 2016 2017

RM

MillionPercent

RM

MillionPercent

RM

MillionPercent

HC.1 Curative care 34,277 75.96 36,204 77.41 40,166 76.90

HC.7Governance,and healthsystemand

financingAdministration4,452 9.87 3,764 8.05 4,770 9.13

HC.5 Medical goods 3,873 8.58 4,236 9.06 4,551 8.71

HC.6 Preventivecare 2,166 4.80 2,264 4.84 2,415 4.62

HC.4 Ancillary services 353 0.78 299 0.64 330 0.63

HC.3 Long-term care(Health) 1 0.00 4 0.01 1 0.00

Total 45,123 100 46,772 100 52,232 100

Current Health Expenditure forFunctions of Health Care,2015-2017


Current Health Expenditure forFunctions of Health Care,2017


SHA

201

1

code

Functions of healthcare

2015 2016 2017

RM

MillionPercen

t

RM

MillionPercen

t

RM

MillionPercen

t

HC.6.3 Early disease detectionprogrammes 697 32.21 739 32.65 781 32.34

HC.6.4 Healthy condition monitoringprogrammes 524 24.19 558 24.66 615 25.45

HC.6.5Epidemiological surveillance and risk anddiseasecontrolprogrammes

507 23.42 512 22.63 545 22.57

HC.6.1Information, education andcounsellingprogrammes

395 18.24 418 18.45 430 17.80

HC.6.2 Immunizationprogrammes 42 1.94 37 1.62 44 1.83

Total 2,166 100 2,264 100 2,415 100

Preventive Care Expenditure, 2015-2017


Preventive Care Expenditure,2017


FUTURE PLANS


2019 andonwards

MNHA 2.0 new version

• Development of MNHA 2Framework

• Update mapping of MNHA 1.0 - SHA1.0 - SHA2011 -MNHA 2.0 based on recommendations from MNHATechnicalAdvisory Committee & policymakers

• Revise definitions of classifications / categories inMNHA 1.0 with stakeholders (e.g. MOH hospitals,preventive components) for MNHA2.0

• Conduct further updates according to new policydevelopment (e.g. new category of Financing Source/Revenue of financing schemes)

SHA 2011 MIGRATION: FUTURE PLANS(1)


Data analysis and reporting

new questionnaire (e.g. Q on• Development of

Revenue)• Additional analyses for ‘provider’ & ‘function’

dimension

• New analysis for Revenue of healthcare financing

schemes dimension• Strengthening process of data validation

and verification for newdatabase

• Reporting SHA 2011 time series outputs byphase

SHA 2011 MIGRATION: FUTURE PLANS(2)


mesyuarat jawatankuasa pemandu mnha 2018 utama... · 2019-01-07 · seksyen malaysia nationalhealth...

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