An Approach On Rapid Calculation Of Total Health Expenditure And Its Application In China

Objectives:The objectives of this paper are:To establish a rapid calculation approach for Total Health Expenditure (THE) in China at the national and provincial levels; To narrow the time-lag in reporting THE; To calculate the THE in the31provinces, To provide information for health policy making.Research Methods:Literature review was used to analyze the accounting system for national health account in China; The percentage of some expenditure in THE was calculated and efforts were made to find out the law of the percentage evolution. Cluster analysis was also used in setting up the THE of the provinces without any THE records. Quantitative analysis was used in the analysis of China’s provincial THE.Results and Analyses:An effective approach for calculating the THE of China was established. The data of the income and expenditure of the government-owned hospitals, medical institutions that belong to the health and Traditional Chinese Medicine Administration, as well as the medical institutions and the health institutions that belongs to the health and Traditional Chinese medicine Administration, were respectively used in setting up the rapid calculative approach.An effective calculation approach for the provincial THE of China was established. The data of the income and expenditure of medical institutions that belongs to the health and Traditional Chinese Medicine Administration was used in setting up the rapid calculation method. And the method was proved to be effective.The data of the Latest THE information was presented. The THE in2010of China and those of31provincesDiscussions: This study established a new technical idea which can solve the time-lag problem in calculating and reporting THE. Previously, there were two methods in solving this problem, one was to improve the efficiency of the data collecting and transmission, the other was to use the predicting techniques. But it was limited in the improvement of data collection and transmission, and the marginal cost was high.This study has reduced the time-lag in reporting the THE information evidently. The calculation approach established in this study reduces the lag time from about1year to1quarter, which has significantly improved the timeliness and the value of the THE information in health policy making.This study got the THE information of the whole31provinces in China. There was no holistic THE information for31provinces before, so there were not enough information to support policy-making for health financing. This study has supplied the information of THE at the provincial level.The rapid calculation approach worked better than other predictive methods available by now.. The rapid calculation method of this study was carried out based on the major components of THE and its ratio to THE.There were dramatic difference among provinces in terms of Health investment and development status. For example, in2010, the THE in each province to its GDP ranged from2.97%to7.17%; the per capita THE of some provinces were below1000yuan, while some provinces were above4000yuan.Suggestions:A stable growth mechanism for health service investment should be established. Health is one of the fundamental human rights. The investment in health should be given high priority in order to keep health service development sustainable and the health system response well.The coordination and fairness of the inter-provincial health costs should be improved. Due to the differences in inter-provincial price levels and purchasing power and demand, the situation of the provincial health costs can differ in extent, but should not be beyond the acceptable level. The data shows that both the ratio of the THE to GDP and the per capita THE difference are far beyond the reasonable level. The central and provincial government should pay much attention to the differences and take effective measures to narrow the gap.The report and calculation work about the provincial THE information should be improved. A stable and complete reporting mechanism for the data of the provincial THE should be established, in order to provide evidence for health policy-making timely. It will not only help the health policy-making, but also promoting the balanced development of health services and all citizens can enjoy the equalization of health security benefits.The THE reporting system should be improved. The current THE information report only once every year, and the release time is seriously lagging behind. The rapid calculation method established in this study make the THE information release by stage possible. The THE reporting system should be divided into three stages, that’s rapid calculation figures, preliminary verified figures and finalized verified figures. The mechanism of the data collection should be adjusted. The data of some health economic indicators which could be used in the calculation of the THE should be collected in the future, Then the lag time of the THE reporting will be even shorter. The capacity of the health information system should be strengthened. The regional health information system should be integrated, and it will make the time-lag issues of the THE information reporting solved better.