Household Expenditures on Health in the ICP 2011 Session III: Global Core List survey materials for regional PPP updates Meeting of ICP Regional Coordinating Agencies Washington, D.C., USA May 28, 2015 Public Disclosure Authorized Public Disclosure Authorized Public Disclosure Authorized closure Authorized
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Public Disclosure Authorized on Health in the ICP 2011pubdocs.worldbank.org/en/586641487258654495/pdf/... · Median is 36%. It is quite high in BRIC economies, for example: 74.4%
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Household Expenditures
on Health in the ICP 2011Session III: Global Core List survey materials for
regional PPP updates
Meeting of ICP Regional Coordinating Agencies
Washington, D.C., USA
May 28, 2015
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ICP 2011
Results:
Note: “Health” in the ICP includes not only household expenditures,
but also expenditures in health goods and services incurred by NPISHs
and the general government on behalf of households.
Importance of health at the global level...
global nominal
health expenditures(% of World GDP)
.
...and at the regional level.
ICP 2011
Results:
Region
Regional nominal
health expenditures
(% of Regions’ GDP)
Ranking of “health”
(out of 12 analytical
categories)
Eurostat-OECD 10.1 2nd
Latin America 6.9 5th
Asia and the Pacific 5.2 3rd
Caribbean 5.0 4th
CIS 4.6 3rd
Africa 4.5 5th
Singletons 3.7 3rd
Western Asia3.0 5th
Item
Class/B. Heading
Group
Category
ICP2011 structure of household consumption of health
HEALTH
Medical Products, appliances & equipment
Pharma-ceuticals
43 items
Therapeutic Appliances
& Eq.
4 items
Other Medical Products
5 items
Out-patient Services
Medical
5 items
Dental
2 items
Parame-dical
5 items
Hospital Services
Hospital Services
Reference PPPs
Performance of health items in the ICP 2011
• Very high CVs for practically all items
• Medical products were harder to price
than services, mainly because of the
difficulty of pricing pharmaceuticals
Issues with pricing health goods and services
1. Complexity of Health Care Systems
Health care systems around the world have different arrangements of who pays
for the health care goods and services consumed by households. These
differences make it difficult to establish full market prices at times, as prices
faced by households may include subsides from the government or NPISHs.
2. Difficulty of Identification
Many dimensions come into play to define what we call a pharmaceutical
product. Different combinations of these parameters may exist between and
within countries, making it difficult to properly identify and compare products.
3. Difficulty of Representativity
Evidence to establish a common basket of representative health products at the
global level is scarce. If there’s no volume sales data, the nature of health markets
further complicates this task. Domestic laws and third-party agents may
sometimes affect consumption patterns of households even within a same
country. Pharmacists or domestic patent laws may influence what drug brands
people consume or on their preference of generics over branded drugs.
Health items pose difficulties...now what?
1. Complexity of Health Care Systems
We can’t change the underlying complexity of health
care systems. Although we can re-emphasize the
notion of full market prices in the SPDs.
2. Difficulty of Identification
We can improve the SPD’s for better and quicker
identification of products.
3. Difficulty of Representativity
We can align the item list to global consumption and
regional disease patterns.
Edits: Medical Services
Medical
Services
• More consistent item names and parameter structure and labels
• Split the original “Features” parameters (contained too much information)
• Removed “10 yr. experience” req. and rule of only pricing “after 2nd visit”
Item Name Consultation: general medical practitioner/primary care physician
Included in Eurostat List 11.06.21.1.01.aa
Number of units 1
Unit of measurement Service
Establishment Doctor's office, incl. those located in outpatient centers, polyclinics and general clinics
Establishment type Private
Timing of Service Normal working hours
Service Medical consultation
Service IncludesGeneral diagnosis and responding to common medical problems (e.g. common cold, flu,
etc.), medical history taking, and referral and prescription, as appropriate
Service by Professionally certified general medical practitioner/primary care physician
Duration 15-20 minutes
Price conceptFull Market Price (=Out-of-pocket payment by patient to provider + payment to
provider by Private Insurance/Non-profit institutions/Social Security)
10 yr. experience
req. removed
Reinforces that we
only want prices
from private service
providers
Reminder of the
price concept
we’re after
Edits: Dental and Paramedical Services
Dental
Services
• Reorganized content of the original and vague “Effect” parameter,
which incl. information on anesthesia used AND qualifications of dentist
• Removed “5 year experience” requirement for dentists and left the
parameter as “Professional certified dentist”
Para-
medical
Services
• Original “Blood test” service replaced with a more common type of
blood test (i.e. “hemogram” or complete blood test)
• For discussion (at the end): should we be pricing “Physiotherapist:
individual therapy after knee surgery”?
� “Establishment”, “Establishment Type” and “Price Concept” parameters were also
added to items under these two basic headings
� Consistency of item and parameter structuring and labeling was also improved
Hard to specify: pricing per session or per set of sessions? How
many sessions per set ? etc. Relevant in developing countries?
Edits: Therapeutical Appliances & Equipment
and Other Medical Products
Therapeutical
Appliances &
Equipment
• Split the “Features” parameter into “Display” (for the blood
pressure monitor), “Exclude, “Thickness”, “Lens Diameter”, etc.
• Added the WKB label to Contact lenses, walker and walking stick
• Replaced contact lenses to be of “[…] soft, monthly disposable,
WKB” type, instead of “soft contact lenses” that are “Permanent
(about 8 months)”
• For discussion (at the end): suggestion to add item to cover