Findings From the First SHA Implementations in 15 Asian Countries - What this Tells About How Asian Countries Differ, and How the Region is Different or the Same as the OECD
Posted: 17 Jun 2007
Abstract
Alongside the first phase of SHA pilot implementations in the OECD, several non-OECD Asian economies piloted the SHA to produce standardised estimates of their national health spending. They range from some of the poorest economies in the world (Bangladesh, Nepal, Mongolia) to some of the richest (Hong Kong SAR, Taiwan). These results provide the first truly comparable measures not only of the level of spending in a representative range of developing economies, but also of the composition and source of spending. Although the Asian countries represent far greater diversity in the organisation and financing of health systems than is the case in the OECD, these first results indicate several similarities and continuities with earlier OECD analysis. First, the close relationship between per capita income and expenditure holds even better across the income range with these new data than previously published statistics for these countries, indicating that use of the SHA has improved the quality of meaasurement. Second, they confirm across a more diverse income range that public spending increases with income, and that countries end-up choosing two broad approaches to raising that public financing. Third they allow classification of regional health systems into three main types based on their patterns of financing and provision, which should facilitate future comparative analysis. Other results include the surprising finding that the better health performers in the group allocate less to preventive services and more to hospitals than the worse health performers. This and other results suggest the need to rethink conventional prescriptions about the functional allocational of spending to improve health outcomes.
Keywords: health expenditure, financing, health systems
Suggested Citation: Suggested Citation