Publications

In 2011, domestic demand for health services accounted for an average of 11 percent of gross domestic product (GDP) in Organisation for Economic Co-operation and Development (OECD) countries, as an item of household demand second only to housing. At the same time, variations between countries are significant, ranging from a modest 4 percent in Luxembourg to a sizable 15 percent in the United States. Such differences within a fairly homogeneous set of countries inunediate1y raise a number of questions: Are we comparing 1ike with like? And if so, are differences in the value of health services due to differences in prices or to differences in the volume of health services provided? A similar question arises when comparing the evolution of health expenditure within a country over time: How much of an increase in expenditure has occurred because of more services delivered and how much has occurred because of services having become more expensive? This chapter aims at exploring the issue of measuring health services and the breakdown of expenditures between prices and vo1umes from an international perspective. It will ask whether health services are defined in the same way across countries and whether statistical offices apply similar methods to undertake a price-volume split when nominal expenditures are tracked over time. The chapter will also present new intercountry comparisons of the volume of health services consumed, based on an approach recently put in place by the OECD and Eurostat.

Schreyer, P. and M. Mas (2018): “Measuring health services in the National Accounts: An international perspective”, in Aizcorbe, A., C. Baker, E. Berndt and D. Cutler (eds.): Measuring and modeling health care costs. Chicago: University of Chicago Press, chapt. I, pp. 25-54.