Health Economics Information Resources: A Self-Study Course

Module 2 - Sources and Characteristics of Information Relating to Health Care Financing in the US

Major statistical sources

In this section we will answer the following questions:

National Health Accounts (U.S.)

The National Health Accounts series, which the U.S. Department of Health and Human Services has published since 1964, aims to “identify all goods and services that can be characterized as relating to health care in the nation, and (to) determine the amount of money used for the purchase of these goods and services”

The Accounts are available for downloading in spreadsheet compatible format from the URL at the Centers for Medicare and & Medicaid Services Web site.

The NHA consists of a matrix of categories which classify and define the sources of health care dollars and the services purchased with these funds. They are based on a vast array of information collected by public agencies and private organizations.

It is, in terms of scope, the most comprehensive source to consult for health care expenditure data.

The series has many important characteristics: The unified structure of the NHA enables researchers to make comparisons of categories over time because it applies a common set of definitions to variables. The NHA aims to be comprehensive because they contain all of the main components of the health care system, including not only personal health care expenditure data, but also that pertaining to medical research, construction of medical facilities, program administration, etc. and, they are multi-dimensional in that the data are further broken down by geography and age-levels of subjects.

In addition, the NHA represents the health care sector of the economy and, as such, show several important relationships:

1. Percentage of Gross Domestic Product (GDP). As previously mentioned, this figure reveals the amount the nation decides to allocate to health care – relative to it’s productive capacity. It quantifies a national choice and, thus - provides a numeric basis for discussion.
2. Expenditures by source of funds and changes over time in those sources. Important for policy makers, insurers, voters.
3. Projection of future expenditures. Created from historical trends, these projections alert public and private sectors to possible future outcomes.

NHA/ NHE Documentation

Given this enormous and rich body of information on U.S. health care expenditures, what should we remember when referring users to this source?

As is the case whenever consulting statistical information, users need to be aware of the limitations of the data. It is critical that users familiarize themselves with the definitions, sources, and methodologies used in creating the NHA in order to grasp what is being measured and how that measurement is being accomplished.

For the NHA, one needs just to consult the Centers for Medicare and Medicaid Services (CMS), formerly Health Care Financing Administration, homepage to find definitions of each category of medical service and source of funding, scope of the program, methodology of program, and source materials from which the NHA are developed. Find information at the CMS Web site.

This information can also be found in the annual review article on NHA in the journal Health Care Financing Review and in Health Affairs.

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