Behind the estimates of out-of-pocket spending on health in the former Soviet Union

ABSTRACT

The countries of the former Soviet Union rely heavily on out-of-pocket payments for health care financing. However, out-of-pocket spending statistics are difficult to compare due to different data collection methodologies. Data are collected either through demand side data collection, via household surveys, or supply side data collection, via health clinics, pharmacies, and other suppliers’ data. This technical report is targeted at producers of out-of-pocket spending data, users of the WHO Global Health Expenditure Database and related publications as well as policy-makers, who wish to improve financial protection, on how to improve the relevant data through introduction of international standards of reporting such as the national health accounts. An analysis of former Soviet Union countries reveals that, all else being constant, countries that use national health accounts report 12% higher out-of-pocket spending. This is because national health accounts promotes the usage of detailed questions in surveys on household health care expenditures. Countries that rely solely on supply side information report 15% percent less out-of-pocket spending than countries with similar economic development and health priority status. The analysis strongly supports the view that national health accounts-based reporting usually based on specialized surveys increases the accuracy of out-of-pocket payments for health care.