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Data set notes

European Health for All database

Indicators: 565

Updated: 18 October 2024

Contact: Data and Digital Health Unit (DDH)

The following abbreviations are used in the indicator titles:

• SDR: age-standardized death rates (see HFA-DB user manual/Technical notes, page 13, for details)

• FTE: full-time equivalent

• PP: physical persons

• PPP$: purchasing power parities expressed in US $, an internationally comparable scale reflecting the relative domestic purchasing powers of currencies.

More information: http://www.euro.who.int/en/data-and-evidence/databases/european-health-for-all-database-hfa-db

Indicator notes

Total health expenditure as % of GDP
Indicator code: E340102.T

For OECD Member States, the data are taken from OECD Health Database (see www.oecd.org). For non-OECD countries, the data are as reported by the country to the HFA-DB and may not necessarily correspond to the common WHO or OECD definition. Adjusted WHO estimates for this indicator, which are generally more accurate, are included as a separate indicator.

Whenever possible, the OECD definition of total expenditure on health is applied (see OECD health systems, Vol. II, page 89, for details). It includes:household health expenses, including goods and services purchased at the consumer's own initiative and the cost-sharing part of publicly financed or supplied care; government-supplied health services including those in schools, prisons and armed forces and special public health programmes such as vaccination; investment in clinics, laboratories etc.; administration costs; research and development, excluding outlays by pharmaceutical firms; industrial medicine; outlays of voluntary and benevolent institutions.In the case of most central and eastern European countries the following has to be included:direct state budget allocated to the health sector, state subsidies to the mandatory health insurance system; mandatory health insurance contributions by employers and employees; direct health expenditure of employers for running industrial medical facilities; direct health expenditures of ministries and governmental agencies; charity health expenditures; foreign assistance; outstanding debt at the end of the year; private health insurance and direct private health charges. It is important to ensure that funding from the general budget revenues and health insurance contributions do not overlap._

Country/Area notes

Albania

Ministry of Health (estimation), Ministry of Finance and INSTAT.

Austria

Source: Data up to 1989 according to National Accounts. Data from 1990 according to SHA (OECD).
Investment (HC.R.1) is included.

Belgium

Source: National Institute for Health Insurance / calculations made by the Federal Public Service
Social Security since 2003.

Bosnia and Herzegovina

National Health Account of B&H http://www.who.int/nha/country/bih/en/ Ministry of Civil Affairs of
B&H, Health Insurance and Reinsurance Fund of Federation of B&H; Health Insurance Fund of Republic
of Srpska; Department for Health of Brcko District

Cyprus

From 1998 health expenditure calculations have been changed. For this reason, a comparison with data
for the previous years should be avoided.

Czechia

Source: Czech Statistical Office, Czech Health Accounts.

Denmark

Source: OECD health database (www.stats.oecd.org).

Estonia

Source: up to 1997 State Statistical Office. From 1998 National Institute for Health Development.
Estonia implements currently SHA2011 methodology in health care expenditure data collection.
In SHA2011 methodology there is no such definition as total health expenditure. SHA2011 uses only
current health expenditure definition and therefore all ratios in years 2009-2014 are calculated
using the current health expenditure figure.

Finland

Source: Social Insurance Institute.
Note: Due to the severe recession in the early 1990s, the Finnish GDP declined by 10%, which also
led to savings in public health expenditure. After the recession, the GDP grew much more rapidly
than health expenditure, which caused the observed decline in the health expenditure share of GDP.

Georgia

Source: Ministry of Labour, Health and Social Affairs of Georgia (MOLHSA)

Germany

Source: Federal Statistical Office, Health Expenditure Accounts.
http://www.gbe-bund.de

Greece

For years 2009 to 2012 2014 data are provided according to the system of Health Accounts (SHA 1.0)
(SHA 2011) Methodology. GDP estimates refer to ESA 2010 Methodology

Iceland

Source: National Economic Institute / Statistics Iceland.

Israel

Since 1995, is based on updated OECD definitions.
Source: National Accounts, Central Bureau of Statistics.

Italy

Source: Istat, National accounts. The OECD definition is applied.
Data for the period 1992-2012 have been estimated on the basis of the updated version of the
classification of economic activities (Ateco 2007, the national version of Nace Rev. 2) and of
products by activity (CPA 2008) and are consistent with the revised time series of national
accounts.

Latvia

Source of data: Central Statistical Bureau of Latvia.
Calculation method: The methodology of the System of Health Accounts has been applied for
calculation of the data starting from 2005.
Note: The figure increased in 2004 because allocated European Structural Funds and household
expenditures were added to the total health expenditure.

Lithuania

Source: up to 2003: Central Statistical Office and LHIC. Methodology of OECD was not used. Simple
sum of state and municipalities' health budget, health insurance budget and private expenditure on
health, taken from household budget survey. Source from 2004 onwards: Central Statistical Office.
Data according to OECD SHA methodology. Since 2013 methodology of SHA2011 is used.
Deviation from the definition: Since 2013 current expenditure on health care is used instead of
total health expenditure.

Malta

As from 2004: National Statistics Office estimate plus cost of geriatric hospital (SVPR). 2008:
Source: NSO (data reviewed from 1999).

Montenegro

Data are not available.

Netherlands

Source of data: Statistics Netherlands: Cost and financing of health care.

North Macedonia

Sources: Bulletin of Health Insurance Fund (HIF); Bulletin of the Ministry of Finance.

Portugal

Source of data: National Statistical Institute/OECD Coverage: National

Republic of Moldova

Starting from 2010 calculation of health financing indicators is based on the National Health
Accounts.

Romania

Source of data: Ministry of Public Finance.

Serbia

NHA data. Total expenditure includes: household health expenses, direct state budget allocated to
the health sector, mandatory health insurance contributions by employers and employees, direct
health expenditure of employers for running industrial medical facilities, direct health
expenditures of ministries and governmental agencies, charity health expenditures, foreign
assistance, government-supplied health services including those in prisons and armed forces. Data
from ?National Health Survey? from 2006 undergone by Institute of Public Health of Serbia(IPHOS) has
been used for assessment of private sector expenditure as well as data from Republican Statistical
Office (RSO) ?Household budget survey? and RSO ?Living standard measurement estimations?.

Slovenia

Source of data: Statistical Office of the Republic of Slovenia.

Türkiye

Source of data: OECD

Turkmenistan

Data are not available.

Ukraine

Total health expenditure from state and local budgets as % of GDP, i.e. actually public health
expenditure only.
Source: Ministry of Health, the Economy and Finance Department.

United Kingdom

Data at England level only by financial year for 2007 onwards.
Source: Department of Health