Transcript Reiner Buchegger/Ursula Fronaschütz

Health as a growth factor
Reiner Buchegger
Johannes Kepler University Linz
Ursula Fronaschütz
Austrian Federal Ministry of Social Security and Generations
BUNDESMINISTERIUM
FÜR SOZIALE SICHERHEIT UND GENERATIONEN
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2
Reiner Buchegger
Ursula Fronaschütz
FEDERAL MINISTRY
FOR SOCIAL SECURITY
AND GENERATIONS
Study: „Health as a growth factor“
Presentation scheme
Introduction (Fronaschütz)
Scientific framework (Buchegger)
Findings of the study (Buchegger, Fronaschütz)
European Health Forum Gastein September 2002
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Reiner Buchegger
Ursula Fronaschütz
FEDERAL MINISTRY
FOR SOCIAL SECURITY
AND GENERATIONS
Austrian health care system
Macroeconomic indicators
Total health expenditure as a share of
GDP 2000: 8,2 %
Public health expenditure as a share
of GDP 2000: 5,9 %
European average
European Health Forum Gastein September 2002
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Reiner Buchegger
Ursula Fronaschütz
Austrian health care system
Macroeconomic indicators
FEDERAL MINISTRY
FOR SOCIAL SECURITY
AND GENERATIONS
Health expenditure % GDP 2000
14
12
10
8
6
4
2
0
Austria
Italy
France
Czech
Rep.
Total health expenditure
European Health Forum Gastein September 2002
Poland
USA
Canada
Public health expenditure
source: OECD health data
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Reiner Buchegger
Ursula Fronaschütz
FEDERAL MINISTRY
FOR SOCIAL SECURITY
AND GENERATIONS
Austrian health care system
Federal & regional levels
European Health Forum Gastein September 2002
Reiner Buchegger
Ursula Fronaschütz
FEDERAL MINISTRY
FOR SOCIAL SECURITY
AND GENERATIONS
European Health Forum Gastein September 2002
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Reiner Buchegger
Ursula Fronaschütz
FEDERAL MINISTRY
FOR SOCIAL SECURITY
AND GENERATIONS
Study: „Health as a growth factor“
Current situation
Health care sector largely financed by public
funds
Public sector budget pressures
Health sector´s contribution to the national
economy needs to be identified
European Health Forum Gastein September 2002
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Reiner Buchegger
Ursula Fronaschütz
FEDERAL MINISTRY
FOR SOCIAL SECURITY
AND GENERATIONS
Study: „Health as a growth factor“
Aims
Assess the overall impact of the health care
sector on the national economy
Over a consistent period of time
Identify key macroeconomic indicators
Describe the development of the main
players in the health care system
Approach goes beyond of what is published
by the statistical office
European Health Forum Gastein September 2002
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Reiner Buchegger
Ursula Fronaschütz
Study: „Health as a growth factor“
FEDERAL MINISTRY
FOR SOCIAL SECURITY
AND GENERATIONS
National accounting
System of national accounting
definitions of economic indicators
empirically compiled
accounts and tables
Forms of national accounting
national book-keeping
input-output-analysis
flow of funds-analysis
European Health Forum Gastein September 2002
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Reiner Buchegger
Ursula Fronaschütz
Study: „Health as a growth factor“
FEDERAL MINISTRY
FOR SOCIAL SECURITY
AND GENERATIONS
National accounting
Characteristics of national book-keeping
value added (NOT assets) of a period
ex post-analysis
prices
flows (instead of stocks)
result: GDP, NDP, ...
European Health Forum Gastein September 2002
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Reiner Buchegger
Ursula Fronaschütz
FEDERAL MINISTRY
FOR SOCIAL SECURITY
AND GENERATIONS
Study: „Health as a growth factor“
National accounting
Input-output-analysis
more information through analysis of
interdependencies (intrasectoral/intersectoral)
periodical I-O-tables
value added (NOT assets) of a period
ex post-analysis
prices
flows (instead of stocks)
European Health Forum Gastein September 2002
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Reiner Buchegger
Ursula Fronaschütz
FEDERAL MINISTRY
FOR SOCIAL SECURITY
AND GENERATIONS
National Production Account
Net Value Added = NDP
intermediate deliveries
economic turnover
depreciation
taxesindirect
minus subsidies
+/- changes in stocks
wages, salaries,
social insurance
capital profits
rental and interest profits
European Health Forum Gastein September 2002
Earnings
own consumption
Gross Value of Production
Gross Value Added = GDP
Expenditures
Study: “Health as a growth factor“
Definition production
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Reiner Buchegger
Ursula Fronaschütz
FEDERAL MINISTRY
FOR SOCIAL SECURITY
AND GENERATIONS
Study: „Health as a growth factor“
Definition production
salaries and wages
+ employers´ contributions
+ imputed pensions
+ indirect taxes
- subsidies
+ gross profits
= value added
+ intermediate deliveries / consumption
= gross value added of production
= total output of national production
European Health Forum Gastein September 2002
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Reiner Buchegger
Ursula Fronaschütz
FEDERAL MINISTRY
FOR SOCIAL SECURITY
AND GENERATIONS
Study: „Health as a growth factor“
Definition consumption
private consumption
+ public consumption
+ investments
+ exports
= FINAL CONSUMPTION
+ intermediate deliveries
= TOTAL CONSUMPTION
European Health Forum Gastein September 2002
national production
+ imports
= TOTAL PRODUCTION
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Reiner Buchegger
Ursula Fronaschütz
FEDERAL MINISTRY
FOR SOCIAL SECURITY
AND GENERATIONS
Study: „Health as a growth factor“
Definition producers
Health producers
outpatient sector (physicians in private
practice)
inpatient sector (hospitals)
long term care
pharmaceuticals industry
medical devices industry
related trade
European Health Forum Gastein September 2002
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Reiner Buchegger
Ursula Fronaschütz
FEDERAL MINISTRY
FOR SOCIAL SECURITY
AND GENERATIONS
Study: „Health as a growth factor“
Definition goods
Health goods
inpatient and outpatient services
long term care
pharmaceuticals
medical devices
trade margin
European Health Forum Gastein September 2002
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Reiner Buchegger
Ursula Fronaschütz
FEDERAL MINISTRY
FOR SOCIAL SECURITY
AND GENERATIONS
Study: „Health as a growth factor“
Definition interdependencies
Classification of economic sectors
agriculture and forestry
energy and water supplies
mining
foodstuffs, beverages, tobacco
textiles and leather
wood and wood products
paper and printing
chemical industry (including pharmaceuticals)
...
European Health Forum Gastein September 2002
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Reiner Buchegger
Ursula Fronaschütz
FEDERAL MINISTRY
FOR SOCIAL SECURITY
AND GENERATIONS
Study: „Health as a growth factor“
Definition interdependencies
Classification of economic sectors (continued)
...
stone and glass
basic metals industry
processed metals industry
construction
wholesale and retail trade
hotel and restaurant businesses
traffic and information services
property management
other services (including health services)
European Health Forum Gastein September 2002
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Reiner Buchegger
Study: „Health as a growth factor“
Findings source: Buchegger, Brunner (2000)
Ursula Fronaschütz
FEDERAL MINISTRY
FOR SOCIAL SECURITY
AND GENERATIONS
Shares of
producers
in value
added
1998
1983
16%
23%
26%
26%
15%
12%
39%
43%
Nprivate
ie d e rgpractice
e la s s e n e Ärz te
Khospitals
ra n ke n h ä u s e r
Flong
ü rs oterm
rg e w
es en
care
Ghealth
e s u n dindustry
h e its in d u s trie
European Health Forum Gastein September 2002
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Reiner Buchegger
Ursula Fronaschütz
Study: „Health as a growth factor“
Findings source: Buchegger, Brunner (2000)
FEDERAL MINISTRY
FOR SOCIAL SECURITY
AND GENERATIONS
16%
16%
4%
4%
Shares of hospital types
in total hospitals value
added 1998
80%
private hospitals
for profit
Private
Krankenhäuser
80%
public hospitals
Krankenhäuser
des öffentl. Dienstes
Krankenhäuser
private hospitals nonder
profitprivaten Dienste ohne Erw erbscharakter
European Health Forum Gastein September 2002
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Reiner Buchegger
Study: „Health as a growth factor“
Findings source: Buchegger, Brunner (2000)
Ursula Fronaschütz
FEDERAL MINISTRY
FOR SOCIAL SECURITY
AND GENERATIONS
Shares of the
health
industry
producers
1998
W ertschöpfung
value
added
Bruttoproduktionswert
gross
domestic production
30%
38%
47%
55%
15%
15%
pharmaceuticals industry
Pharmazeutische
Industrie
Medizinischer
Handel
trade in health goods
European Health Forum Gastein September 2002
30%
W er ts c höpf ung
55%
15%
pharmacauticals / medical
devices industry
Medizinisch-Techn.
Industrie
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Reiner Buchegger
Ursula Fronaschütz
Study: „Health as a growth factor“
Findings source: Buchegger, Brunner (2000)
FEDERAL MINISTRY
FOR SOCIAL SECURITY
AND GENERATIONS
pharmaceuticals
P h a rm a ze u tis c h e G ü te r
Distribution
of final
consumption
pharmaceuticals
medical devices
goods 1998
medical devices
Mediz inisch-Technische G üter
13%
17%
26%
11%
27%
60%
46%
P
riva te rconsumption
K ons um
private
17%
26%
11%
46%
European Health Forum Gastein September 2002
Ö
ffe n tlic
her K ons um
public
consumption
E xp o rt
exports
In
ve s titio n e n
investments
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Reiner Buchegger
Ursula Fronaschütz
FEDERAL MINISTRY
FOR SOCIAL SECURITY
AND GENERATIONS
Study: „Health as a growth factor“
Findings source: Buchegger, Brunner (2000)
private practice & hospitals
long term care
N ie d e r g e la s s e n e Är z te u n d
Shares of the most important
intermediate delivery sectors
to the health care
producers 1995 (in %)
F ü r s o r g e w e s e n in %
K r a n k e n h ä u s e r in %
9
3
5
14
4
2
22
19
10
44
28
4
20
16
E energy,
n e rg ie /water
W a s s e rve rs o rg u n g
N a h ru n g s m it t e l u n d G e t rä n k e
C chemical
h e m is c hindustry
e In d u s t rie
S . u n t e rn e h m e n s b e z . D ie n s t le is t u n g e n
S others
o n s t ig e V o rle is t u n g e n
M metal
e t a llve
ra rb e it u n g
processing
V transport,
e rk e h r/ Ncommunication
a c h ric h t e n ü b e rm it t l.
European Health Forum Gastein September 2002
foodstuffs, beverages
company related services
M e d iz in -, M e s s , - R e g e lu n g s t e c h n ik ,
optical, engineering services
Handel
trade
O p t ik
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Reiner Buchegger
Study: „Health as a growth factor“
Findings source: Buchegger, Brunner (2000)
Ursula Fronaschütz
FEDERAL MINISTRY
FOR SOCIAL SECURITY
AND GENERATIONS
Direct and indirect health employment 1998
(9,7% of total employment)
18%
direct private practice &
hospitals
direct pharmaceuticals
direct medical devices
12%
54%
direct trade health goods
direct long term care
13%
indirect employment
2%
European Health Forum Gastein September 2002
1%
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Reiner Buchegger
Ursula Fronaschütz
FEDERAL MINISTRY
FOR SOCIAL SECURITY
AND GENERATIONS
Study: „Health as a growth factor“
Findings source: Buchegger, Brunner (2000)
Health is an important growth sector that
contributes to the national economy in terms of
value added, employment and foreign trade
(Public) hospitals have been and still are the
largest providers of health services
Within the health sector, the relative shares of
hospitals and long term care have decreased,
private practice has remained stable whereas the
largest winner has been the health industry
(pharmaceuticals, medical devices, trade in health
goods)
European Health Forum Gastein September 2002
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Reiner Buchegger
Ursula Fronaschütz
FEDERAL MINISTRY
FOR SOCIAL SECURITY
AND GENERATIONS
Study: „Health as a growth factor“
Findings source: Buchegger, Brunner (2000)
Within the health industry (pharmaceuticals,
medical devices, trade) the trade sector has been
the largest winner
The pharmaceuticals and medical devices industry
show important import/export shares
Health services (hospitals and private practice) are
primarily offered and consumed within Austria
The health market is an important job provider - one
in ten of the workforce is directly or indirectly
employed in the health sector
European Health Forum Gastein September 2002
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Reiner Buchegger
Ursula Fronaschütz
FEDERAL MINISTRY
FOR SOCIAL SECURITY
AND GENERATIONS
Study: „Health as a growth factor“
What is the benefit for other countries?
Comparative studies at EU levels
cooperation with European Hospitals
Association (HOPE)
DG SANCO public health framework program
(EU system of national accounts)
OECD health accounts
possible introduction into the system
European Health Forum Gastein September 2002
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Reiner Buchegger
Ursula Fronaschütz
FEDERAL MINISTRY
FOR SOCIAL SECURITY
AND GENERATIONS
Federal Ministry for Social Security
and Generations
http://www.gesundheit.bmsg.gv.at
Reports & brochures service
http://www.economics.uni-linz.ac.at
[email protected]
European Health Forum Gastein September 2002