Health care systems in all countries continue to evolve in response to changing demographics and disease patterns, rapid technological advances and more and more complex financing and delivery mechanisms, to name but a few factors. In striving towards some of the common health care system goals of equity, efficiency and effectiveness of care, one of the key questions for policy makers is “How much do we spend on health and is it measured in a comparable way?”

Annex A aims to support the mapping of categories of the three core classifications of SHA 2011 with international economic classifications used within the frameworks of the System of National Accounts (SNA) and the European System of Social Protection Statistics (ESSPROS). Each of the three core classifications of SHA 2011 – ICHA-HC, ICHA-HP and ICHA-HF – focuses on specific characteristics of actors (organisations) and transactions that differ from those of the other classifications. This annex briefly discusses some of the conceptual issues involved and then presents correspondence tables with the classification categories of the SNA and ESSPROS. Despite similar terms and some overlap with the main categories, there is no one-to-one relationship between the classifications of SHA and those of the two other statistical systems. Both users and compilers should also be aware that the international classifications undergo regular revisions and can be differently applied by countries. The same holds for the actors (organisations) used as statistical units in SHA and the economic entities (institutional units) used in SNA. The cross-tables of this annex, therefore, can only serve as a tentative guide to map the different classifications. Furthermore, the classifications discussed are not the only available classifications in the statistical systems of the countries.

This annex illustrates the relationship between the System of Health Accounts (SHA) and the System of National Accounts (SNA). Readers who are to some extent familiar with either health accounts or national accounts, but not both, will find a description of how health expenditure and financing data reported in the SHA cross-classified tables relate to the main macroeconomic variables in the SNA. In other words, the point is to develop a common language between the two disciplines, which should be of value both theoretically and practically.

The health system provides health care goods and services to the population in the form of health care products. Health products are repeatedly referred to throughout the SHA 2011 Manual and, as such, a standardised concept of what a health product is should be established as a basis for any analysis of the production and consumption processes. This annex discusses the development of a classification of health care products based on their composition and characteristics. The categories presented are not intended as a definitive classification at this stage. The annex also includes an initial overview of the potential uses of such a classification and a brief reference to products as mentioned in the main chapters.

Trade statistics play an important information role in analysing the strengths and weaknesses of economies and in assessing the impacts of different policies and identifying opportunities offered by partners’ markets. The World Trade Organisation, recognising the increasing role of the service sector, concluded the General Agreement of Trade in Services (GATS) in 1995, bringing services more into the spotlight of considerations about international trade. In addition to the general obligations that apply across all service sectors of all WTO Members, countries can choose which service sector and mode they wish to open up to trade. GATS has been an important driving force for the development of statistics on the international supply of services,1 and has influenced the establishment of a classification of four different modes of trade in services. The supply of health care services can take place in all four of these GATS modes, although not all are relevant to the measurement of trade under the System of Health Accounts.