National Health Accounts

About National Health Account (NHA)

• National Health Account 2018-19 is the sixth consecutive National Health Accountestimates report prepared by National Health Systems Resource Centre (NHSRC), designated as National Health Accounts Technical Secretariat (NHATS) in 2014 by the Union Health Ministry.
• System of Health Accounts 2011 framework (SHA 2011): National Health Accounts estimates for India are based on SHA 2011 framework and National Health AccountGuidelines for India, 2016.
  • SHA 2011 defines health accounts as a systematic description of the financial flows related to consumption of healthcare goods and services and a standard for classifying health expenditures according to the three axes – consumption, provision, and financing

Highlight Of National Health Account Report

• Government health expenditure to the GDP: It has increased from 1.15% in 2013-14 to 1.28% in 2018-19.
  • However, Union government’s healthcare declined to 1.28% of GDP in 2018-19 from 1.35% in 2017-18.
  • Total health expenditure (money spent on healthcare by the government, people, private entities and external funding) has fallen from 3.9% of the GDP to 3.2% in five years ending in 2018-19.
• Share of Government National Health Expenditure in Total Health Expenditure has increased over time.
  • In 2018-19, the share of government expenditure was 40.6%, substantially higher than the share of 28.6% in 2013-14.
• Per capita government spending on National Health care has increased by 74% since 2013-14.
• Out-of-Pocket Expenditure (OOPE) as percentage of total health expenditure has declined substantially by 16% points, from 64.2% to 48.2%.
  • Per capita out-of-pocket expenditure in the country has decreased by 8% since 2013-14, from Rs. 2,366 to Rs. 2,155 currently.
  • In Worldwide per-capita OOPE, India ranks 66^th out of 189 countries.

1. Out-of-pocket expenditures are expenditures directly made by households at the point of receiving healthcare. This indicates the extent of financial protection available for households towards healthcare payments.
2. Social security expenditure on health includes the social health insurance program, government-financed health insurance schemes, and medical reimbursements made to government employees.
3. Total health expenditure is the sum of current health expenditure and capital health expenditure during the same year.

• Social security expenditure on health as a percentage of total health expenditure growing from 6% to 9.6% now.
• Government-financed health insurance expenditure has increased by 167% since 2013-14.
• Atma-Nirbharta in Health Sector: Dependence on external funding in the health sector of the country has declined to 0.4% in 2018-19 from 2.3% in 2004-05, showcasing India’s economic self-reliance.
• Sector wise Healthcare Expenditure: Of the Current Health Expenditures (CHE), the Union Government’s share is 11.71% of CHE and the State Governments’ share is 19.63% of CHE.
• Primary Vs Secondary Vs Tertiary Health Care: Current Health Expenditure attributed to Primary Care is of around 47.4%, Secondary Care of 31.7%, Tertiary care of 14.9% and governance and supervision of 4.0%.
  • Primary and secondary care accounts for more than 80% of the current Government Health Expenditure.
    • Between 2013-14 and 2018-19, in government, the share of primary and secondary care has increased from 74% to 86%.
    • Government’s expenditure on Primary Care is 55.2%, Secondary Care is 30.5% and Tertiary Care is 5.9%.
  • In case of the private sector, the share of tertiary care has increased but primary and secondary care has declined.
    • Private expenditure on Primary Care is 36.9%, Secondary Care is 33.3% and Tertiary Care is 26.9%.
• Provider of health care services: Current Health Expenditure (CHE) attributed Rs. 93,689 crores to Government Hospitals (17.34% of CHE) and Rs. 1,55,013 crores to Private Hospitals (28.69% of CHE).

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