Health Financing Summit

        04.14.10
World Bank Sector Assessment Team (Sarbani Chakraborty,
George Scheiber, Ajay Tandon, Oscar Picazo, Eduardo Banzon
       ...
Methodology
 •  Trends over time on readily measurable performance
    indicators and health systems inputs against other
...
HEALTH FINANCING
TOTAL HEALTH SPENDING PER CAPITA
HEALTH FINANCING
Total spending for health per capita in constant pesos (1995-2007)




                                    3.9% growth
Composition of total spending for health (1995-2007)
Total spending for health per capita in US$ PPP in selected comparators
(1995-2007)
HEALTH SPENDING AS SHARE of GDP
HEALTH FINANCING
Health spending component share of GDP (1995-2007)


          3.4%
                                                     3...
Total spending for health as share of GDP in selected comparators
(1995-2007)
GOVERNMENT HEALTH SPENDING
HEALTH FINANCING
Department of Health budget (2005-2010)




 Source: General Appropriations Acts 2005 to 2010
Government spending for health as share of GDP (1995-2007)
Real Per Capita Government Health Expenditures (1997-2008)




 Source: Sicat et al 2010
SOCIAL HEALTH INSURANCE
HEALTH FINANCING
% of uninsured Filipinos (based on PhilHealth reports
                               2000-2008)




Source: PhilHealth ann...
Out of pocket spending for health as share of total health spending vs. GDP per capita (1995-2007)




                   ...
Private spending for health as share of total health spending vs. income per capita
(1995-2007)



                       ...
Catastrophic Health Expenditure Headcounts, by Various Thresholds
                                            OOP as % of ...
HEALTH OUTCOMES
POPULATION HEALTH INDICATORS, 1960-2007
INFANT MORTALITY RATE
HEALTH OUTCOMES
INFANT MORTALITY RATE as to INCOME and TOTAL HEALTH SPENDING,
2007
FEMALE LITERACY versus INCOME, 2000-2007
IMR (2007) as to YEARS of FEMALE EDUCATION
INFANT MORTALITY RATE, 1960-2007
INFANT MORTALITY RATE (2007)
LIFE EXPECTANCY
HEALTH OUTCOMES
LIFE EXPECTANCY at birth in selected Asian countries (1960-2008)


          53 years



                                 ...
LIFE EXPECTANCY versus INCOME and TOTAL HEALTH SPENDING, 2007
LIFE EXPECTANCY (2006)
MATERNAL MORTALITY
HEALTH OUTCOMES
MATERNAL MORTALITY versus INCOME and TOTAL HEALTH SPENDING, 2005
MMR (2005) as to YEARS of FEMALE EDUCATION




  Source: WDI; Barro-Lee
Skilled birth attendance relative to income and spending,
2003-2007
% of Births attended by health professionals (comparison across countries and Philippine regions),
2008
HEALTH INPUTS
Physician to Population ratio in selected Asian countries (1960- available
current year)
Total Health Worker to Population ratio Relative to Total Health Spending and
Income
Hospital Beds to Population ratio in selected Asian countries (1960- available
current year)
Total Hospital Bed to Population ratio Relative to Total Health Spending and
Income
Hospital/inpatient facility as Place of Death for Filipinos




 Source: National Statistics Office
TOWARDS MORE VALUE FOR MONEY:
IMPLEMENT A-B-C
IMPLEMENT:

•  A-O 29 series of 2008 or the Rapid Reduction of
   Maternal and Neonatal Mortality particularly promotion o...
IMPLEMENT:

•  D- ata dictionaries (for health) towards a national
   health IT system/ improved PhilHealth IT system

•  ...
Health Financing Summit

        04.14.10
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HFS Banzon

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HFS Banzon

  1. 1. Health Financing Summit 04.14.10
  2. 2. World Bank Sector Assessment Team (Sarbani Chakraborty, George Scheiber, Ajay Tandon, Oscar Picazo, Eduardo Banzon et al) Presented by: Dr. Eduardo Banzon Senior Health Specialist World Bank
  3. 3. Methodology •  Trends over time on readily measurable performance indicators and health systems inputs against other comparable income and health spending countries •  Assessing the country against global averages –  Nothing right or wrong about a global average –  But large deviations indicate areas that may require changes in health policies. Three areas •  HEALTH SPENDING –  total, public or government , private, and out-of-pocket (OOP) health spending •  HEALTH OUTCOMES –  Life expectancy, IMR and MMR •  HEALTH INPUTS –  Health workers and Hospital beds
  4. 4. HEALTH FINANCING
  5. 5. TOTAL HEALTH SPENDING PER CAPITA HEALTH FINANCING
  6. 6. Total spending for health per capita in constant pesos (1995-2007) 3.9% growth
  7. 7. Composition of total spending for health (1995-2007)
  8. 8. Total spending for health per capita in US$ PPP in selected comparators (1995-2007)
  9. 9. HEALTH SPENDING AS SHARE of GDP HEALTH FINANCING
  10. 10. Health spending component share of GDP (1995-2007) 3.4% 3.9%
  11. 11. Total spending for health as share of GDP in selected comparators (1995-2007)
  12. 12. GOVERNMENT HEALTH SPENDING HEALTH FINANCING
  13. 13. Department of Health budget (2005-2010) Source: General Appropriations Acts 2005 to 2010
  14. 14. Government spending for health as share of GDP (1995-2007)
  15. 15. Real Per Capita Government Health Expenditures (1997-2008) Source: Sicat et al 2010
  16. 16. SOCIAL HEALTH INSURANCE HEALTH FINANCING
  17. 17. % of uninsured Filipinos (based on PhilHealth reports 2000-2008) Source: PhilHealth annual reports
  18. 18. Out of pocket spending for health as share of total health spending vs. GDP per capita (1995-2007) > 50%
  19. 19. Private spending for health as share of total health spending vs. income per capita (1995-2007) 65%
  20. 20. Catastrophic Health Expenditure Headcounts, by Various Thresholds OOP as % of Total Income 12% 10% 8% 5% 10% 6% 15% 20% 25% 5% 4% 3% 3% 3% 3% 3% 2% 2% 2% 0% 1985 1988 1991 1994 1997 2000 2003 2006 Source: Lavado et al 2010
  21. 21. HEALTH OUTCOMES
  22. 22. POPULATION HEALTH INDICATORS, 1960-2007
  23. 23. INFANT MORTALITY RATE HEALTH OUTCOMES
  24. 24. INFANT MORTALITY RATE as to INCOME and TOTAL HEALTH SPENDING, 2007
  25. 25. FEMALE LITERACY versus INCOME, 2000-2007
  26. 26. IMR (2007) as to YEARS of FEMALE EDUCATION
  27. 27. INFANT MORTALITY RATE, 1960-2007
  28. 28. INFANT MORTALITY RATE (2007)
  29. 29. LIFE EXPECTANCY HEALTH OUTCOMES
  30. 30. LIFE EXPECTANCY at birth in selected Asian countries (1960-2008) 53 years 72 years
  31. 31. LIFE EXPECTANCY versus INCOME and TOTAL HEALTH SPENDING, 2007
  32. 32. LIFE EXPECTANCY (2006)
  33. 33. MATERNAL MORTALITY HEALTH OUTCOMES
  34. 34. MATERNAL MORTALITY versus INCOME and TOTAL HEALTH SPENDING, 2005
  35. 35. MMR (2005) as to YEARS of FEMALE EDUCATION Source: WDI; Barro-Lee
  36. 36. Skilled birth attendance relative to income and spending, 2003-2007
  37. 37. % of Births attended by health professionals (comparison across countries and Philippine regions), 2008
  38. 38. HEALTH INPUTS
  39. 39. Physician to Population ratio in selected Asian countries (1960- available current year)
  40. 40. Total Health Worker to Population ratio Relative to Total Health Spending and Income
  41. 41. Hospital Beds to Population ratio in selected Asian countries (1960- available current year)
  42. 42. Total Hospital Bed to Population ratio Relative to Total Health Spending and Income
  43. 43. Hospital/inpatient facility as Place of Death for Filipinos Source: National Statistics Office
  44. 44. TOWARDS MORE VALUE FOR MONEY: IMPLEMENT A-B-C
  45. 45. IMPLEMENT: •  A-O 29 series of 2008 or the Rapid Reduction of Maternal and Neonatal Mortality particularly promotion of facility-based deliveries •  B-enefits Reforms in PhilHealth –  Converting PhilHealth into an Active Purchaser of health services (thru contracts and case payments) –  Expansion of primary care benefits to the entire enrolled population –  PhilHealth coverage of P100 drugs •  C-overage for all Filipinos in the PhilHealth Sponsored Program with National Government financing using the DSWD’s proxy means test from its National Household Targeting System for Poverty Reduction or the NHTS-PR PMT –  TEACH the member of the poor (SP members) utilize their benefits
  46. 46. IMPLEMENT: •  D- ata dictionaries (for health) towards a national health IT system/ improved PhilHealth IT system •  E- xpansion of Results-based Financing –  Needs-based facilities and health personnel master plan to guide future investments in the health sector by expanding capacity in underserved areas of the country –  Performance –based budgets/grants –  Hold LGUs, hospitals and PhilHealth accountable for services and outputs •  F-acility autonomy reforms •  G-ame plan against Non-Communicable Diseases
  47. 47. Health Financing Summit 04.14.10

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