title: Improved estimates of Belgian private health expenditure can give important lessons to other OECD countries.
abstract: OECD Health Data are a well-known source for detailed information about health expenditure. These data enable us to analyze health policy issues over time and in comparison with other countries. However, current official Belgian estimates of private expenditure (as published in the OECD Health Data) have proven not to be reliable. We distinguish four potential major sources of problems with estimating private health spending: interpretation of definitions, formulation of assumptions, missing or incomplete data and incorrect data. Using alternative sources of billing information, we have reached more accurate estimates of private and out-of-pocket expenditure. For Belgium we found differences of more than 100% between our estimates and the official Belgian estimates of private health expenditure (as published in the OECD Health Data). For instance, according to OECD Health Data private expenditure on hospitals in Belgium amounts to €3.1 billion, while according to our alternative calculations these expenses represent only €1.1 billion. Total private expenditure differs only 1%, but this is a mere coincidence. This exercise may be of interest to other OECD countries looking to improve their estimates of private expenditure on health.
authors.affiliation: Department of Health Policy and Management, Erasmus University Rotterdam, PO Box 1738, 3000 DR Rotterdam, The Netherlands; Medical Legal Department, DKV Belgium, Bischoffsheimlaan 1-8, 1000 Brussels, Belgium. Electronic address: pietcalcoen@hotmail.com.
authors.forename: Piet
authors.initials: P
authors.lastname: Calcoen
authors.affiliation: Belgian Federal Public Service Social Security, Administratief Centrum Kruidtuin, Finance Tower, Kruidtuinlaan 50, PO Box 100, 1000 Brussels, Belgium.
authors.forename: Dirk
authors.initials: D
authors.lastname: Moens
authors.affiliation: Medical Legal Department, DKV Belgium, Bischoffsheimlaan 1-8, 1000 Brussels, Belgium.
authors.forename: Pieter
authors.initials: P
authors.lastname: Verlinden
authors.affiliation: Department of Health Policy and Management, Erasmus University Rotterdam, PO Box 1738, 3000 DR Rotterdam, The Netherlands.
authors.forename: Wynand P M M
authors.initials: WP
authors.lastname: van de Ven
authors.affiliation: Research Group Welfare State and Housing, University of Leuven, Parkstraat 47, PO Box 5300, 3000 Leuven, Belgium.
authors.forename: Jozef
authors.initials: J
authors.lastname: Pacolet
mesh_terms: D001530:Belgium; D000068598:Data Accuracy; D005382:Financing, Personal / Q000706:statistics & numerical data; D005102:Health Expenditures / Q000706:statistics & numerical data; D006296:Health Services / Q000191:economics; D066150:Organisation for Economic Co-Operation and Development; D017149:Private Sector
keywords: Belgium; OECD Health Data; Out-of-pocket expenditure; Private expenditure; System of Health Accounts