Definition: Health expenditure

Category: Social statistics

The components of the expenditure effected by the households in the field of health are:
 - expenditure refunded at a later date by the Social Security organisms or by private (complementary) insurance;
 - non refunded expenditure;
 - Social Security contributions;
 - premiums for private insurance.
Various possibilities of treatment can be envisaged, approaching the concept via either (i) gross expenditure, or (ii) net expenditure.
(i) The 'gross expenditure' approach would consist in totalling what households actually pay, without subtraction of any possible reimbursement by the social welfare organizations or by private insurers. In this hypothesis, social security contributions and private insurance premiums are not included since reimbursements are not deducted. On this precise point of health contributions and insurance, the national accounts nomenclature (COICOP) records only service remuneration (transaction cost) and not the whole premium.
(ii) The 'net expenditure' approach stresses the household's actual contribution, and the record covers the households' effective expenditure minus later reimbursements. Here, on the other hand, it is best to bring contributions and insurance premiums into account.