Jordan national health accounts, 2000 and 2001

It describes how much a country spends on health care services and maps out the flow of health care funding from the financing sources, through the financing agents, to the ultimate consumers of health care services. This report presents the results of the second round of NHA estimates, for 2000 and 2001, for the Hashemite Kingdom of Jordan. Since issuance of the first NHA report for Jordan, for 1998, several indicators have significantly changed. For example, health care expenditures have increased in nominal and per capita terms, and as a share of gross domestic product (GDP). In particular, expenditures on curative care and pharmaceuticals services have increased significantly. The private sector, principally households through out-of-pocket expenditures but also health insurance premiums and co-payments, continues to represent the largest source of health care funding, followed by the public sector and donor organizations. The main issues emerging from the 2000-01 results are those identified for 1998: the high level of total health care expenditures as a percentage of GDP, and implications of this for future and current service provisions, and overall quality of care. Other issues of paramount importance are: the consistently high level of pharmaceutical expenditures, the continued high level of investment in the private sector, and the paucity of health care regulation (covering capital investment). This last has resulted in a surge of private hospitals, and a consistently high level of spending on curative care as opposed to primary care. The report discusses the policy implications of NHA results: sustainability of current levels of health care expenditures, pharmaceutical cost containment, reallocation of expenditures from curative to primary care, public and private sector coordination, and equity. It also addresses the institutionalization of the NHA effort in Jordan, making specific recommendations for continued government support, as well as the development of a standardized data reporting system. (Author abstract)