* CONTENTS

1. Introduction 2. Structure and Trends of Health Expenditure 3. Conclusions

* SUMMARY

The first efforts to estimate Sri Lanka’s health spending using a health accounts approach were by Abel-Smith in the early 1980s, and Rannan-Eliya and De Mel in 1997. Subsequently, the first formal set of accounts were prepared for the health ministry by Rannan-Eliya and others during 1998-2002. These first set of official estimates covered the time period 1990-1999. Since then, these estimates have been continuously updated by the Institute for Health Policy, the most recent series covering the period 1990 -2005. Sri Lanka’s health accounts are fully compatible with the SHA framework for health accounts, with a parallel national classification used to format results for local users. Data sources are principally the government’s treasury accounting system for central government spending, provincial council financial statements, and surveys of private hospitals, insurance, and employers. Two additional sources are national household surveys and pharmaceutical industry sales data. For the most part, estimation of private spending relies on a production approach....