* CONTENTS

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

* SUMMARY

With assistance from the World Bank, China first initiated work developing its own NHA system and methodology in the early 1980s. To provide a standardized, quantitative evidence platform for national policy analysis as well as for international benchmarking, China’'s NHA system has since evolved to dual OECD SHA compatible classifications from 1999. Estimates have been largely consistent across both classification systems. However, heterogeneity of health financing and health services provision in China precluded producing complete three dimensional NHA based on available survey data at sub-national level. Currently, China has completed nationwide spending estimates classified by financing source and by provider for 1990 through 2006 while health accounts with all three dimensional classifications (financing source, provider and function) are only available for Tianjin municipality for the year 2005. It should be noted that as many of the characteristics of the Tianjin municipality’'s health system differ significantly from those of the national health system it is often not appropriate to draw national implications from Tianjin data....