How Can National Health Accounts Be Transformed into a Data-Driven Strategic Management Tool

Since the 1970s, OECD countries have struggled to control health care expenditure, which has grown much faster than GDP. One of the responses was the development of National Health Accounts (NHA). Today, NHA provide an accounting, classification, and monitoring framework for health expenditure. Developed by the OECD and recommended by WHO, they are mandatory in all European Union countries and are used by many WHO member states under the international SHA 2011 standard. However, the introduction of NHA has not curbed health care spending in OECD countries, which continues to outpace GDP growth. The authors argue that a key limitation of NHA is the lack of end-to-end integration with financial and managerial accounting systems, which reduces the accuracy, timeliness, and practical value of NHA data and makes them poorly suited for management purposes. As a result, NHA are currently used primarily for retrospective monitoring and sector-level analysis, macroeconomic research, and cross-country comparisons. The authors propose transforming NHA from a method of statistical observation into a data-driven management tool by combining the SHA 2011 standard with end-to-end financial management of the health sector based on line‑item budgeting—an approach that ensured the high efficiency of the Soviet health system.