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Creating Evidence for Better Health Financing Decisions
Georgia places a strong emphasis on dissemination and information sharing, ensuring that data can be used by a broad array of audiences. Whereas previously there was less access to and, therefore, less confidence in NHA results, broadening dissemination has built confidence in NHA numbers. NHA data are displayed on the websites of the MoLHSA and WHO. They are also made available to universities for academic purposes. Key summary statistics (for example, health expenditures as related to gross domestic product) are picked up by the media and displayed in newspapers and on television. These data have been used to inform current debates on health reform.5 The Ministry of Health and its agencies, the MOF, and other public institutions use NHA data broadly. Outside of government, insurance companies use the data in their management of premiums and contracts with providers (World Bank 2008). Georgia employs a variety of data sources and instruments that are used in conjunction with NHA. For example, the Georgia Health Utilization and Expenditure Survey (HUES) is used with NHA data to estimate household out-of-pocket payments and private health expenditures. The first HUES was conducted in 2007 and the second in 2010. Both surveys were (a) implemented by the State Department of Statistics of Georgia, (b) supported by the World Bank, and (c) implemented by the Georgia Health and Social Project Implementation Center. NHA data have also been used to inform the 2006–10 Medium-Term Expenditure Framework, using 2001–03 NHA estimates. Currently, Georgia is investing in a robust Health Management Information System with World Bank and USAID support, which will directly link health use to financing data. It will allow for countrywide data inputs to be directly translated in ways that can inform policy. This system will ease data production costs and provide for a seamless flow of information from the district to the central level that will be accessible nationally.6 As Georgia continues with NHA production and analysis, it will be interesting to observe how these key areas develop to better inform decision making.
Using Insights from NHA to Inform Policy in Georgia The following insights were used to inform policy: • Financial access to care. The issue of limited financial access to care was brought to light by routine NHA analysis. Data highlighted that Georgia primarily relies on private sources of financing, which ranging