Statistical annex ANNEX TaBLE 8 National health accounts are designed to be a policy relevant, comprehensive, consis tent, timely and standardized instrument that traces the levels and trends of consumption of medical goods and services( the expenditure approach), the value-added created by service nd manufacturing industries producing these commodities(the production approach) and the incomes generated by this process as well as the taxes, mandatory contributions premiums and direct payments that fund the system(the financial approach). The current developmental stage of WHO national health accounts leans more towards a measure- hent of the financing flows Health care finance is divided into public and private flows. For public expenditure, the source most frequently used was Table B on expenditure by function published by the IMF in Government finance statistics yearbook. This rests on a body of exacting rules (not always strictly applied by the respondent countries) and deals in most cases only with central government expenditure. IMF and national sources have been used as far as possible to complement the central government data. United Nations National accounts (Tables 2.1 and 2.3 )and consistent domestic sources have also been used. OECD Health data has sup plied much of the information for the 29 OECD Member countries. Private expenditure on health has been estimated from United Nations and OECD National accounts ( Tables 2.3 and 2.1, respectively) and from the ratio of medical care to total consumption as derived from household surveys, that ratio being applied to total private consumption. This con- cerns mainly out-of-pocket spending. Private insurance premiums, mandated employer health programmes, expenditure by non-profit institutions serving mainly households and less frequently, private investment have been obtained from national sources. National health accounts prepared by a number of countries have been used to the extent that they were accessible. The plausibility of the estimates has been tested against financial and other analyses conducted in some countries or involving a group of countries A first complete table was reviewed by a large number of experts on individual countries and by policy analysts and statisticians of WHO Member States. Their observations led toa reassessment of certain sub-aggregate ANNEX TABLE 9 Overall health system attainment is presented in Annex Table 9. This composite meas- are of achievement in the level of health, the distribution of health, the level of responsive ness, the distribution of responsiveness and faimess of financial contribution has been constructed based on weights derived from the survey of over one thousand public health practitioners from over 100 countries. The composite is constructed on a scale from 0 to 100, the maximum value. As explained in Box 2.4, the weights on the five components are 25%level of health, 25% distribution of health, 12.5% level of responsiveness, 12.5% distr bution of responsiveness and 25% fairness of financial contribution. The mean value and uncertainty intervals have been estimated for overall health system achievement using the uncertainty intervals for each of the five components. In addition, the table provides un- certainty intervals for the ranks as well as the value of overall health system achievement Rank uncertainty is not only a function of the uncertainty of the measurement for each country but also the uncertainty of the measurement of adjacent countries in the leagueStatistical Annex 149 ANNEX TABLE 8 National health accounts are designed to be a policy relevant, comprehensive, consis￾tent, timely and standardized instrument that traces the levels and trends of consumption of medical goods and services (the expenditure approach), the value-added created by service and manufacturing industries producing these commodities (the production approach) and the incomes generated by this process as well as the taxes, mandatory contributions, premiums and direct payments that fund the system (the financial approach). The current developmental stage of WHO national health accounts leans more towards a measure￾ment of the financing flows.29 Health care finance is divided into public and private flows. For public expenditure, the source most frequently used was Table B on expenditure by function published by the IMF in Government finance statistics yearbook. This rests on a body of exacting rules (not always strictly applied by the respondent countries) and deals in most cases only with central government expenditure. IMF and national sources have been used as far as possible to complement the central government data. United Nations National accounts (Tables 2.1 and 2.3) and consistent domestic sources have also been used. OECD Health data has sup￾plied much of the information for the 29 OECD Member countries. Private expenditure on health has been estimated from United Nations and OECD National accounts (Tables 2.5 and 2.1, respectively) and from the ratio of medical care to total consumption as derived from household surveys, that ratio being applied to total private consumption. This con￾cerns mainly out-of-pocket spending. Private insurance premiums, mandated employer health programmes, expenditure by non-profit institutions serving mainly households and, less frequently, private investment have been obtained from national sources. National health accounts prepared by a number of countries have been used to the extent that they were accessible. The plausibility of the estimates has been tested against financial and other analyses conducted in some countries or involving a group of countries. A first complete table was reviewed by a large number of experts on individual countries and by policy analysts and statisticians of WHO Member States. Their observations led to a reassessment of certain sub-aggregates. ANNEX TABLE 9 Overall health system attainment is presented in Annex Table 9. This composite meas￾ure of achievement in the level of health, the distribution of health, the level of responsive￾ness, the distribution of responsiveness and fairness of financial contribution has been constructed based on weights derived from the survey of over one thousand public health practitioners from over 100 countries.22 The composite is constructed on a scale from 0 to 100, the maximum value. As explained in Box 2.4, the weights on the five components are 25% level of health, 25% distribution of health, 12.5% level of responsiveness, 12.5% distri￾bution of responsiveness and 25% fairness of financial contribution. The mean value and uncertainty intervals have been estimated for overall health system achievement using the uncertainty intervals for each of the five components.30 In addition, the table provides un￾certainty intervals for the ranks as well as the value of overall health system achievement. Rank uncertainty is not only a function of the uncertainty of the measurement for each country but also the uncertainty of the measurement of adjacent countries in the league table