Estimating Public Spending on Health by Levels of Care for National Health Accounts: An Illustration of Use of Data on Withdrawals by Drawing and Disbursing Officers (DDOs) in India

This paper illustrates the use of information on withdrawals by Drawing and Disbursing Officers (DDOs) for improving estimates of public spending for National Health Accounts (NHAs) in India. Using information from two selected States (Karnataka and Rajasthan), the study highlights the advantages of combining DDO-level information with budgetary data for two purposes (i) mapping public spending to different provider classes of the international System of Health Accounts 2011 (SHA 2011) and (ii) mapping public spending to different types of healthcare providers in India. The benefits of using DDO-level information are found to be higher while mapping expenditure to healthcare providers in India than mapping to international categories of the SHA 2011. In particular, while mapping public spending to different types of healthcare providers in India, the improvement in precision of estimates brought about by DDO-level information was found to be significant in the two States.