Health care is one of the largest sectors in OECD countries, and accounts now for over 8% of GDP on average. This manual of the System of Health Accounts (Version 1.0) provides a set of comprehensive, consistent and flexible accounts to meet the needs of government and private-sector analysts and policy-makers. These accounts constitute a common framework for enhancing the comparability of data over time and across countries, and suggest basic links with non-monetary indicators. The manual establishes a conceptual basis of statistical reporting rules compatible with other economic and social statistics and proposes a newly developed International Classification for Health Accounts (ICHA) which covers three dimensions: health care by functions of care; providers of health care services; and sources of funding. Once this new accounting standard has been implemented in a large number of OECD countries, it will allow for more consistent and reliable comparisons of health care expenditure across countries.