Evolution and patterns of global health financing 1995-2014: Development assistance for health, and government, prepaid private, and out-of-pocket health spending in 184 countries

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Dieleman, J.Institute for Health Metrics and Evaluation, University of Washington, Seattle WA, USA (author)

Evolution and patterns of global health financing 1995-2014 : Development assistance for health, and government, prepaid private, and out-of-pocket health spending in 184 countries

Article/chapterEnglish2017

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Lancet Publishing Group,2017
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LIBRIS-ID:oai:DiVA.org:miun-39810
https://urn.kb.se/resolve?urn=urn:nbn:se:miun:diva-39810URI
https://doi.org/10.1016/S0140-6736(17)30874-7DOI
https://urn.kb.se/resolve?urn=urn:nbn:se:oru:diva-57836URI
https://lup.lub.lu.se/record/380dde3f-c4fe-40d9-8181-88b59074a333URI

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Language:English
Summary in:English

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SwePubSwePub

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Subject category:ref swepub-contenttype
Subject category:art swepub-publicationtype

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Funding Agency:Bill & Melinda Gates Foundation
Background: An adequate amount of prepaid resources for health is important to ensure access to health services and for the pursuit of universal health coverage. Previous studies on global health financing have described the relationship between economic development and health financing. In this study, we further explore global health financing trends and examine how the sources of funds used, types of services purchased, and development assistance for health disbursed change with economic development. We also identify countries that deviate from the trends. Methods: We estimated national health spending by type of care and by source, including development assistance for health, based on a diverse set of data including programme reports, budget data, national estimates, and 964 National Health Accounts. These data represent health spending for 184 countries from 1995 through 2014. We converted these data into a common inflation-adjusted and purchasing power-adjusted currency, and used non-linear regression methods to model the relationship between health financing, time, and economic development. Findings: Between 1995 and 2014, economic development was positively associated with total health spending and a shift away from a reliance on development assistance and out-of-pocket (OOP) towards government spending. The largest absolute increase in spending was in high-income countries, which increased to purchasing power-adjusted $5221 per capita based on an annual growth rate of 3.0%. The largest health spending growth rates were in upper-middle-income (5.9) and lower-middle-income groups (5.0), which both increased spending at more than 5% per year, and spent $914 and $267 per capita in 2014, respectively. Spending in low-income countries grew nearly as fast, at 4.6%, and health spending increased from $51 to $120 per capita. In 2014, 59.2% of all health spending was financed by the government, although in low-income and lower-middle-income countries, 29.1% and 58.0% of spending was OOP spending and 35.7% and 3.0% of spending was development assistance. Recent growth in development assistance for health has been tepid; between 2010 and 2016, it grew annually at 1.8%, and reached US$37.6 billion in 2016. Nonetheless, there is a great deal of variation revolving around these averages. 29 countries spend at least 50% more than expected per capita, based on their level of economic development alone, whereas 11 countries spend less than 50% their expected amount. Interpretation: Health spending remains disparate, with low-income and lower-middle-income countries increasing spending in absolute terms the least, and relying heavily on OOP spending and development assistance. Moreover, tremendous variation shows that neither time nor economic development guarantee adequate prepaid health resources, which are vital for the pursuit of universal health coverage. Â© The Author(s). Published by Elsevier Ltd.

Subject headings and genre

MEDICIN OCH HÄLSOVETENSKAP Hälsovetenskap Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi hsv//swe
MEDICAL AND HEALTH SCIENCES Health Sciences Public Health, Global Health, Social Medicine and Epidemiology hsv//eng
MEDICIN OCH HÄLSOVETENSKAP Hälsovetenskap Hälso- och sjukvårdsorganisation, hälsopolitik och hälsoekonomi hsv//swe
MEDICAL AND HEALTH SCIENCES Health Sciences Health Care Service and Management, Health Policy and Services and Health Economy hsv//eng
Article; economic development; evolution; financial management; global health; government; health care access; health care cost; health insurance; high income country; human; low income country; middle income country; priority journal; developing country; economics; global health; health care cost; health care delivery; health care financing; history; socioeconomics; trends
Developing Countries; Economic Development; Financing
Government; Global Health; Health Expenditures; Health Services Accessibility; Healthcare Financing; History
20th Century; History
21st Century; Humans; Socioeconomic Factors
global health financing

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Campbell, M. (author)
Chapin, A. (author)
Eldrenkamp, E. (author)
Fan, V. Y. (author)
Haakenstad, A. (author)
Kates, J. (author)
Liu, Y. (author)
Matyasz, T. (author)
Micah, A. (author)
Reynolds, A. (author)
Sadat, N. (author)
Schneider, M. T. (author)
Sorensen, R. (author)
Evans, T. (author)
Evans, D. (author)
Kurowski, C. (author)
Tandon, A. (author)
Abbas, K. M. (author)
Abera, S. F. (author)
Ahmad Kiadaliri, AliasgharLund University,Lunds universitet,Ortopedi, Lund,Sektion III,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Lund OsteoArthritis Division - Clinical Epidemiology Unit,Forskargrupper vid Lunds universitet,Orthopaedics (Lund),Section III,Department of Clinical Sciences, Lund,Faculty of Medicine,Lund University Research Groups(Swepub:lu)med-ald (author)
Ahmed, K. Y. (author)
Ahmed, M. B. (author)
Alam, K. (author)
Alizadeh-Navaei, R. (author)
Alkerwi, A. (author)
Amini, E. (author)
Ammar, W. (author)
Amrock, S. M. (author)
Antonio, C. A. T. (author)
Atey, T. M. (author)
Avila-Burgos, L. (author)
Awasthi, A. (author)
Barac, A. (author)
Bernal, O. A. (author)
Beyene, A. S. (author)
Beyene, T. J. (author)
Birungi, C. (author)
Bizuayehu, H. M. (author)
Breitborde, N. J. K. (author)
Cahuana-Hurtado, L. (author)
Castro, R. E. (author)
CatalÃ¡-LÃ³pez, F. (author)
Dalal, KoustuvÖrebro universitet,Institutionen för hälsovetenskaper,Centre for Injury Prevention and Safety Promotion(Swepub:oru)kdl (author)
Dandona, L. (author)
Dandona, R. (author)
De Jager, P. (author)
Dharmaratne, S. D. (author)
Dubey, M. (author)
Farinha, C. S. E. S. (author)
Faro, A. (author)
Feigl, A. B. (author)
Fischer, F. (author)
Fitchett, J. R. A. (author)
Foigt, N. (author)
Giref, A. Z. (author)
Gupta, R. (author)
Hamidi, S. (author)
Harb, H. L. (author)
Hay, S. I. (author)
Hendrie, D. (author)
Horino, M. (author)
JÃŒrisson, M. (author)
Jakovljevic, M. B. (author)
Javanbakht, M.Institute for Health Metrics and Evaluation, University of Washington, Seattle WA, USA (author)
John, D. (author)
Jonas, J. B. (author)
Karimi, S. M. (author)
Khang, Y. -H (author)
Khubchandani, J. (author)
Kim, Y. J. (author)
Kinge, J. M. (author)
Krohn, K. J. (author)
Kumar, G. A. (author)
Magdy Abd El Razek, H. (author)
Magdy Abd El Razek, M. (author)
Majeed, A. (author)
Malekzadeh, R. (author)
Masiye, F. (author)
Meier, T. (author)
Meretoja, A. (author)
Miller, T. R. (author)
Mirrakhimov, E. M. (author)
Mohammed, S. (author)
Nangia, V. (author)
Olgiati, S. (author)
Osman, A. S. (author)
Owolabi, M. O. (author)
Patel, T. (author)
Paternina Caicedo, A. J. (author)
Pereira, D. M. (author)
Perelman, J. (author)
Polinder, S. (author)
Rafay, A. (author)
Rahimi-Movaghar, V. (author)
Rai, R. K. (author)
Ram, U. (author)
Ranabhat, C. L. (author)
Roba, H. S. (author)
Salama, J. (author)
Savic, M. (author)
Sepanlou, S. G. (author)
Shrime, M. G. (author)
Talongwa, R. T. (author)
Te Ao, B. J. (author)
Tediosi, F. (author)
Tesema, A. G. (author)
Thomson, A. J. (author)
Tobe-Gai, R. (author)
Topor-Madry, R. (author)
Undurraga, E. A. (author)
Vasankari, T. (author)
Violante, F. S. (author)
Werdecker, A. (author)
Wijeratne, T. (author)
Xu, G. (author)
Yonemoto, N. (author)
Younis, M. Z. (author)
Yu, C. (author)
Zaidi, Z. (author)
El Sayed Zaki, M. (author)
Murray, C. J. L. (author)
Network, Global Burden of Disease Health Financing Collaborator (author)
Institute for Health Metrics and Evaluation, University of Washington, Seattle WA, USAOrtopedi, Lund (creator_code:org_t)

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In:The Lancet: Lancet Publishing Group389:10083, s. 1981-20040140-67361474-547X

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By the author/editor: Dieleman, J.; Campbell, M.; Chapin, A.; Eldrenkamp, E.; Fan, V. Y.; Haakenstad, A.; show more...; Kates, J.; Liu, Y.; Matyasz, T.; Micah, A.; Reynolds, A.; Sadat, N.; Schneider, M. T.; Sorensen, R.; Evans, T.; Evans, D.; Kurowski, C.; Tandon, A.; Abbas, K. M.; Abera, S. F.; Ahmad Kiadaliri, ...; Ahmed, K. Y.; Ahmed, M. B.; Alam, K.; Alizadeh-Navaei, ...; Alkerwi, A.; Amini, E.; Ammar, W.; Amrock, S. M.; Antonio, C. A. T ...; Atey, T. M.; Avila-Burgos, L.; Awasthi, A.; Barac, A.; Bernal, O. A.; Beyene, A. S.; Beyene, T. J.; Birungi, C.; Bizuayehu, H. M.; Breitborde, N. J ...; Cahuana-Hurtado, ...; Castro, R. E.; CatalÃ¡-LÃ³pez, ...; Dalal, Koustuv; Dandona, L.; Dandona, R.; De Jager, P.; Dharmaratne, S. ...; Dubey, M.; Farinha, C. S. E ...; Faro, A.; Feigl, A. B.; Fischer, F.; Fitchett, J. R. ...; Foigt, N.; Giref, A. Z.; Gupta, R.; Hamidi, S.; Harb, H. L.; Hay, S. I.; Hendrie, D.; Horino, M.; JÃŒrisson, M.; Jakovljevic, M. ...; Javanbakht, M.; John, D.; Jonas, J. B.; Karimi, S. M.; Khang, Y. -H; Khubchandani, J.; Kim, Y. J.; Kinge, J. M.; Krohn, K. J.; Kumar, G. A.; Magdy Abd El Raz ...; Magdy Abd El Raz ...; Majeed, A.; Malekzadeh, R.; Masiye, F.; Meier, T.; Meretoja, A.; Miller, T. R.; Mirrakhimov, E. ...; Mohammed, S.; Nangia, V.; Olgiati, S.; Osman, A. S.; Owolabi, M. O.; Patel, T.; Paternina Caiced ...; Pereira, D. M.; Perelman, J.; Polinder, S.; Rafay, A.; Rahimi-Movaghar, ...; Rai, R. K.; Ram, U.; Ranabhat, C. L.; Roba, H. S.; Salama, J.; Savic, M.; Sepanlou, S. G.; Shrime, M. G.; Talongwa, R. T.; Te Ao, B. J.; Tediosi, F.; Tesema, A. G.; Thomson, A. J.; Tobe-Gai, R.; Topor-Madry, R.; Undurraga, E. A.; Vasankari, T.; Violante, F. S.; Werdecker, A.; Wijeratne, T.; Xu, G.; Yonemoto, N.; Younis, M. Z.; Yu, C.; Zaidi, Z.; El Sayed Zaki, M ...; Murray, C. J. L.; Network, Global ...; show less...

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