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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

Summary 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 t... Full description

Journal Title: Lancet 2017-05-20, Vol.389 (10083), p.1981-2004
Main Author: Dieleman, Joseph
Other Authors: Campbell, Madeline , Eldrenkamp, Erika , Fan, Victoria Y , Haakenstad, Annie , Kates, Jennifer , Liu, Yingying , Micah, Angela , Reynolds, Alex , Sadat, Nafis , Schneider, Matthew T , Sorensen, Reed , Evans, Tim , Evans, David , Abbas, Kaja M , Abera, Semaw Ferede , Kiadaliri, Aliasghar Ahmad , Ahmed, Kedir Yimam , Ahmed, Muktar Beshir , Alam, Khurshid , Alizadeh-Navaei, Reza , Alkerwi, Ala'a , Amini, Erfan , Ammar, Walid , Amrock, Stephen Marc , Antonio, Carl Abelardo T , Avila-Burgos, Leticia , Awasthi, Ashish , Bernal, Oscar Alberto , Beyene, Addisu Shunu , Beyene, Tariku Jibat , Birungi, Charles , Breitborde, Nicholas J K , Cahuana-Hurtado, Lucero , Castro, Ruben Estanislao , Catalia-Lopez, Ferran , Dalal, Koustuv , Dandona, Lalit , Dandona, Rakhi , Farinha, Carla Sofia e Sa , Faro, Andre , Feigl, Andrea B , Fitchett, Joseph Robert Anderson , Foigt, Nataliya , Giref, Ababi Zergaw , Gupta, Rahul , Hamidi, Samer , Harb, Hilda L , Horino, Masako , Jürisson, Mikk , Jakovljevic, Mihajlo B , Javanbakht, Mehdi , John, Denny , Jonas, Jost B , Karimi, Seyed M , Khang, Young-Ho , Khubchandani, Jagdish , Kinge, Jonas M , Krohn, Kristopher J , Kumar, G Anil , Majeed, Azeem , Malekzadeh, Reza , Masiye, Felix , Meier, Toni , Meretoja, Atte , Mirrakhimov, Erkin M , Mohammed, Shafiu , Osman, Abdalla Sidahmed , Owolabi, Mayowa O , Patel, Tejas , Caicedo, Angel J Paternina , Pereira, David M , Perelman, Julian , Polinder, Suzanne , Rafay, Anwar , Rahimi-Movaghar, Vafa , Rai, Rajesh Kumar , Ram, Usha , Ranabhat, Chhabi Lal , Roba, Hirbo Shore , Salama, Joseph , Savic, Miloje , Sepanlou, Sadaf G , Shrime, Mark G , Talongwa, Roberto Tchio , Ao, Braden J Te , Tediosi, Fabrizio , Thomson, Alan J , Tobe-Gai, Ruoyan , Undurraga, Eduardo A , Violante, Francesco S , Werdecker, Andrea , Wijeratne, Tissa , Xu, Gelin , Yonemoto, Naohiro , Younis, Mustafa Z , Yu, Chuanhua , Zaidi, Zoubida , El Sayed Zaki, Maysaa , Murray, Christopher J L
Format: Electronic Article Electronic Article
Language: English
Subjects:
Quelle: Alma/SFX Local Collection
Publisher: England: Elsevier Ltd
ID: ISSN: 0140-6736
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recordid: cdi_wageningen_narcis_oai_library_wur_nl_wurpubs_530598
title: 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
format: Article
creator:
  • Dieleman, Joseph
  • Campbell, Madeline
  • Eldrenkamp, Erika
  • Fan, Victoria Y
  • Haakenstad, Annie
  • Kates, Jennifer
  • Liu, Yingying
  • Micah, Angela
  • Reynolds, Alex
  • Sadat, Nafis
  • Schneider, Matthew T
  • Sorensen, Reed
  • Evans, Tim
  • Evans, David
  • Abbas, Kaja M
  • Abera, Semaw Ferede
  • Kiadaliri, Aliasghar Ahmad
  • Ahmed, Kedir Yimam
  • Ahmed, Muktar Beshir
  • Alam, Khurshid
  • Alizadeh-Navaei, Reza
  • Alkerwi, Ala'a
  • Amini, Erfan
  • Ammar, Walid
  • Amrock, Stephen Marc
  • Antonio, Carl Abelardo T
  • Avila-Burgos, Leticia
  • Awasthi, Ashish
  • Bernal, Oscar Alberto
  • Beyene, Addisu Shunu
  • Beyene, Tariku Jibat
  • Birungi, Charles
  • Breitborde, Nicholas J K
  • Cahuana-Hurtado, Lucero
  • Castro, Ruben Estanislao
  • Catalia-Lopez, Ferran
  • Dalal, Koustuv
  • Dandona, Lalit
  • Dandona, Rakhi
  • Farinha, Carla Sofia e Sa
  • Faro, Andre
  • Feigl, Andrea B
  • Fitchett, Joseph Robert Anderson
  • Foigt, Nataliya
  • Giref, Ababi Zergaw
  • Gupta, Rahul
  • Hamidi, Samer
  • Harb, Hilda L
  • Horino, Masako
  • Jürisson, Mikk
  • Jakovljevic, Mihajlo B
  • Javanbakht, Mehdi
  • John, Denny
  • Jonas, Jost B
  • Karimi, Seyed M
  • Khang, Young-Ho
  • Khubchandani, Jagdish
  • Kinge, Jonas M
  • Krohn, Kristopher J
  • Kumar, G Anil
  • Majeed, Azeem
  • Malekzadeh, Reza
  • Masiye, Felix
  • Meier, Toni
  • Meretoja, Atte
  • Mirrakhimov, Erkin M
  • Mohammed, Shafiu
  • Osman, Abdalla Sidahmed
  • Owolabi, Mayowa O
  • Patel, Tejas
  • Caicedo, Angel J Paternina
  • Pereira, David M
  • Perelman, Julian
  • Polinder, Suzanne
  • Rafay, Anwar
  • Rahimi-Movaghar, Vafa
  • Rai, Rajesh Kumar
  • Ram, Usha
  • Ranabhat, Chhabi Lal
  • Roba, Hirbo Shore
  • Salama, Joseph
  • Savic, Miloje
  • Sepanlou, Sadaf G
  • Shrime, Mark G
  • Talongwa, Roberto Tchio
  • Ao, Braden J Te
  • Tediosi, Fabrizio
  • Thomson, Alan J
  • Tobe-Gai, Ruoyan
  • Undurraga, Eduardo A
  • Violante, Francesco S
  • Werdecker, Andrea
  • Wijeratne, Tissa
  • Xu, Gelin
  • Yonemoto, Naohiro
  • Younis, Mustafa Z
  • Yu, Chuanhua
  • Zaidi, Zoubida
  • El Sayed Zaki, Maysaa
  • Murray, Christopher J L
subjects:
  • 11 Medical And Health Sciences
  • 20th Century
  • History
  • 21st Century
  • Humans
  • Socioeconomic Factors
  • 3121 Internal medicine
  • Abridged Index Medicus
  • Adjustment
  • Agrarische bedrijfseconomie
  • 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
  • Articles
  • Bedrijfseconomie
  • Business Economics
  • Charities
  • developing Countries
  • Developing Countries
  • Economic Development
  • Financing
  • Economic development
  • Economic models
  • Epidemiology
  • Expenditures, Public
  • Federal budgets
  • Financing
  • Folkhälsovetenskap
  • Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi
  • General & Internal
  • General & Internal Medicine
  • Global Burden of Disease
  • Global Health
  • global health financing
  • global hälsa
  • Government finance
  • Government procurement
  • Government spending
  • Government
  • Global Health
  • Health Expenditures
  • Health Services Accessibility
  • Healthcare Financing
  • History
  • Growth rate
  • Health care
  • Health care access
  • Health Care Service and Management, Health Policy and Services and Health Economy
  • Health economics
  • health expenditures
  • Health Sciences
  • health services accessibility
  • High income
  • humans socioeconomic factors
  • Hälso- och sjukvårdsorganisation, hälsopolitik och hälsoekonomi
  • Hälsovetenskap
  • Hälsovetenskaper
  • Identification methods
  • Income
  • Internal Medicine
  • Life Sciences & Biomedicine
  • Low income groups
  • Medical and Health Sciences
  • Medical economics
  • Medical savings accounts
  • Medicin och hälsovetenskap
  • Medicine
  • Medicine (all)
  • National health insurance
  • Per capita
  • Prepaid services
  • Public Health
  • Public Health, Global Health, Social Medicine and Epidemiology
  • Regression models
  • Science & Technology
  • Social Medicine
  • socialmedicin och epidemiologi
  • Trends
ispartof: Lancet, 2017-05-20, Vol.389 (10083), p.1981-2004
description: Summary 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 am
language: eng
source: Alma/SFX Local Collection
identifier: ISSN: 0140-6736
fulltext: fulltext
issn:
  • 0140-6736
  • 1474-547X
  • 1474-547X
url: Link


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titleEvolution 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
sourceAlma/SFX Local Collection
creatorDieleman, Joseph ; Campbell, Madeline ; Eldrenkamp, Erika ; Fan, Victoria Y ; Haakenstad, Annie ; Kates, Jennifer ; Liu, Yingying ; Micah, Angela ; Reynolds, Alex ; Sadat, Nafis ; Schneider, Matthew T ; Sorensen, Reed ; Evans, Tim ; Evans, David ; Abbas, Kaja M ; Abera, Semaw Ferede ; Kiadaliri, Aliasghar Ahmad ; Ahmed, Kedir Yimam ; Ahmed, Muktar Beshir ; Alam, Khurshid ; Alizadeh-Navaei, Reza ; Alkerwi, Ala'a ; Amini, Erfan ; Ammar, Walid ; Amrock, Stephen Marc ; Antonio, Carl Abelardo T ; Avila-Burgos, Leticia ; Awasthi, Ashish ; Bernal, Oscar Alberto ; Beyene, Addisu Shunu ; Beyene, Tariku Jibat ; Birungi, Charles ; Breitborde, Nicholas J K ; Cahuana-Hurtado, Lucero ; Castro, Ruben Estanislao ; Catalia-Lopez, Ferran ; Dalal, Koustuv ; Dandona, Lalit ; Dandona, Rakhi ; Farinha, Carla Sofia e Sa ; Faro, Andre ; Feigl, Andrea B ; Fitchett, Joseph Robert Anderson ; Foigt, Nataliya ; Giref, Ababi Zergaw ; Gupta, Rahul ; Hamidi, Samer ; Harb, Hilda L ; Horino, Masako ; Jürisson, Mikk ; Jakovljevic, Mihajlo B ; Javanbakht, Mehdi ; John, Denny ; Jonas, Jost B ; Karimi, Seyed M ; Khang, Young-Ho ; Khubchandani, Jagdish ; Kinge, Jonas M ; Krohn, Kristopher J ; Kumar, G Anil ; Majeed, Azeem ; Malekzadeh, Reza ; Masiye, Felix ; Meier, Toni ; Meretoja, Atte ; Mirrakhimov, Erkin M ; Mohammed, Shafiu ; Osman, Abdalla Sidahmed ; Owolabi, Mayowa O ; Patel, Tejas ; Caicedo, Angel J Paternina ; Pereira, David M ; Perelman, Julian ; Polinder, Suzanne ; Rafay, Anwar ; Rahimi-Movaghar, Vafa ; Rai, Rajesh Kumar ; Ram, Usha ; Ranabhat, Chhabi Lal ; Roba, Hirbo Shore ; Salama, Joseph ; Savic, Miloje ; Sepanlou, Sadaf G ; Shrime, Mark G ; Talongwa, Roberto Tchio ; Ao, Braden J Te ; Tediosi, Fabrizio ; Thomson, Alan J ; Tobe-Gai, Ruoyan ; Undurraga, Eduardo A ; Violante, Francesco S ; Werdecker, Andrea ; Wijeratne, Tissa ; Xu, Gelin ; Yonemoto, Naohiro ; Younis, Mustafa Z ; Yu, Chuanhua ; Zaidi, Zoubida ; El Sayed Zaki, Maysaa ; Murray, Christopher J L
creatorcontribDieleman, Joseph ; Campbell, Madeline ; Eldrenkamp, Erika ; Fan, Victoria Y ; Haakenstad, Annie ; Kates, Jennifer ; Liu, Yingying ; Micah, Angela ; Reynolds, Alex ; Sadat, Nafis ; Schneider, Matthew T ; Sorensen, Reed ; Evans, Tim ; Evans, David ; Abbas, Kaja M ; Abera, Semaw Ferede ; Kiadaliri, Aliasghar Ahmad ; Ahmed, Kedir Yimam ; Ahmed, Muktar Beshir ; Alam, Khurshid ; Alizadeh-Navaei, Reza ; Alkerwi, Ala'a ; Amini, Erfan ; Ammar, Walid ; Amrock, Stephen Marc ; Antonio, Carl Abelardo T ; Avila-Burgos, Leticia ; Awasthi, Ashish ; Bernal, Oscar Alberto ; Beyene, Addisu Shunu ; Beyene, Tariku Jibat ; Birungi, Charles ; Breitborde, Nicholas J K ; Cahuana-Hurtado, Lucero ; Castro, Ruben Estanislao ; Catalia-Lopez, Ferran ; Dalal, Koustuv ; Dandona, Lalit ; Dandona, Rakhi ; Farinha, Carla Sofia e Sa ; Faro, Andre ; Feigl, Andrea B ; Fitchett, Joseph Robert Anderson ; Foigt, Nataliya ; Giref, Ababi Zergaw ; Gupta, Rahul ; Hamidi, Samer ; Harb, Hilda L ; Horino, Masako ; Jürisson, Mikk ; Jakovljevic, Mihajlo B ; Javanbakht, Mehdi ; John, Denny ; Jonas, Jost B ; Karimi, Seyed M ; Khang, Young-Ho ; Khubchandani, Jagdish ; Kinge, Jonas M ; Krohn, Kristopher J ; Kumar, G Anil ; Majeed, Azeem ; Malekzadeh, Reza ; Masiye, Felix ; Meier, Toni ; Meretoja, Atte ; Mirrakhimov, Erkin M ; Mohammed, Shafiu ; Osman, Abdalla Sidahmed ; Owolabi, Mayowa O ; Patel, Tejas ; Caicedo, Angel J Paternina ; Pereira, David M ; Perelman, Julian ; Polinder, Suzanne ; Rafay, Anwar ; Rahimi-Movaghar, Vafa ; Rai, Rajesh Kumar ; Ram, Usha ; Ranabhat, Chhabi Lal ; Roba, Hirbo Shore ; Salama, Joseph ; Savic, Miloje ; Sepanlou, Sadaf G ; Shrime, Mark G ; Talongwa, Roberto Tchio ; Ao, Braden J Te ; Tediosi, Fabrizio ; Thomson, Alan J ; Tobe-Gai, Ruoyan ; Undurraga, Eduardo A ; Violante, Francesco S ; Werdecker, Andrea ; Wijeratne, Tissa ; Xu, Gelin ; Yonemoto, Naohiro ; Younis, Mustafa Z ; Yu, Chuanhua ; Zaidi, Zoubida ; El Sayed Zaki, Maysaa ; Murray, Christopher J L ; Global Burden of Disease Health Financing Collaborator Network
descriptionSummary 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. Funding The Bill & Melinda Gates Foundation.
identifier
0ISSN: 0140-6736
1ISSN: 1474-547X
2EISSN: 1474-547X
3DOI: 10.1016/S0140-6736(17)30874-7
4PMID: 28433256
languageeng
publisherEngland: Elsevier Ltd
subject11 Medical And Health Sciences ; 20th Century; History ; 21st Century; Humans; Socioeconomic Factors ; 3121 Internal medicine ; Abridged Index Medicus ; Adjustment ; Agrarische bedrijfseconomie ; 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 ; Articles ; Bedrijfseconomie ; Business Economics ; Charities ; developing Countries ; Developing Countries; Economic Development; Financing ; Economic development ; Economic models ; Epidemiology ; Expenditures, Public ; Federal budgets ; Financing ; Folkhälsovetenskap ; Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi ; General & Internal ; General & Internal Medicine ; Global Burden of Disease ; Global Health ; global health financing ; global hälsa ; Government finance ; Government procurement ; Government spending ; Government; Global Health; Health Expenditures; Health Services Accessibility; Healthcare Financing; History ; Growth rate ; Health care ; Health care access ; Health Care Service and Management, Health Policy and Services and Health Economy ; Health economics ; health expenditures ; Health Sciences ; health services accessibility ; High income ; humans socioeconomic factors ; Hälso- och sjukvårdsorganisation, hälsopolitik och hälsoekonomi ; Hälsovetenskap ; Hälsovetenskaper ; Identification methods ; Income ; Internal Medicine ; Life Sciences & Biomedicine ; Low income groups ; Medical and Health Sciences ; Medical economics ; Medical savings accounts ; Medicin och hälsovetenskap ; Medicine ; Medicine (all) ; National health insurance ; Per capita ; Prepaid services ; Public Health ; Public Health, Global Health, Social Medicine and Epidemiology ; Regression models ; Science & Technology ; Social Medicine ; socialmedicin och epidemiologi ; Trends
ispartofLancet, 2017-05-20, Vol.389 (10083), p.1981-2004
rights
0The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license
12017 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license
2info:eu-repo/semantics/openAccess
3Copyright © 2017 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license. Published by Elsevier Ltd.. All rights reserved.
4COPYRIGHT 2017 Elsevier B.V.
5Copyright Elsevier Limited May 20, 2017
62017. The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license.
72017 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license 2017
8Wageningen University & Research
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creatorcontrib
0Dieleman, Joseph
1Campbell, Madeline
2Eldrenkamp, Erika
3Fan, Victoria Y
4Haakenstad, Annie
5Kates, Jennifer
6Liu, Yingying
7Micah, Angela
8Reynolds, Alex
9Sadat, Nafis
10Schneider, Matthew T
11Sorensen, Reed
12Evans, Tim
13Evans, David
14Abbas, Kaja M
15Abera, Semaw Ferede
16Kiadaliri, Aliasghar Ahmad
17Ahmed, Kedir Yimam
18Ahmed, Muktar Beshir
19Alam, Khurshid
20Alizadeh-Navaei, Reza
21Alkerwi, Ala'a
22Amini, Erfan
23Ammar, Walid
24Amrock, Stephen Marc
25Antonio, Carl Abelardo T
26Avila-Burgos, Leticia
27Awasthi, Ashish
28Bernal, Oscar Alberto
29Beyene, Addisu Shunu
30Beyene, Tariku Jibat
31Birungi, Charles
32Breitborde, Nicholas J K
33Cahuana-Hurtado, Lucero
34Castro, Ruben Estanislao
35Catalia-Lopez, Ferran
36Dalal, Koustuv
37Dandona, Lalit
38Dandona, Rakhi
39Farinha, Carla Sofia e Sa
40Faro, Andre
41Feigl, Andrea B
42Fitchett, Joseph Robert Anderson
43Foigt, Nataliya
44Giref, Ababi Zergaw
45Gupta, Rahul
46Hamidi, Samer
47Harb, Hilda L
48Horino, Masako
49Jürisson, Mikk
50Jakovljevic, Mihajlo B
51Javanbakht, Mehdi
52John, Denny
53Jonas, Jost B
54Karimi, Seyed M
55Khang, Young-Ho
56Khubchandani, Jagdish
57Kinge, Jonas M
58Krohn, Kristopher J
59Kumar, G Anil
60Majeed, Azeem
61Malekzadeh, Reza
62Masiye, Felix
63Meier, Toni
64Meretoja, Atte
65Mirrakhimov, Erkin M
66Mohammed, Shafiu
67Osman, Abdalla Sidahmed
68Owolabi, Mayowa O
69Patel, Tejas
70Caicedo, Angel J Paternina
71Pereira, David M
72Perelman, Julian
73Polinder, Suzanne
74Rafay, Anwar
75Rahimi-Movaghar, Vafa
76Rai, Rajesh Kumar
77Ram, Usha
78Ranabhat, Chhabi Lal
79Roba, Hirbo Shore
80Salama, Joseph
81Savic, Miloje
82Sepanlou, Sadaf G
83Shrime, Mark G
84Talongwa, Roberto Tchio
85Ao, Braden J Te
86Tediosi, Fabrizio
87Thomson, Alan J
88Tobe-Gai, Ruoyan
89Undurraga, Eduardo A
90Violante, Francesco S
91Werdecker, Andrea
92Wijeratne, Tissa
93Xu, Gelin
94Yonemoto, Naohiro
95Younis, Mustafa Z
96Yu, Chuanhua
97Zaidi, Zoubida
98El Sayed Zaki, Maysaa
99Murray, Christopher J L
100Global Burden of Disease Health Financing Collaborator Network
title
0Evolution 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
1Lancet
addtitleLancet
descriptionSummary 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. Funding The Bill & Melinda Gates Foundation.
subject
011 Medical And Health Sciences
120th Century; History
221st Century; Humans; Socioeconomic Factors
33121 Internal medicine
4Abridged Index Medicus
5Adjustment
6Agrarische bedrijfseconomie
7Article; 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
8Articles
9Bedrijfseconomie
10Business Economics
11Charities
12developing Countries
13Developing Countries; Economic Development; Financing
14Economic development
15Economic models
16Epidemiology
17Expenditures, Public
18Federal budgets
19Financing
20Folkhälsovetenskap
21Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi
22General & Internal
23General & Internal Medicine
24Global Burden of Disease
25Global Health
26global health financing
27global hälsa
28Government finance
29Government procurement
30Government spending
31Government; Global Health; Health Expenditures; Health Services Accessibility; Healthcare Financing; History
32Growth rate
33Health care
34Health care access
35Health Care Service and Management, Health Policy and Services and Health Economy
36Health economics
37health expenditures
38Health Sciences
39health services accessibility
40High income
41humans socioeconomic factors
42Hälso- och sjukvårdsorganisation, hälsopolitik och hälsoekonomi
43Hälsovetenskap
44Hälsovetenskaper
45Identification methods
46Income
47Internal Medicine
48Life Sciences & Biomedicine
49Low income groups
50Medical and Health Sciences
51Medical economics
52Medical savings accounts
53Medicin och hälsovetenskap
54Medicine
55Medicine (all)
56National health insurance
57Per capita
58Prepaid services
59Public Health
60Public Health, Global Health, Social Medicine and Epidemiology
61Regression models
62Science & Technology
63Social Medicine
64socialmedicin och epidemiologi
65Trends
issn
00140-6736
11474-547X
21474-547X
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startdate20170520
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0Dieleman, Joseph
1Campbell, Madeline
2Eldrenkamp, Erika
3Fan, Victoria Y
4Haakenstad, Annie
5Kates, Jennifer
6Liu, Yingying
7Micah, Angela
8Reynolds, Alex
9Sadat, Nafis
10Schneider, Matthew T
11Sorensen, Reed
12Evans, Tim
13Evans, David
14Abbas, Kaja M
15Abera, Semaw Ferede
16Kiadaliri, Aliasghar Ahmad
17Ahmed, Kedir Yimam
18Ahmed, Muktar Beshir
19Alam, Khurshid
20Alizadeh-Navaei, Reza
21Alkerwi, Ala'a
22Amini, Erfan
23Ammar, Walid
24Amrock, Stephen Marc
25Antonio, Carl Abelardo T
26Avila-Burgos, Leticia
27Awasthi, Ashish
28Bernal, Oscar Alberto
29Beyene, Addisu Shunu
30Beyene, Tariku Jibat
31Birungi, Charles
32Breitborde, Nicholas J K
33Cahuana-Hurtado, Lucero
34Castro, Ruben Estanislao
35Catalia-Lopez, Ferran
36Dalal, Koustuv
37Dandona, Lalit
38Dandona, Rakhi
39Farinha, Carla Sofia e Sa
40Faro, Andre
41Feigl, Andrea B
42Fitchett, Joseph Robert Anderson
43Foigt, Nataliya
44Giref, Ababi Zergaw
45Gupta, Rahul
46Hamidi, Samer
47Harb, Hilda L
48Horino, Masako
49Jürisson, Mikk
50Jakovljevic, Mihajlo B
51Javanbakht, Mehdi
52John, Denny
53Jonas, Jost B
54Karimi, Seyed M
55Khang, Young-Ho
56Khubchandani, Jagdish
57Kinge, Jonas M
58Krohn, Kristopher J
59Kumar, G Anil
60Majeed, Azeem
61Malekzadeh, Reza
62Masiye, Felix
63Meier, Toni
64Meretoja, Atte
65Mirrakhimov, Erkin M
66Mohammed, Shafiu
67Osman, Abdalla Sidahmed
68Owolabi, Mayowa O
69Patel, Tejas
70Caicedo, Angel J Paternina
71Pereira, David M
72Perelman, Julian
73Polinder, Suzanne
74Rafay, Anwar
75Rahimi-Movaghar, Vafa
76Rai, Rajesh Kumar
77Ram, Usha
78Ranabhat, Chhabi Lal
79Roba, Hirbo Shore
80Salama, Joseph
81Savic, Miloje
82Sepanlou, Sadaf G
83Shrime, Mark G
84Talongwa, Roberto Tchio
85Ao, Braden J Te
86Tediosi, Fabrizio
87Thomson, Alan J
88Tobe-Gai, Ruoyan
89Undurraga, Eduardo A
90Violante, Francesco S
91Werdecker, Andrea
92Wijeratne, Tissa
93Xu, Gelin
94Yonemoto, Naohiro
95Younis, Mustafa Z
96Yu, Chuanhua
97Zaidi, Zoubida
98El Sayed Zaki, Maysaa
99Murray, Christopher J L
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titleEvolution 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
authorDieleman, Joseph ; Campbell, Madeline ; Eldrenkamp, Erika ; Fan, Victoria Y ; Haakenstad, Annie ; Kates, Jennifer ; Liu, Yingying ; Micah, Angela ; Reynolds, Alex ; Sadat, Nafis ; Schneider, Matthew T ; Sorensen, Reed ; Evans, Tim ; Evans, David ; Abbas, Kaja M ; Abera, Semaw Ferede ; Kiadaliri, Aliasghar Ahmad ; Ahmed, Kedir Yimam ; Ahmed, Muktar Beshir ; Alam, Khurshid ; Alizadeh-Navaei, Reza ; Alkerwi, Ala'a ; Amini, Erfan ; Ammar, Walid ; Amrock, Stephen Marc ; Antonio, Carl Abelardo T ; Avila-Burgos, Leticia ; Awasthi, Ashish ; Bernal, Oscar Alberto ; Beyene, Addisu Shunu ; Beyene, Tariku Jibat ; Birungi, Charles ; Breitborde, Nicholas J K ; Cahuana-Hurtado, Lucero ; Castro, Ruben Estanislao ; Catalia-Lopez, Ferran ; Dalal, Koustuv ; Dandona, Lalit ; Dandona, Rakhi ; Farinha, Carla Sofia e Sa ; Faro, Andre ; Feigl, Andrea B ; Fitchett, Joseph Robert Anderson ; Foigt, Nataliya ; Giref, Ababi Zergaw ; Gupta, Rahul ; Hamidi, Samer ; Harb, Hilda L ; Horino, Masako ; Jürisson, Mikk ; Jakovljevic, Mihajlo B ; Javanbakht, Mehdi ; John, Denny ; Jonas, Jost B ; Karimi, Seyed M ; Khang, Young-Ho ; Khubchandani, Jagdish ; Kinge, Jonas M ; Krohn, Kristopher J ; Kumar, G Anil ; Majeed, Azeem ; Malekzadeh, Reza ; Masiye, Felix ; Meier, Toni ; Meretoja, Atte ; Mirrakhimov, Erkin M ; Mohammed, Shafiu ; Osman, Abdalla Sidahmed ; Owolabi, Mayowa O ; Patel, Tejas ; Caicedo, Angel J Paternina ; Pereira, David M ; Perelman, Julian ; Polinder, Suzanne ; Rafay, Anwar ; Rahimi-Movaghar, Vafa ; Rai, Rajesh Kumar ; Ram, Usha ; Ranabhat, Chhabi Lal ; Roba, Hirbo Shore ; Salama, Joseph ; Savic, Miloje ; Sepanlou, Sadaf G ; Shrime, Mark G ; Talongwa, Roberto Tchio ; Ao, Braden J Te ; Tediosi, Fabrizio ; Thomson, Alan J ; Tobe-Gai, Ruoyan ; Undurraga, Eduardo A ; Violante, Francesco S ; Werdecker, Andrea ; Wijeratne, Tissa ; Xu, Gelin ; Yonemoto, Naohiro ; Younis, Mustafa Z ; Yu, Chuanhua ; Zaidi, Zoubida ; El Sayed Zaki, Maysaa ; Murray, Christopher J L
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languageeng
creationdate2017
topic
011 Medical And Health Sciences
120th Century; History
221st Century; Humans; Socioeconomic Factors
33121 Internal medicine
4Abridged Index Medicus
5Adjustment
6Agrarische bedrijfseconomie
7Article; 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
8Articles
9Bedrijfseconomie
10Business Economics
11Charities
12developing Countries
13Developing Countries; Economic Development; Financing
14Economic development
15Economic models
16Epidemiology
17Expenditures, Public
18Federal budgets
19Financing
20Folkhälsovetenskap
21Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi
22General & Internal
23General & Internal Medicine
24Global Burden of Disease
25Global Health
26global health financing
27global hälsa
28Government finance
29Government procurement
30Government spending
31Government; Global Health; Health Expenditures; Health Services Accessibility; Healthcare Financing; History
32Growth rate
33Health care
34Health care access
35Health Care Service and Management, Health Policy and Services and Health Economy
36Health economics
37health expenditures
38Health Sciences
39health services accessibility
40High income
41humans socioeconomic factors
42Hälso- och sjukvårdsorganisation, hälsopolitik och hälsoekonomi
43Hälsovetenskap
44Hälsovetenskaper
45Identification methods
46Income
47Internal Medicine
48Life Sciences & Biomedicine
49Low income groups
50Medical and Health Sciences
51Medical economics
52Medical savings accounts
53Medicin och hälsovetenskap
54Medicine
55Medicine (all)
56National health insurance
57Per capita
58Prepaid services
59Public Health
60Public Health, Global Health, Social Medicine and Epidemiology
61Regression models
62Science & Technology
63Social Medicine
64socialmedicin och epidemiologi
65Trends
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creatorcontrib
0Dieleman, Joseph
1Campbell, Madeline
2Eldrenkamp, Erika
3Fan, Victoria Y
4Haakenstad, Annie
5Kates, Jennifer
6Liu, Yingying
7Micah, Angela
8Reynolds, Alex
9Sadat, Nafis
10Schneider, Matthew T
11Sorensen, Reed
12Evans, Tim
13Evans, David
14Abbas, Kaja M
15Abera, Semaw Ferede
16Kiadaliri, Aliasghar Ahmad
17Ahmed, Kedir Yimam
18Ahmed, Muktar Beshir
19Alam, Khurshid
20Alizadeh-Navaei, Reza
21Alkerwi, Ala'a
22Amini, Erfan
23Ammar, Walid
24Amrock, Stephen Marc
25Antonio, Carl Abelardo T
26Avila-Burgos, Leticia
27Awasthi, Ashish
28Bernal, Oscar Alberto
29Beyene, Addisu Shunu
30Beyene, Tariku Jibat
31Birungi, Charles
32Breitborde, Nicholas J K
33Cahuana-Hurtado, Lucero
34Castro, Ruben Estanislao
35Catalia-Lopez, Ferran
36Dalal, Koustuv
37Dandona, Lalit
38Dandona, Rakhi
39Farinha, Carla Sofia e Sa
40Faro, Andre
41Feigl, Andrea B
42Fitchett, Joseph Robert Anderson
43Foigt, Nataliya
44Giref, Ababi Zergaw
45Gupta, Rahul
46Hamidi, Samer
47Harb, Hilda L
48Horino, Masako
49Jürisson, Mikk
50Jakovljevic, Mihajlo B
51Javanbakht, Mehdi
52John, Denny
53Jonas, Jost B
54Karimi, Seyed M
55Khang, Young-Ho
56Khubchandani, Jagdish
57Kinge, Jonas M
58Krohn, Kristopher J
59Kumar, G Anil
60Majeed, Azeem
61Malekzadeh, Reza
62Masiye, Felix
63Meier, Toni
64Meretoja, Atte
65Mirrakhimov, Erkin M
66Mohammed, Shafiu
67Osman, Abdalla Sidahmed
68Owolabi, Mayowa O
69Patel, Tejas
70Caicedo, Angel J Paternina
71Pereira, David M
72Perelman, Julian
73Polinder, Suzanne
74Rafay, Anwar
75Rahimi-Movaghar, Vafa
76Rai, Rajesh Kumar
77Ram, Usha
78Ranabhat, Chhabi Lal
79Roba, Hirbo Shore
80Salama, Joseph
81Savic, Miloje
82Sepanlou, Sadaf G
83Shrime, Mark G
84Talongwa, Roberto Tchio
85Ao, Braden J Te
86Tediosi, Fabrizio
87Thomson, Alan J
88Tobe-Gai, Ruoyan
89Undurraga, Eduardo A
90Violante, Francesco S
91Werdecker, Andrea
92Wijeratne, Tissa
93Xu, Gelin
94Yonemoto, Naohiro
95Younis, Mustafa Z
96Yu, Chuanhua
97Zaidi, Zoubida
98El Sayed Zaki, Maysaa
99Murray, Christopher J L
100Global Burden of Disease Health Financing Collaborator Network
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au
0Dieleman, Joseph
1Campbell, Madeline
2Eldrenkamp, Erika
3Fan, Victoria Y
4Haakenstad, Annie
5Kates, Jennifer
6Liu, Yingying
7Micah, Angela
8Reynolds, Alex
9Sadat, Nafis
10Schneider, Matthew T
11Sorensen, Reed
12Evans, Tim
13Evans, David
14Abbas, Kaja M
15Abera, Semaw Ferede
16Kiadaliri, Aliasghar Ahmad
17Ahmed, Kedir Yimam
18Ahmed, Muktar Beshir
19Alam, Khurshid
20Alizadeh-Navaei, Reza
21Alkerwi, Ala'a
22Amini, Erfan
23Ammar, Walid
24Amrock, Stephen Marc
25Antonio, Carl Abelardo T
26Avila-Burgos, Leticia
27Awasthi, Ashish
28Bernal, Oscar Alberto
29Beyene, Addisu Shunu
30Beyene, Tariku Jibat
31Birungi, Charles
32Breitborde, Nicholas J K
33Cahuana-Hurtado, Lucero
34Castro, Ruben Estanislao
35Catalia-Lopez, Ferran
36Dalal, Koustuv
37Dandona, Lalit
38Dandona, Rakhi
39Farinha, Carla Sofia e Sa
40Faro, Andre
41Feigl, Andrea B
42Fitchett, Joseph Robert Anderson
43Foigt, Nataliya
44Giref, Ababi Zergaw
45Gupta, Rahul
46Hamidi, Samer
47Harb, Hilda L
48Horino, Masako
49Jürisson, Mikk
50Jakovljevic, Mihajlo B
51Javanbakht, Mehdi
52John, Denny
53Jonas, Jost B
54Karimi, Seyed M
55Khang, Young-Ho
56Khubchandani, Jagdish
57Kinge, Jonas M
58Krohn, Kristopher J
59Kumar, G Anil
60Majeed, Azeem
61Malekzadeh, Reza
62Masiye, Felix
63Meier, Toni
64Meretoja, Atte
65Mirrakhimov, Erkin M
66Mohammed, Shafiu
67Osman, Abdalla Sidahmed
68Owolabi, Mayowa O
69Patel, Tejas
70Caicedo, Angel J Paternina
71Pereira, David M
72Perelman, Julian
73Polinder, Suzanne
74Rafay, Anwar
75Rahimi-Movaghar, Vafa
76Rai, Rajesh Kumar
77Ram, Usha
78Ranabhat, Chhabi Lal
79Roba, Hirbo Shore
80Salama, Joseph
81Savic, Miloje
82Sepanlou, Sadaf G
83Shrime, Mark G
84Talongwa, Roberto Tchio
85Ao, Braden J Te
86Tediosi, Fabrizio
87Thomson, Alan J
88Tobe-Gai, Ruoyan
89Undurraga, Eduardo A
90Violante, Francesco S
91Werdecker, Andrea
92Wijeratne, Tissa
93Xu, Gelin
94Yonemoto, Naohiro
95Younis, Mustafa Z
96Yu, Chuanhua
97Zaidi, Zoubida
98El Sayed Zaki, Maysaa
99Murray, Christopher J L
aucorpGlobal Burden of Disease Health Financing Collaborator Network
formatjournal
genrearticle
ristypeJOUR
atitleEvolution 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
jtitleLancet
addtitleLancet
date2017-05-20
risdate2017
volume389
issue10083
spage1981
epage2004
pages1981-2004
issn
00140-6736
11474-547X
eissn1474-547X
notesCollaborators listed at the end of the Article
abstractSummary 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. Funding The Bill & Melinda Gates Foundation.
copEngland
pubElsevier Ltd
pmid28433256
doi10.1016/S0140-6736(17)30874-7
oafree_for_read