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Future and Potential Spending on Health 2015-40: Development Assistance for Health, and Government, Prepaid Private, and Out-Of-Pocket Health Spending in 184 Countries Publisher Pubmed



Dieleman JL1 ; Campbell M1 ; Chapin A1 ; Eldrenkamp E1 ; Fan VY2, 3, 5 ; Haakenstad A1 ; Kates J6 ; Li Z1 ; Matyasz T1 ; Micah A1 ; Reynolds A1 ; Sadat N1 ; Schneider MT1 ; Sorensen R1 Show All Authors
Authors
  1. Dieleman JL1
  2. Campbell M1
  3. Chapin A1
  4. Eldrenkamp E1
  5. Fan VY2, 3, 5
  6. Haakenstad A1
  7. Kates J6
  8. Li Z1
  9. Matyasz T1
  10. Micah A1
  11. Reynolds A1
  12. Sadat N1
  13. Schneider MT1
  14. Sorensen R1
  15. Abbas KM7
  16. Abera SF8, 9
  17. Ahmad Kiadaliri A10
  18. Ahmed MB11
  19. Alam K12, 13
  20. Alizadehnavaei R14
  21. Alkerwi A15
  22. Amini E16, 17
  23. Ammar W20
  24. Antonio CAT21
  25. Atey TM8
  26. Avilaburgos L22
  27. Awasthi A23
  28. Barac A24
  29. Berheto TM25
  30. Beyene AS26
  31. Beyene TJ27, 28
  32. Birungi C29
  33. Bizuayehu HM30
  34. Breitborde NJK31
  35. Cahuanahurtado L22
  36. Castro RE32
  37. Catalalopez F33, 34
  38. Dalal K35
  39. Dandona L1, 36
  40. Dharmaratne RDSD1, 36, 37
  41. Dubey M38
  42. Faro A39
  43. Feigl AB4
  44. Fischer F40
  45. Fitchett JRA4
  46. Foigt N41
  47. Giref AZ27
  48. Gupta R42
  49. Hamidi S43
  50. Harb HL20
  51. Hay SI1, 44
  52. Hendrie D45
  53. Horino M46
  54. Jurisson M47
  55. Jakovljevic MB48
  56. Javanbakht M49
  57. John D50
  58. Jonas JB51
  59. Karimi SM52
  60. Khang YH53
  61. Khubchandani J54
  62. Kim YJ55
  63. Kinge JM56
  64. Krohn KJ1
  65. Kumar GA36
  66. Leung R57
  67. Magdy Abd El Razek H58
  68. Magdy Abd El Razek M59
  69. Majeed A60
  70. Malekzadeh R18
  71. Malta DC61
  72. Meretoja A62, 63
  73. Miller TR64, 65
  74. Mirrakhimov EM66, 67
  75. Mohammed S68, 69
  76. Molla G70
  77. Nangia V71
  78. Olgiati S72
  79. Owolabi MO73, 74
  80. Patel T75
  81. Paternina Caicedo AJ76, 77
  82. Pereira DM78
  83. Perelman J79
  84. Polinder S80
  85. Rafay A81, 82
  86. Rahimimovaghar V19
  87. Rai RK83
  88. Ram U38
  89. Ranabhat CL84
  90. Roba HS26
  91. Savic M56
  92. Sepanlou SG18
  93. Te Ao BJ85
  94. Tesema AG8
  95. Thomson AJ86
  96. Tobegai R87
  97. Topormadry R88, 89
  98. Undurraga EA90
  99. Vargas V91
  100. Vasankari T92
  101. Violante FS93
  102. Wijeratne T62, 94
  103. Xu G95
  104. Yonemoto N96
  105. Younis MZ97
  106. Yu C98
  107. Zaidi Z99
  108. El Sayed Zaki M100
  109. Murray CJL1
Show Affiliations
Authors Affiliations
  1. 1. Institute for Health Metrics and Evaluation, University of Washington, 2301 5th Avenue, Seattle, 98121, WA, United States
  2. 2. University of Hawaii at Manoa, Honolulu, HI, United States
  3. 3. Francois-Xavier Bagnoud Center for Health and Human Rights, Harvard University, Boston, MA, United States
  4. 4. Department of Global Health and Population, TH Chan School of Public Health, Harvard University, Boston, MA, United States
  5. 5. Center for Global Development, Washington, DC, United States
  6. 6. Kaiser Family Foundation, Washington, DC, United States
  7. 7. Virginia Tech., Blacksburg, VA, United States
  8. 8. School of Public Health, College of Health Sciences, Mekelle University, Mekelle, Ethiopia
  9. 9. Food Security and Institute for Biological Chemistry and Nutrition, University of Hohenheim, Stuttgart, Germany
  10. 10. Department of Clinical Sciences Lund, Orthopedics, Clinical Epidemiology Unit, Lund University, Lund, Sweden
  11. 11. College of Health Sciences, Department of Epidemiology, ICT and e-Learning Coordinator, Jimma University, Jimma, Ethiopia
  12. 12. Murdoch Childrens Research Institute, University of Melbourne, Melbourne, VIC, Australia
  13. 13. University of Sydney, Sydney, NSW, Australia
  14. 14. Gastrointestinal Cancer Research Center, Mazandaran University of Medical Sciences, Sari, Iran
  15. 15. Luxembourg Institute of Health, Strassen, Luxembourg
  16. 16. Uro-Oncology Research Center, Tehran University of Medical Sciences, Tehran, Iran
  17. 17. Non-communicable Diseases Research Center, Endocrinology and Metabolism Research Institute, Tehran University of Medical Sciences, Tehran, Iran
  18. 18. Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
  19. 19. Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran
  20. 20. Ministry of Public Health, Beirut, Lebanon
  21. 21. Department of Health Policy and Administration, College of Public Health, University of the Philippines Manila, Manila, Philippines
  22. 22. National Institute of Public Health, Cuernavaca, Mexico
  23. 23. Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India
  24. 24. Faculty of Medicine, University of Belgrade, Belgrade, Serbia
  25. 25. College of Health Sciences, School of Public Health, Wolaita Sodo University, Wolaita Sodo, Ethiopia
  26. 26. College of Health and Medical Science, Haramaya University, Harar, Ethiopia
  27. 27. Addis Ababa University, Addis Ababa, Ethiopia
  28. 28. Wageningen University, Wageningen, Netherlands
  29. 29. University College London, London, United Kingdom
  30. 30. Debre Markos University, Debre Markos, Ethiopia
  31. 31. Ohio State University, Columbus, OH, United States
  32. 32. Universidad Diego Portales, Santiago, Chile
  33. 33. Department of Medicine, University of Valencia, INCLIVA Health Research Institute, CIBERSAM, Valencia, Spain
  34. 34. Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada
  35. 35. Centre for Injury Prevention and Safety Promotion, School of Health and Medical Sciences, Orebro University, Orebro, Sweden
  36. 36. Public Health Foundation of India, New Delhi, India
  37. 37. Department of Community Medicine, Faculty of Medicine, University of Peradeniya, Peradeniya, Sri Lanka
  38. 38. International Institute for Population Sciences, Mumbai, India
  39. 39. Federal University of Sergipe, Aracaju, Brazil
  40. 40. School of Public Health, Bielefeld University, Bielefeld, Germany
  41. 41. Institute of Gerontology, Academy of Medical Science, Kyiv, Ukraine
  42. 42. West Virginia Bureau for Public Health, Charleston, WV, United States
  43. 43. Hamdan Bin Mohammed Smart University, Dubai, United Arab Emirates
  44. 44. Oxford Big Data Institute, Li Ka Shing Centre for Health Information and Discovery, University of Oxford, Oxford, United Kingdom
  45. 45. Centre for Population Health Research, Curtin University, Bentley, WA, Australia
  46. 46. Department of Health and Human Services, Nevada Division of Public and Behavioral Health, Carson City, NV, United States
  47. 47. Institute of Family Medicine and Public Health, University of Tartu, Tartu, Estonia
  48. 48. Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia
  49. 49. University of Aberdeen, Aberdeen, United Kingdom
  50. 50. International Center for Research on Women, New Delhi, India
  51. 51. Department of Ophthalmology, Medical Faculty Mannheim, Ruprecht-Karls-University Heidelberg, Mannheim, Germany
  52. 52. University of Washington Tacoma, Tacoma, WA, United States
  53. 53. College of Medicine, Seoul National University, Seoul, South Korea
  54. 54. Ball State University, Muncie, IN, United States
  55. 55. Southern University College, Skudai, Malaysia
  56. 56. Norwegian Institute of Public Health, Oslo, Norway
  57. 57. State University of New York, Albany, Rensselaer, NY, United States
  58. 58. Mansoura Faculty of Medicine, Mansoura, Egypt
  59. 59. Aswan University Hospital, Aswan Faculty of Medicine, Aswan, Egypt
  60. 60. Imperial College London, London, United Kingdom
  61. 61. Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
  62. 62. Department of Medicine, University of Melbourne, Melbourne, VIC, Australia
  63. 63. Department of Neurology, Helsinki University Hospital, Helsinki, Finland
  64. 64. Pacific Institute for Research and Evaluation, Calverton, MD, United States
  65. 65. Centre for Population Health, Curtin University, Perth, WA, Australia
  66. 66. Kyrgyz State Medical Academy, Bishkek, Kyrgyzstan
  67. 67. National Center of Cardiology and Internal Disease, Bishkek, Kyrgyzstan
  68. 68. Health Systems and Policy Research Unit, Ahmadu Bello University, Zaria, Nigeria
  69. 69. Institute of Public Health, Heidelberg University, Heidelberg, Germany
  70. 70. Federal Ministry of Health, Addis Ababa, Ethiopia
  71. 71. Suraj Eye Institute, Nagpur, India
  72. 72. State University of Bergamo, Bergamo, Italy
  73. 73. Department of Medicine, Ibadan, Nigeria
  74. 74. Blossom Specialist Medical Center, Ibadan, Nigeria
  75. 75. Mount Sinai Health System, New York, NY, United States
  76. 76. Universidad de Cartagena, Cartagena, Colombia
  77. 77. Public Health Dynamics Laboratory, University of Pittsburgh, Pittsburgh, PA, United States
  78. 78. REQUIMTE/LAQV, Laboratorio de Farmacognosia, Departamento de Quimica, Faculdade de Farmacia, Universidade do Porto, Porto, Portugal
  79. 79. National School of Public Health, Lisbon, Portugal
  80. 80. Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, Netherlands
  81. 81. Contech International Health Consultants, Lahore, Pakistan
  82. 82. Contech School of Public Health, Lahore, Pakistan
  83. 83. Society for Health and Demographic Surveillance, Suri, India
  84. 84. Wonju College of Medicine, Institute for Poverty Alleviation and International Development, Yonsei University, Seoul, South Korea
  85. 85. Auckland University of Technology, Auckland, New Zealand
  86. 86. Adaptive Knowledge Management, Victoria, BC, Canada
  87. 87. National Center for Child Health and Development, Tokyo, Japan
  88. 88. Institute of Public Health, Faculty of Health Sciences, Jagiellonian University Medical College, Krakow, Poland
  89. 89. Faculty of Health Sciences, Wroclaw Medical University, Wroclaw, Poland
  90. 90. Brandeis University, Waltham, MA, United States
  91. 91. Universidad Alberto Hurtado, Santiago, Chile
  92. 92. UKK Institute for Health Promotion Research, Tampere, Finland
  93. 93. University of Bologna, Bologna, Italy
  94. 94. Western Health, Footscray, VIC, Australia
  95. 95. Department of Neurology, Jinling Hospital, Nanjing University School of Medicine, Nanjing, China
  96. 96. Department of Biostatistics, School of Public Health, Kyoto University, Kyoto, Japan
  97. 97. Jackson State University, Jackson, MS, United States
  98. 98. Department of Epidemiology and Biostatistics, School of Public Health, Global Health Institute, Wuhan University, Wuhan, China
  99. 99. University Hospital, Setif, Algeria
  100. 100. Faculty of Medicine, Mansoura University, Mansoura, Egypt

Source: The Lancet Published:2017


Abstract

Background: The amount of resources, particularly prepaid resources, available for health can affect access to health care and health outcomes. Although health spending tends to increase with economic development, tremendous variation exists among health financing systems. Estimates of future spending can be beneficial for policy makers and planners, and can identify financing gaps. In this study, we estimate future gross domestic product (GDP), all-sector government spending, and health spending disaggregated by source, and we compare expected future spending to potential future spending. Methods: We extracted GDP, government spending in 184 countries from 1980-2015, and health spend data from 1995-2014. We used a series of ensemble models to estimate future GDP, all-sector government spending, development assistance for health, and government, out-of-pocket, and prepaid private health spending through 2040. We used frontier analyses to identify patterns exhibited by the countries that dedicate the most funding to health, and used these frontiers to estimate potential health spending for each low-income or middle-income country. All estimates are inflation and purchasing power adjusted. Findings: We estimated that global spending on health will increase from US$9.21 trillion in 2014 to $24.24 trillion (uncertainty interval [UI] 20.47-29.72) in 2040. We expect per capita health spending to increase fastest in upper-middle-income countries, at 5.3% (UI 4.1-6.8) per year. This growth is driven by continued growth in GDP, government spending, and government health spending. Lower-middle income countries are expected to grow at 4.2% (3.8-4.9). High-income countries are expected to grow at 2.1% (UI 1.8-2.4) and low-income countries are expected to grow at 1.8% (1.0-2.8). Despite this growth, health spending per capita in low-income countries is expected to remain low, at $154 (UI 133-181) per capita in 2030 and $195 (157-258) per capita in 2040. Increases in national health spending to reach the level of the countries who spend the most on health, relative to their level of economic development, would mean $321 (157-258) per capita was available for health in 2040 in low-income countries. Interpretation: Health spending is associated with economic development but past trends and relationships suggest that spending will remain variable, and low in some low-resource settings. Policy change could lead to increased health spending, although for the poorest countries external support might remain essential. © The Author(s).
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