Trends in future health financing and coverage: future health spending and universal health coverage in 188 countries, 2016-40

Dieleman JL, Sadat N, Chang AY, Fullman N, Abbafati C, Acharya P, Adou AK, Kiadaliri AA, Alam K, Alizadeh-Navaei R, Alkerwi A'a, et al. (2018)
LANCET 391(10132): 1783-1798.

Zeitschriftenaufsatz | Veröffentlicht | Englisch
 
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Autor*in
Dieleman, Joseph L.; Sadat, Nafis; Chang, Angela Y.; Fullman, Nancy; Abbafati, Cristiana; Acharya, Pawan; Adou, Arsene Kouablan; Kiadaliri, Aliasghar Ahmad; Alam, Khurshid; Alizadeh-Navaei, Reza; Alkerwi, Ala'a; Ammar, Walid
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Abstract / Bemerkung
Background Achieving universal health coverage (UHC) requires health financing systems that provide prepaid pooled resources for key health services without placing undue financial stress on households. Understanding current and future trajectories of health financing is vital for progress towards UHC. We used historical health financing data for 188 countries from 1995 to 2015 to estimate future scenarios of health spending and pooled health spending through to 2040. Methods We extracted historical data on gross domestic product (GDP) and health spending for 188 countries from 1995 to 2015, and projected annual GDP, development assistance for health, and government, out-of-pocket, and prepaid private health spending from 2015 through to 2040 as a reference scenario. These estimates were generated using an ensemble of models that varied key demographic and socioeconomic determinants. We generated better and worse alternative future scenarios based on the global distribution of historic health spending growth rates. Last, we used stochastic frontier analysis to investigate the association between pooled health resources and UHC index, a measure of a country's UHC service coverage. Finally, we estimated future UHC performance and the number of people covered under the three future scenarios. Findings In the reference scenario, global health spending was projected to increase from US$10 trillion (95% uncertainty interval 10 trillion to 10 trillion) in 2015 to $20 trillion (18 trillion to 22 trillion) in 2040. Per capita health spending was projected to increase fastest in upper-middle-income countries, at 4.2% (3.4-5.1) per year, followed by lower-middle-income countries (4.0%, 3.6-4.5) and low-income countries (2.2%, 1.7-2.8). Despite global growth, per capita health spending was projected to range from only $40 (24-65) to $413 (263-668) in 2040 in low-income countries, and from $140 (90-200) to $1699 (711-3423) in lower-middle-income countries. Globally, the share of health spending covered by pooled resources would range widely, from 19.8% (10.3-38.6) in Nigeria to 97.9% (96.4-98.5) in Seychelles. Historical performance on the UHC index was significantly associated with pooled resources per capita. Across the alternative scenarios, we estimate UHC reaching between 5.1 billion (4.9 billion to 5.3 billion) and 5.6 billion (5.3 billion to 5.8 billion) lives in 2030. Interpretation We chart future scenarios for health spending and its relationship with UHC. Ensuring that all countries have sustainable pooled health resources is crucial to the achievement of UHC. Copyright (c) 2018 The Author(s). Published by Elsevier Ltd.
Erscheinungsjahr
2018
Zeitschriftentitel
LANCET
Band
391
Ausgabe
10132
Seite(n)
1783-1798
ISSN
0140-6736
eISSN
1474-547X
Page URI
https://pub.uni-bielefeld.de/record/2920314

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Dieleman JL, Sadat N, Chang AY, et al. Trends in future health financing and coverage: future health spending and universal health coverage in 188 countries, 2016-40. LANCET. 2018;391(10132):1783-1798.
Dieleman, J. L., Sadat, N., Chang, A. Y., Fullman, N., Abbafati, C., Acharya, P., Adou, A. K., et al. (2018). Trends in future health financing and coverage: future health spending and universal health coverage in 188 countries, 2016-40. LANCET, 391(10132), 1783-1798. doi:10.1016/S0140-6736(18)30697-4
Dieleman, J. L., Sadat, N., Chang, A. Y., Fullman, N., Abbafati, C., Acharya, P., Adou, A. K., Kiadaliri, A. A., Alam, K., Alizadeh-Navaei, R., et al. (2018). Trends in future health financing and coverage: future health spending and universal health coverage in 188 countries, 2016-40. LANCET 391, 1783-1798.
Dieleman, J.L., et al., 2018. Trends in future health financing and coverage: future health spending and universal health coverage in 188 countries, 2016-40. LANCET, 391(10132), p 1783-1798.
J.L. Dieleman, et al., “Trends in future health financing and coverage: future health spending and universal health coverage in 188 countries, 2016-40”, LANCET, vol. 391, 2018, pp. 1783-1798.
Dieleman, J.L., Sadat, N., Chang, A.Y., Fullman, N., Abbafati, C., Acharya, P., Adou, A.K., Kiadaliri, A.A., Alam, K., Alizadeh-Navaei, R., Alkerwi, A.'a, Ammar, W., Antonio, C.A.T., Arernu, O., Asgedom, S.W., Atey, T.M., Avila-Burgos, L., Awasthi, A., Ayer, R., Badali, H., Banach, M., Banstola, A., Barac, A., Belachew, A.B., Birungi, C., Bragazzi, N.L., Breitborde, N.J.K., Cahuana-Hurtado, L., Car, J., Catala-Lopez, F., Chapin, A., Chen, C.S., Dandona, L., Dandona, R., Daryani, A., Dharmaratne, S.D., Dubey, M., Edessa, D., Eldrenkamp, E., Eshrati, B., Faro, A., Feigl, A.B., Fenny, A.P., Fischer, F., Foigt, N., Foreman, K.J., Furst, T., Ghimire, M., Goli, S., Hailu, A.D., Hamidi, S., Harb, H.L., Hay, S.I., Hendrie, D., Ikilezi, G., Javanbakht, M., John, D., Jonas, J.B., Kaldjian, A., Kasaeian, A., Kasahun, Y.C., Khalil, I.A., Khang, Y.-H., Khubchandani, J., Kim, Y.J., Kinge, J.M., Kosen, S., Krohn, K.J., Kumar, G.A., Lafranconi, A., Lam, H., Listl, S., Abd El Razek, H.M., Abd El Razek, M.M., Majeed, A., Malekzadeh, R., Malta, D.C., Martinez, G., Mensah, G.A., Meretoja, A., Micah, A., Miller, T.R., Mirrakhimov, E.M., Mlashu, F.W., Mohammed, E., Mohammed, S., Mokdad, A.H., Moses, M., Mousavi, S.M., Naghavi, M., Nangia, V., Ngalesoni, F.N., Cuong Tat Nguyen, C.T.N., Trang Huyen Nguyen, T.H.N., Niriayo, Y., Noroozi, M., Owolabi, M.O., Patel, T., Pereira, D.M., Polinder, S., Qorbani, M., Rafay, A., Rafiei, A., Rahimi-Movaghar, V., Rai, R.K., Ram, U., Ranabhat, C.L., Ray, S.E., Reiner, R.C., Sajadi, H.S., Santoro, R., Santos, J.V., Sarker, A.R., Sartorius, B., Satpathy, M., Sepanlou, S.G., Shaikh, M.A., Sharif, M., She, J., Sheikh, A., Shrime, M.G., Sisay, M., Soneji, S., Soofi, M., Sorensen, R.J.D., Tao, T., Templin, T., Tesema, A.G., Thapa, S., Tobe-Gai, R., Topor-Madry, R., Bach Xuan Tran, B.X.T., Khanh Bao Tran, K.B.T., Tung Thanh Tran, T.T.T., Undurraga, E.A., Vasankari, T., Violante, F.S., Werdecker, A., Wijeratne, T., Xu, G., Yonemoto, N., Younis, M.Z., Yu, C., Zaki, M.E.S., Zlavog, B., Murray, C.J.L.: Trends in future health financing and coverage: future health spending and universal health coverage in 188 countries, 2016-40. LANCET. 391, 1783-1798 (2018).
Dieleman, Joseph L., Sadat, Nafis, Chang, Angela Y., Fullman, Nancy, Abbafati, Cristiana, Acharya, Pawan, Adou, Arsene Kouablan, Kiadaliri, Aliasghar Ahmad, Alam, Khurshid, Alizadeh-Navaei, Reza, Alkerwi, Ala'a, Ammar, Walid, Antonio, Carl Abelardo T., Arernu, Olatunde, Asgedom, Solomon Weldegebreal, Atey, Tesfay Mehari, Avila-Burgos, Leticia, Awasthi, A., Ayer, Rakesh, Badali, Hamid, Banach, Maciej, Banstola, Amrit, Barac, Aleksandra, Belachew, Abate Bekele, Birungi, Charles, Bragazzi, Nicola L., Breitborde, Nicholas J. K., Cahuana-Hurtado, Lucero, Car, Josip, Catala-Lopez, Ferran, Chapin, Abigail, Chen, Catherine S., Dandona, Lalit, Dandona, Rakhi, Daryani, Ahmad, Dharmaratne, Samath D., Dubey, Manisha, Edessa, Dumessa, Eldrenkamp, Erika, Eshrati, Babak, Faro, Andre, Feigl, Andrea B., Fenny, Ama P., Fischer, Florian, Foigt, Nataliya, Foreman, Kyle J., Furst, Thomas, Ghimire, Mamata, Goli, Srinivas, Hailu, Alemayehu Desalegne, Hamidi, Samer, Harb, Hilda L., Hay, Simon I., Hendrie, Delia, Ikilezi, Gloria, Javanbakht, Mehdi, John, Denny, Jonas, Jost B., Kaldjian, Alexander, Kasaeian, Amir, Kasahun, Yawukal Chane, Khalil, Ibrahim A., Khang, Young-Ho, Khubchandani, Jagdish, Kim, Yun Jin, Kinge, Jonas M., Kosen, Soewarta, Krohn, Kristopher J., Kumar, G. Anil, Lafranconi, Alessandra, Lam, Hilton, Listl, Stefan, Abd El Razek, Hassan Magdy, Abd El Razek, Mohammed Magdy, Majeed, Azeem, Malekzadeh, Reza, Malta, Deborah Carvalho, Martinez, Gabriel, Mensah, George A., Meretoja, Atte, Micah, Angela, Miller, Ted R., Mirrakhimov, Erkin M., Mlashu, Fitsum Weldegebreal, Mohammed, Ebrahim, Mohammed, Shafiu, Mokdad, Ali H., Moses, Mark, Mousavi, Seyyed Meysam, Naghavi, Mohsen, Nangia, Vinay, Ngalesoni, Frida Namnyak, Cuong Tat Nguyen, Cuong Tat Nguyen, Trang Huyen Nguyen, Trang Huyen Nguyen, Niriayo, Yirga, Noroozi, Mehdi, Owolabi, Mayowa O., Patel, Tejas, Pereira, David M., Polinder, Suzanne, Qorbani, Mostafa, Rafay, Anwar, Rafiei, Alireza, Rahimi-Movaghar, Vafa, Rai, Rajesh Kumar, Ram, Usha, Ranabhat, Chhabi Lal, Ray, Sarah E., Reiner, Robert C., Sajadi, Haniye Sadat, Santoro, Rocco, Santos, Joao Vasco, Sarker, Abdur Razzaque, Sartorius, Benn, Satpathy, Maheswar, Sepanlou, Sadaf G., Shaikh, Masood Ali, Sharif, Mehdi, She, Jun, Sheikh, Aziz, Shrime, Mark G., Sisay, Mekonnen, Soneji, Samir, Soofi, Moslem, Sorensen, Reed J. D., Tao, Tianchan, Templin, Tara, Tesema, Azeb Gebresilassie, Thapa, Subash, Tobe-Gai, Ruoyan, Topor-Madry, Roman, Bach Xuan Tran, Bach Xuan Tran, Khanh Bao Tran, Khanh Bao Tran, Tung Thanh Tran, Tung Thanh Tran, Undurraga, Eduardo A., Vasankari, Tommi, Violante, Francesco S., Werdecker, Andrea, Wijeratne, Tissa, Xu, Gelin, Yonemoto, Naohiro, Younis, Mustafa Z., Yu, Chuanhua, Zaki, Maysaa El Sayed, Zlavog, Bianca, and Murray, Christopher J. L. “Trends in future health financing and coverage: future health spending and universal health coverage in 188 countries, 2016-40”. LANCET 391.10132 (2018): 1783-1798.

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