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2. Health sector spending and spending on HIV/AIDS, tuberculosis, and malaria, and development assistance for health: progress towards Sustainable Development Goal 3

Author

Micah, A, Su, Y, Bachmeier, S, Chapin, A, Cogswell, I, Crosby, S, Cunningham, B, Harle, A, Maddison, E, Moitra, M, Sahu, M, Schneider, M, Simpson, K, Stutzman, H, Tsakalos, G, Zende, R, Zlavog, B, Abbafati, C, Abebo, Z, Abolhassani, H, Abrigo, M, Ahmed, M, Akinyemi, R, Alam, K, Ali, S, Alinia, C, Alipour, V, Aljunid, S, Almasi, A, Alvis-Guzman, N, Ancuceanu, R, Andrei, T, Andrei, C, Anjomshoa, M, Antonio, C, Arabloo, J, Arab-Zozani, M, Aremu, O, Atnafu, D, Ausloos, M, Avila-Burgos, L, Ayanore, M, Azari, S, Babalola, T, Bagherzadeh, M, Baig, A, Bakhtiari, A, Banach, M, Banerjee, S, Barnighausen, T, Basu, S, Baune, B, Bayati, M, Berman, A, Bhageerathy, R, Bhardwaj, P, Bohluli, M, Busse, R, Cahuana-Hurtado, L, Camera, L, Castaneda-Orjuela, C, Catala-Lopez, F, Cevik, M, Chattu, V, Dandona, L, Dandona, R, Dianatinasab, M, Do, H, Doshmangir, L, El Tantawi, M, Eskandarieh, S, Esmaeilzadeh, F, Faraj, A, Farzadfar, F, Fischer, F, Foigt, N, Fullman, N, Gad, M, Ghafourifard, M, Ghashghaee, A, Gholamian, A, Goharinezhad, S, Grada, A, Haghparast Bidgoli, H, Hamidi, S, Harb, H, Hasanpoor, E, Hay, S, Hendrie, D, Henry, N, Herteliu, C, Hole, M, Hosseinzadeh, M, Hostiuc, S, Huda, T, Humayun, A, Hwang, B, Ilesanmi, O, Iqbal, U, Irvani, S, Islam, S, Islam, M, Jahani, M, Jakovljevic, M, James, S, Javaheri, Z, Jonas, J, Joukar, F, Jozwiak, J, Jurisson, M, Kalhor, R, Karami Matin, B, Karimi, S, Kayode, G, Kazemi Karyani, A, Kinfu, Y, Kisa, A, Kohler, S, Komaki, H, Kosen, S, Kotlo, A, Koyanagi, A, Kumar, G, Kusuma, D, Lansingh, V, Larsson, A, Lasrado, S, Lee, S, Lim, L, Lozano, R, Magdy Abd El Razek, H, Mahdavi, M, Maleki, S, Malekzadeh, R, Mansour-Ghanaei, F, Mansournia, M, Mantovani, L, Martinez, G, Masoumi, S, Massenburg, B, Menezes, R, Mengesha, E, Meretoja, T, Meretoja, A, Mestrovic, T, Milevska Kostova, N, Miller, T, Mirica, A, Mirrakhimov, E, Moghadaszadeh, M, Mohajer, B, Mohamadi, E, Mohammad Darwesh, A, Mohammadian-Hafshejani, A, Mohammadpourhodki, R, Mohammed, S, Mohebi, F, Mokdad, A, Morrison, S, Mosser, J, Mousavi, S, Muriithi, M, Muthupandian, S, Myint, C, Naderi, M, Nagarajan, A, Nguyen, C, Nguyen, H, Nonvignon, J, Noubiap, J, Oh, I, Olagunju, A, Olusanya, J, Olusanya, B, Omar Bali, A, Onwujekwe, O, Otstavnov, S, Otstavnov, N, Owolabi, M, Padubidri, J, Palladino, R, Panda-Jonas, S, Pandey, A, Postma, M, Prada, S, Pribadi, D, Rabiee, M, Rabiee, N, Rahim, F, Ranabhat, C, Rao, S, Rathi, P, Rawaf, S, Rawaf, D, Rawal, L, Rawassizadeh, R, Rezapour, A, Sabour, S, Sahraian, M, Salman, O, Salomon, J, Samy, A, Sanabria, J, Santos, J, Santric Milicevic, M, Sao Jose, B, Savic, M, Schwendicke, F, Senthilkumaran, S, Sepanlou, S, Servan-Mori, E, Setayesh, H, Shaikh, M, Sheikh, A, Shibuya, K, Shrime, M, Simonetti, B, Singh, J, Singh, P, Skryabin, V, Soheili, A, Soltani, S, Stefan, S, Tabares-Seisdedos, R, Topor-Madry, R, Tovani-Palone, M, Tran, B, Travillian, R, Undurraga, E, Valdez, P, van Boven, J, Vasankari, T, Violante, F, Vlassov, V, Vos, T, Wolfe, C, Wu, J, Yaya, S, Yazdi-Feyzabadi, V, Yip, P, Yonemoto, N, Younis, M, Yu, C, Zaidi, Z, Zaman, S, Zastrozhin, M, Zhang, Z, Zhao, Y, Murray, C, Dieleman, J, Micah A. E., Su Y., Bachmeier S. D., Chapin A., Cogswell I. E., Crosby S. W., Cunningham B., Harle A. C., Maddison E. R., Moitra M., Sahu M., Schneider M. T., Simpson K. E., Stutzman H. N., Tsakalos G., Zende R. R., Zlavog B. S., Abbafati C., Abebo Z. H., Abolhassani H., Abrigo M. R. M., Ahmed M. B., Akinyemi R. O., Alam K., Ali S., Alinia C., Alipour V., Aljunid S. M., Almasi A., Alvis-Guzman N., Ancuceanu R., Andrei T., Andrei C. L., Anjomshoa M., Antonio C. A. T., Arabloo J., Arab-Zozani M., Aremu O., Atnafu D. D., Ausloos M., Avila-Burgos L., Ayanore M. A., Azari S., Babalola T. K., Bagherzadeh M., Baig A. A., Bakhtiari A., Banach M., Banerjee S. K., Barnighausen T. W., Basu S., Baune B. T., Bayati M., Berman A. E., Bhageerathy R., Bhardwaj P., Bohluli M., Busse R., Cahuana-Hurtado L., Camera L. L. A., Castaneda-Orjuela C. A., Catala-Lopez F., Cevik M., Chattu V. K., Dandona L., Dandona R., Dianatinasab M., Do H. T., Doshmangir L., El Tantawi M., Eskandarieh S., Esmaeilzadeh F., Faraj A., Farzadfar F., Fischer F., Foigt N. A., Fullman N., Gad M. M., Ghafourifard M., Ghashghaee A., Gholamian A., Goharinezhad S., Grada A., Haghparast Bidgoli H., Hamidi S., Harb H. L., Hasanpoor E., Hay S. I., Hendrie D., Henry N. J., Herteliu C., Hole M. K., Hosseinzadeh M., Hostiuc S., Huda T. M., Humayun A., Hwang B. -F., Ilesanmi O. S., Iqbal U., Irvani S. S. N., Islam S. M. S., Islam M. M., Jahani M. A., Jakovljevic M., James S. L., Javaheri Z., Jonas J. B., Joukar F., Jozwiak J. J., Jurisson M., Kalhor R., Karami Matin B., Karimi S. E., Kayode G. A., Kazemi Karyani A., Kinfu Y., Kisa A., Kohler S., Komaki H., Kosen S., Kotlo A., Koyanagi A., Kumar G. A., Kusuma D., Lansingh V. C., Larsson A. O., Lasrado S., Lee S. W. H., Lim L. -L., Lozano R., Magdy Abd El Razek H., Mahdavi M. M., Maleki S., Malekzadeh R., Mansour-Ghanaei F., Mansournia M. A., Mantovani L. G., Martinez G., Masoumi S. Z., Massenburg B. B., Menezes R. G., Mengesha E. W., Meretoja T. J., Meretoja A., Mestrovic T., Milevska Kostova N., Miller T. R., Mirica A., Mirrakhimov E. M., Moghadaszadeh M., Mohajer B., Mohamadi E., Mohammad Darwesh A., Mohammadian-Hafshejani A., Mohammadpourhodki R., Mohammed S., Mohebi F., Mokdad A. H., Morrison S. D., Mosser J. F., Mousavi S. M., Muriithi M. K., Muthupandian S., Myint C. -Y., Naderi M., Nagarajan A. J., Nguyen C. T., Nguyen H. L. T., Nonvignon J., Noubiap J. J., Oh I. -H., Olagunju A. T., Olusanya J. O., Olusanya B. O., Omar Bali A., Onwujekwe O. E., Otstavnov S. S., Otstavnov N., Owolabi M. O., Padubidri J. R., Palladino R., Panda-Jonas S., Pandey A., Postma M. J., Prada S. I., Pribadi D. R. A., Rabiee M., Rabiee N., Rahim F., Ranabhat C. L., Rao S. J., Rathi P., Rawaf S., Rawaf D. L., Rawal L., Rawassizadeh R., Rezapour A., Sabour S., Sahraian M. A., Salman O. M., Salomon J. A., Samy A. M., Sanabria J., Santos J. V., Santric Milicevic M. M., Sao Jose B. P., Savic M., Schwendicke F., Senthilkumaran S., Sepanlou S. G., Servan-Mori E., Setayesh H., Shaikh M. A., Sheikh A., Shibuya K., Shrime M. G., Simonetti B., Singh J. A., Singh P., Skryabin V. Y., Soheili A., Soltani S., Stefan S. C., Tabares-Seisdedos R., Topor-Madry R., Tovani-Palone M. R., Tran B. X., Travillian R., Undurraga E. A., Valdez P. R., van Boven J. F. M., Vasankari T. J., Violante F. S., Vlassov V., Vos T., Wolfe C. D. A., Wu J., Yaya S., Yazdi-Feyzabadi V., Yip P., Yonemoto N., Younis M. Z., Yu C., Zaidi Z., Zaman S. B., Zastrozhin M. S., Zhang Z. -J., Zhao Y., Murray C. J. L., Dieleman J. L., Micah, A, Su, Y, Bachmeier, S, Chapin, A, Cogswell, I, Crosby, S, Cunningham, B, Harle, A, Maddison, E, Moitra, M, Sahu, M, Schneider, M, Simpson, K, Stutzman, H, Tsakalos, G, Zende, R, Zlavog, B, Abbafati, C, Abebo, Z, Abolhassani, H, Abrigo, M, Ahmed, M, Akinyemi, R, Alam, K, Ali, S, Alinia, C, Alipour, V, Aljunid, S, Almasi, A, Alvis-Guzman, N, Ancuceanu, R, Andrei, T, Andrei, C, Anjomshoa, M, Antonio, C, Arabloo, J, Arab-Zozani, M, Aremu, O, Atnafu, D, Ausloos, M, Avila-Burgos, L, Ayanore, M, Azari, S, Babalola, T, Bagherzadeh, M, Baig, A, Bakhtiari, A, Banach, M, Banerjee, S, Barnighausen, T, Basu, S, Baune, B, Bayati, M, Berman, A, Bhageerathy, R, Bhardwaj, P, Bohluli, M, Busse, R, Cahuana-Hurtado, L, Camera, L, Castaneda-Orjuela, C, Catala-Lopez, F, Cevik, M, Chattu, V, Dandona, L, Dandona, R, Dianatinasab, M, Do, H, Doshmangir, L, El Tantawi, M, Eskandarieh, S, Esmaeilzadeh, F, Faraj, A, Farzadfar, F, Fischer, F, Foigt, N, Fullman, N, Gad, M, Ghafourifard, M, Ghashghaee, A, Gholamian, A, Goharinezhad, S, Grada, A, Haghparast Bidgoli, H, Hamidi, S, Harb, H, Hasanpoor, E, Hay, S, Hendrie, D, Henry, N, Herteliu, C, Hole, M, Hosseinzadeh, M, Hostiuc, S, Huda, T, Humayun, A, Hwang, B, Ilesanmi, O, Iqbal, U, Irvani, S, Islam, S, Islam, M, Jahani, M, Jakovljevic, M, James, S, Javaheri, Z, Jonas, J, Joukar, F, Jozwiak, J, Jurisson, M, Kalhor, R, Karami Matin, B, Karimi, S, Kayode, G, Kazemi Karyani, A, Kinfu, Y, Kisa, A, Kohler, S, Komaki, H, Kosen, S, Kotlo, A, Koyanagi, A, Kumar, G, Kusuma, D, Lansingh, V, Larsson, A, Lasrado, S, Lee, S, Lim, L, Lozano, R, Magdy Abd El Razek, H, Mahdavi, M, Maleki, S, Malekzadeh, R, Mansour-Ghanaei, F, Mansournia, M, Mantovani, L, Martinez, G, Masoumi, S, Massenburg, B, Menezes, R, Mengesha, E, Meretoja, T, Meretoja, A, Mestrovic, T, Milevska Kostova, N, Miller, T, Mirica, A, Mirrakhimov, E, Moghadaszadeh, M, Mohajer, B, Mohamadi, E, Mohammad Darwesh, A, Mohammadian-Hafshejani, A, Mohammadpourhodki, R, Mohammed, S, Mohebi, F, Mokdad, A, Morrison, S, Mosser, J, Mousavi, S, Muriithi, M, Muthupandian, S, Myint, C, Naderi, M, Nagarajan, A, Nguyen, C, Nguyen, H, Nonvignon, J, Noubiap, J, Oh, I, Olagunju, A, Olusanya, J, Olusanya, B, Omar Bali, A, Onwujekwe, O, Otstavnov, S, Otstavnov, N, Owolabi, M, Padubidri, J, Palladino, R, Panda-Jonas, S, Pandey, A, Postma, M, Prada, S, Pribadi, D, Rabiee, M, Rabiee, N, Rahim, F, Ranabhat, C, Rao, S, Rathi, P, Rawaf, S, Rawaf, D, Rawal, L, Rawassizadeh, R, Rezapour, A, Sabour, S, Sahraian, M, Salman, O, Salomon, J, Samy, A, Sanabria, J, Santos, J, Santric Milicevic, M, Sao Jose, B, Savic, M, Schwendicke, F, Senthilkumaran, S, Sepanlou, S, Servan-Mori, E, Setayesh, H, Shaikh, M, Sheikh, A, Shibuya, K, Shrime, M, Simonetti, B, Singh, J, Singh, P, Skryabin, V, Soheili, A, Soltani, S, Stefan, S, Tabares-Seisdedos, R, Topor-Madry, R, Tovani-Palone, M, Tran, B, Travillian, R, Undurraga, E, Valdez, P, van Boven, J, Vasankari, T, Violante, F, Vlassov, V, Vos, T, Wolfe, C, Wu, J, Yaya, S, Yazdi-Feyzabadi, V, Yip, P, Yonemoto, N, Younis, M, Yu, C, Zaidi, Z, Zaman, S, Zastrozhin, M, Zhang, Z, Zhao, Y, Murray, C, Dieleman, J, Micah A. E., Su Y., Bachmeier S. D., Chapin A., Cogswell I. E., Crosby S. W., Cunningham B., Harle A. C., Maddison E. R., Moitra M., Sahu M., Schneider M. T., Simpson K. E., Stutzman H. N., Tsakalos G., Zende R. R., Zlavog B. S., Abbafati C., Abebo Z. H., Abolhassani H., Abrigo M. R. M., Ahmed M. B., Akinyemi R. O., Alam K., Ali S., Alinia C., Alipour V., Aljunid S. M., Almasi A., Alvis-Guzman N., Ancuceanu R., Andrei T., Andrei C. L., Anjomshoa M., Antonio C. A. T., Arabloo J., Arab-Zozani M., Aremu O., Atnafu D. D., Ausloos M., Avila-Burgos L., Ayanore M. A., Azari S., Babalola T. K., Bagherzadeh M., Baig A. A., Bakhtiari A., Banach M., Banerjee S. K., Barnighausen T. W., Basu S., Baune B. T., Bayati M., Berman A. E., Bhageerathy R., Bhardwaj P., Bohluli M., Busse R., Cahuana-Hurtado L., Camera L. L. A., Castaneda-Orjuela C. A., Catala-Lopez F., Cevik M., Chattu V. K., Dandona L., Dandona R., Dianatinasab M., Do H. T., Doshmangir L., El Tantawi M., Eskandarieh S., Esmaeilzadeh F., Faraj A., Farzadfar F., Fischer F., Foigt N. A., Fullman N., Gad M. M., Ghafourifard M., Ghashghaee A., Gholamian A., Goharinezhad S., Grada A., Haghparast Bidgoli H., Hamidi S., Harb H. L., Hasanpoor E., Hay S. I., Hendrie D., Henry N. J., Herteliu C., Hole M. K., Hosseinzadeh M., Hostiuc S., Huda T. M., Humayun A., Hwang B. -F., Ilesanmi O. S., Iqbal U., Irvani S. S. N., Islam S. M. S., Islam M. M., Jahani M. A., Jakovljevic M., James S. L., Javaheri Z., Jonas J. B., Joukar F., Jozwiak J. J., Jurisson M., Kalhor R., Karami Matin B., Karimi S. E., Kayode G. A., Kazemi Karyani A., Kinfu Y., Kisa A., Kohler S., Komaki H., Kosen S., Kotlo A., Koyanagi A., Kumar G. A., Kusuma D., Lansingh V. C., Larsson A. O., Lasrado S., Lee S. W. H., Lim L. -L., Lozano R., Magdy Abd El Razek H., Mahdavi M. M., Maleki S., Malekzadeh R., Mansour-Ghanaei F., Mansournia M. A., Mantovani L. G., Martinez G., Masoumi S. Z., Massenburg B. B., Menezes R. G., Mengesha E. W., Meretoja T. J., Meretoja A., Mestrovic T., Milevska Kostova N., Miller T. R., Mirica A., Mirrakhimov E. M., Moghadaszadeh M., Mohajer B., Mohamadi E., Mohammad Darwesh A., Mohammadian-Hafshejani A., Mohammadpourhodki R., Mohammed S., Mohebi F., Mokdad A. H., Morrison S. D., Mosser J. F., Mousavi S. M., Muriithi M. K., Muthupandian S., Myint C. -Y., Naderi M., Nagarajan A. J., Nguyen C. T., Nguyen H. L. T., Nonvignon J., Noubiap J. J., Oh I. -H., Olagunju A. T., Olusanya J. O., Olusanya B. O., Omar Bali A., Onwujekwe O. E., Otstavnov S. S., Otstavnov N., Owolabi M. O., Padubidri J. R., Palladino R., Panda-Jonas S., Pandey A., Postma M. J., Prada S. I., Pribadi D. R. A., Rabiee M., Rabiee N., Rahim F., Ranabhat C. L., Rao S. J., Rathi P., Rawaf S., Rawaf D. L., Rawal L., Rawassizadeh R., Rezapour A., Sabour S., Sahraian M. A., Salman O. M., Salomon J. A., Samy A. M., Sanabria J., Santos J. V., Santric Milicevic M. M., Sao Jose B. P., Savic M., Schwendicke F., Senthilkumaran S., Sepanlou S. G., Servan-Mori E., Setayesh H., Shaikh M. A., Sheikh A., Shibuya K., Shrime M. G., Simonetti B., Singh J. A., Singh P., Skryabin V. Y., Soheili A., Soltani S., Stefan S. C., Tabares-Seisdedos R., Topor-Madry R., Tovani-Palone M. R., Tran B. X., Travillian R., Undurraga E. A., Valdez P. R., van Boven J. F. M., Vasankari T. J., Violante F. S., Vlassov V., Vos T., Wolfe C. D. A., Wu J., Yaya S., Yazdi-Feyzabadi V., Yip P., Yonemoto N., Younis M. Z., Yu C., Zaidi Z., Zaman S. B., Zastrozhin M. S., Zhang Z. -J., Zhao Y., Murray C. J. L., and Dieleman J. L.

Abstract

Background: Sustainable Development Goal (SDG) 3 aims to “ensure healthy lives and promote well-being for all at all ages”. While a substantial effort has been made to quantify progress towards SDG3, less research has focused on tracking spending towards this goal. We used spending estimates to measure progress in financing the priority areas of SDG3, examine the association between outcomes and financing, and identify where resource gains are most needed to achieve the SDG3 indicators for which data are available. Methods: We estimated domestic health spending, disaggregated by source (government, out-of-pocket, and prepaid private) from 1995 to 2017 for 195 countries and territories. For disease-specific health spending, we estimated spending for HIV/AIDS and tuberculosis for 135 low-income and middle-income countries, and malaria in 106 malaria-endemic countries, from 2000 to 2017. We also estimated development assistance for health (DAH) from 1990 to 2019, by source, disbursing development agency, recipient, and health focus area, including DAH for pandemic preparedness. Finally, we estimated future health spending for 195 countries and territories from 2018 until 2030. We report all spending estimates in inflation-adjusted 2019 US$, unless otherwise stated. Findings: Since the development and implementation of the SDGs in 2015, global health spending has increased, reaching $7·9 trillion (95% uncertainty interval 7·8–8·0) in 2017 and is expected to increase to $11·0 trillion (10·7–11·2) by 2030. In 2017, in low-income and middle-income countries spending on HIV/AIDS was $20·2 billion (17·0–25·0) and on tuberculosis it was $10·9 billion (10·3–11·8), and in malaria-endemic countries spending on malaria was $5·1 billion (4·9–5·4). Development assistance for health was $40·6 billion in 2019 and HIV/AIDS has been the health focus area to receive the highest contribution since 2004. In 2019, $374 million of DAH was provided for pandemic preparedness, less than 1% of

Published
2020

3. 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

Author

Dieleman, J. L., Campbell, M., Chapin, A., Eldrenkamp, E., Fan, V. Y., Haakenstad, A., Kates, J., Li, Z., Matyasz, T., Micah, A., Reynolds, A., Sadat, N., Schneider, M. T., Sorensen, R., Abbas, K. M., Abera, S. F., Ahmad Kiadaliri, A., Ahmed, M. B., Alam, K., Alizadeh-Navaei, R., Alkerwi, A., Amini, E., Ammar, W., Antonio, C. A. T., Atey, T. M., Avila-Burgos, L., Awasthi, A., Barac, A., Berheto, T. M., Beyene, A. S., Beyene, T. J., Birungi, C., Bizuayehu, H. M., Breitborde, N. J. K., Cahuana-Hurtado, L., Castro, R. E., Catalá-López, F., Dalal, Koustuv, Dandona, L., Dharmaratne, R. D. S. D., Dubey, M., Faro, A., Feigl, A. B., Fischer, F., Fitchett, J. R. A., Foigt, N., Giref, A. Z., Gupta, R., Hamidi, S., Harb, H. L., Hay, S. I., Hendrie, D., Horino, M., JÌrisson, M., Jakovljevic, M. B., 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., Leung, R., Magdy Abd El Razek, H., Magdy Abd El Razek, M., Majeed, A., Malekzadeh, R., Malta, D. C., Meretoja, A., Miller, T. R., Mirrakhimov, E. M., Mohammed, S., Molla, G., Nangia, V., Olgiati, S., Owolabi, M. O., Patel, T., Paternina Caicedo, A. J., Pereira, D. M., Perelman, J., Polinder, S., Rafay, A., Rahimi-Movaghar, V., Rai, R. K., Ram, U., Ranabhat, C. L., Roba, H. S., Savic, M., Sepanlou, S. G., Te Ao, B. J., Tesema, A. G., Thomson, A. J., Tobe-Gai, R., Topor-Madry, R., Undurraga, E. A., Vargas, V., Vasankari, T., Violante, F. S., Wijeratne, T., Xu, G., Yonemoto, N., Younis, M. Z., Yu, C., Zaidi, Z., El Sayed Zaki, M., Murray, C. J. L., Network, Global Burden of Disease Health Financing Collaborator, Dieleman, J. L., Campbell, M., Chapin, A., Eldrenkamp, E., Fan, V. Y., Haakenstad, A., Kates, J., Li, Z., Matyasz, T., Micah, A., Reynolds, A., Sadat, N., Schneider, M. T., Sorensen, R., Abbas, K. M., Abera, S. F., Ahmad Kiadaliri, A., Ahmed, M. B., Alam, K., Alizadeh-Navaei, R., Alkerwi, A., Amini, E., Ammar, W., Antonio, C. A. T., Atey, T. M., Avila-Burgos, L., Awasthi, A., Barac, A., Berheto, T. M., Beyene, A. S., Beyene, T. J., Birungi, C., Bizuayehu, H. M., Breitborde, N. J. K., Cahuana-Hurtado, L., Castro, R. E., Catalá-López, F., Dalal, Koustuv, Dandona, L., Dharmaratne, R. D. S. D., Dubey, M., Faro, A., Feigl, A. B., Fischer, F., Fitchett, J. R. A., Foigt, N., Giref, A. Z., Gupta, R., Hamidi, S., Harb, H. L., Hay, S. I., Hendrie, D., Horino, M., JÌrisson, M., Jakovljevic, M. B., 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., Leung, R., Magdy Abd El Razek, H., Magdy Abd El Razek, M., Majeed, A., Malekzadeh, R., Malta, D. C., Meretoja, A., Miller, T. R., Mirrakhimov, E. M., Mohammed, S., Molla, G., Nangia, V., Olgiati, S., Owolabi, M. O., Patel, T., Paternina Caicedo, A. J., Pereira, D. M., Perelman, J., Polinder, S., Rafay, A., Rahimi-Movaghar, V., Rai, R. K., Ram, U., Ranabhat, C. L., Roba, H. S., Savic, M., Sepanlou, S. G., Te Ao, B. J., Tesema, A. G., Thomson, A. J., Tobe-Gai, R., Topor-Madry, R., Undurraga, E. A., Vargas, V., Vasankari, T., Violante, F. S., Wijeratne, T., Xu, G., Yonemoto, N., Younis, M. Z., Yu, C., Zaidi, Z., El Sayed Zaki, M., Murray, C. J. L., and Network, Global Burden of Disease Health Financing Collaborator

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 hea

Published
2017
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4. 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

Author

Dieleman, J., Campbell, M., Chapin, A., Eldrenkamp, E., Fan, V. Y., Haakenstad, A., 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, A., Ahmed, K. Y., Ahmed, M. B., Alam, K., Alizadeh-Navaei, R., 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. K., Cahuana-Hurtado, L., Castro, R. E., Catalá-López, F., Dalal, Koustuv, Dandona, L., Dandona, R., De Jager, P., Dharmaratne, S. D., Dubey, M., Farinha, C. S. E. S., Faro, A., Feigl, A. B., Fischer, F., Fitchett, J. R. A., Foigt, N., Giref, A. Z., Gupta, R., Hamidi, S., Harb, H. L., Hay, S. I., Hendrie, D., Horino, M., JÌrisson, M., Jakovljevic, M. B., 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 Razek, H., Magdy Abd El Razek, M., Majeed, A., Malekzadeh, R., Masiye, F., Meier, T., Meretoja, A., Miller, T. R., Mirrakhimov, E. M., Mohammed, S., Nangia, V., Olgiati, S., Osman, A. S., Owolabi, M. O., Patel, T., Paternina Caicedo, A. J., Pereira, D. M., Perelman, J., Polinder, S., Rafay, A., Rahimi-Movaghar, V., 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 Burden of Disease Health Financing Collaborator, Dieleman, J., Campbell, M., Chapin, A., Eldrenkamp, E., Fan, V. Y., Haakenstad, A., 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, A., Ahmed, K. Y., Ahmed, M. B., Alam, K., Alizadeh-Navaei, R., 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. K., Cahuana-Hurtado, L., Castro, R. E., Catalá-López, F., Dalal, Koustuv, Dandona, L., Dandona, R., De Jager, P., Dharmaratne, S. D., Dubey, M., Farinha, C. S. E. S., Faro, A., Feigl, A. B., Fischer, F., Fitchett, J. R. A., Foigt, N., Giref, A. Z., Gupta, R., Hamidi, S., Harb, H. L., Hay, S. I., Hendrie, D., Horino, M., JÌrisson, M., Jakovljevic, M. B., 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 Razek, H., Magdy Abd El Razek, M., Majeed, A., Malekzadeh, R., Masiye, F., Meier, T., Meretoja, A., Miller, T. R., Mirrakhimov, E. M., Mohammed, S., Nangia, V., Olgiati, S., Osman, A. S., Owolabi, M. O., Patel, T., Paternina Caicedo, A. J., Pereira, D. M., Perelman, J., Polinder, S., Rafay, A., Rahimi-Movaghar, V., 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., and Network, Global Burden of Disease Health Financing Collaborator

Abstract

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%

Published
2017
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5. Health sector spending and spending on HIV/AIDS, tuberculosis, and malaria, and development assistance for health: progress towards Sustainable Development Goal 3

Author

Priya Rathi, Ritesh G. Menezes, Edris Hasanpoor, Sanni Yaya, Mohsen Bayati, Maciej Banach, Raffaele Palladino, Mikhail Sergeevich Zastrozhin, Siamak Sabour, Theo Vos, Tuomo J. Meretoja, Dimas Ria Angga Pribadi, Shahin Soltani, Simona Cătălina Ștefan, Behzad Karami Matin, Cyrus Alinia, Tudorel Andrei, Mehdi Bohluli, Nikita Otstavnov, Yanfang Su, Mohammad Ali Mansournia, Simon I. Hay, Mansour Ghafourifard, Songhomitra Panda-Jonas, Pushpendra Singh, Salman Rawaf, Morteza Arab-Zozani, Robert Ancuceanu, Samer Hamidi, Maarten J. Postma, Vijay Kumar Chattu, Ted R. Miller, Stanislav S. Otstavnov, Gbenga A. Kayode, Chhabi Lal Ranabhat, João Vasco Santos, Savita Lasrado, Jonathan F. Mosser, Chaw Yin Myint, Mihajlo Jakovljevic, Masoud Moghadaszadeh, Tanvir M. Huda, Fakher Rahim, Seyedeh Zahra Masoumi, Yingxi Zhao, Aziz Sheikh, Subramanian Senthilkumaran, Sheikh Mohammed Shariful Islam, Fariborz Mansour-Ghanaei, Andrew T Olagunju, Atif Amin Baig, Ali H. Mokdad, Anders Larsson, Atte Meretoja, Bach Xuan Tran, Lal B. Rawal, Brandon Cunningham, Vahid Alipour, Sowmya J. Rao, Anamika Pandey, Vahid Yazdi-Feyzabadi, Salime Goharinezhad, Angela E Micah, Leticia Avila-Burgos, Hayley N Stutzman, Farshad Farzadfar, M. Mofizul Islam, Sharareh Eskandarieh, Saqib Ali, Srikanta Banerjee, Zhi-Jiang Zhang, Anirudh Kotlo, Ravensara S. Travillian, Aziz Rezapour, Huong Lan Thi Nguyen, Sergio I. Prada, Biagio Simonetti, Maitreyi Sahu, Sadaf G. Sepanlou, Carlos A Castañeda-Orjuela, Hoa Thi Do, Farahnaz Joukar, Aso Mohammad Darwesh, Syed Mohamed Aljunid, Modhurima Moitra, In-Hwan Oh, Ayman Grada, Kenji Shibuya, Sojib Bin Zaman, Steven D Bachmeier, Hilda L Harb, Edson Serván-Mori, Bahram Mohajer, Van C. Lansingh, Ali Almasi, German Martinez, Till Bärnighausen, Reza Malekzadeh, Adam E. Berman, Matthew T. Schneider, Michael K. Hole, Reza Rawassizadeh, Bing-Fang Hwang, Bianca S. Zlavog, Mohammad Rabiee, Moses K. Muriithi, Anton C Harle, Mokhtar Mahdavi, Yohannes Kinfu, Olatunde Aremu, Cristiana Abbafati, Nelson Alvis-Guzman, Joseph L Dieleman, Lucero Cahuana-Hurtado, Abdollah Mohammadian-Hafshejani, Soewarta Kosen, Zeleke Hailemariam Abebo, Muge Cevik, Hassan Abolhassani, Farnam Mohebi, Job F M van Boven, Nataliya Foigt, Neda Milevska Kostova, Abdallah M. Samy, Roman Topor-Madry, Golsum Tsakalos, Benjamin B. Massenburg, Spencer L. James, Erkin M. Mirrakhimov, Miloje Savic, Mehdi Hosseinzadeh, Sawyer W Crosby, Ayesha Humayun, Hamidreza Setayesh, G Anil Kumar, Juan Sanabria, Jalal Arabloo, Milena M Santric Milicevic, Ai Koyanagi, Shokofeh Maleki, Junjie Wu, Nathaniel J Henry, Efat Mohamadi, Francesco Saverio Violante, Samad Azari, Delia Hendrie, Ahad Bakhtiari, Olayinka Stephen Ilesanmi, Pankaj Bhardwaj, Ahamarshan Jayaraman Nagarajan, Adnan Kisa, Masood Ali Shaikh, Shafiu Mohammed, Justice Nonvignon, Firooz Esmaeilzadeh, Eduardo A. Undurraga, Khurshid Alam, Muktar Beshir Ahmed, Mohamed M. Gad, Mikk Jürisson, Usman Iqbal, Chuanhua Yu, Luis Camera, Mohammad Ali Jahani, Abigail Chapin, Pascual R. Valdez, Reinhard Busse, Tomislav Mestrovic, Paul S. F. Yip, Christopher J L Murray, Jacob Olusegun Olusanya, Salah Eddin Karimi, Mustafa Z. Younis, Michael R.M. Abrigo, Rahul R. Zende, Mina Anjomshoa, Shane D. Morrison, Marcel Ausloos, Bruno Piassi Sao Jose, Zohre Javaheri, Saravanan Muthupandian, Valentin Yurievich Skryabin, Endalkachew Worku Mengesha, Lalit Dandona, Jacek Jerzy Jozwiak, Omar Mukhtar Salman, Rakhi Dandona, Mojtaba Bagherzadeh, Mostafa Dianatinasab, Reza Mohammadpourhodki, Seyed Sina Naghibi Irvani, Nancy Fullman, Claudiu Herteliu, Andreea Mirica, Jasvinder A. Singh, Amin Soheili, Lee Ling Lim, Charles D.A. Wolfe, Catalina Liliana Andrei, Ali Kazemi Karyani, Bolajoko O. Olusanya, Carl Abelardo T. Antonio, Tommi Vasankari, Jean Jacques Noubiap, Mehdi Naderi, Jagadish Rao Padubidri, Bernhard T. Baune, Navid Rabiee, Mark G. Shrime, Mayowa O. Owolabi, Lorenzo G. Mantovani, Desta Debalkie Atnafu, Vasily Vlassov, Kyle E. Simpson, Sorin Hostiuc, Shaun Wen Huey Lee, Cuong Tat Nguyen, Ian E Cogswell, Tesleem Kayode Babalola, Sanjay Basu, Hassan Haghparast Bidgoli, Leila Doshmangir, Marcos Roberto Tovani-Palone, Maha El Tantawi, Obinna Onwujekwe, Mohammad Ali Sahraian, Ahmed Omar Bali, Joshua A. Salomon, Hamidreza Komaki, David Laith Rawaf, Zoubida Zaidi, Hassan Magdy Abd El Razek, Reshmi Bhageerathy, Emilie R Maddison, Naohiro Yonemoto, Ahmad Ghashghaee, Asadollah Gholamian, Ferrán Catalá-López, Stefan Kohler, Rafael Tabarés-Seisdedos, Anwar Faraj, Rafael Lozano, Rufus Akinyemi, Florian Fischer, Jost B. Jonas, Dian Kusuma, Martin Amogre Ayanore, Rohollah Kalhor, Falk Schwendicke, Seyyed Meysam Mousavi, Micah, A. E., Su, Y., Bachmeier, S. D., Chapin, A., Cogswell, I. E., Crosby, S. W., Cunningham, B., Harle, A. C., Maddison, E. R., Moitra, M., Sahu, M., Schneider, M. T., Simpson, K. E., Stutzman, H. N., Tsakalos, G., Zende, R. R., Zlavog, B. S., Abbafati, C., Abebo, Z. H., Abolhassani, H., Abrigo, M. R. M., Ahmed, M. B., Akinyemi, R. O., Alam, K., Ali, S., Alinia, C., Alipour, V., Aljunid, S. M., Almasi, A., Alvis-Guzman, N., Ancuceanu, R., Andrei, T., Andrei, C. L., Anjomshoa, M., Antonio, C. A. T., Arabloo, J., Arab-Zozani, M., Aremu, O., Atnafu, D. D., Ausloos, M., Avila-Burgos, L., Ayanore, M. A., Azari, S., Babalola, T. K., Bagherzadeh, M., Baig, A. A., Bakhtiari, A., Banach, M., Banerjee, S. K., Barnighausen, T. W., Basu, S., Baune, B. T., Bayati, M., Berman, A. E., Bhageerathy, R., Bhardwaj, P., Bohluli, M., Busse, R., Cahuana-Hurtado, L., Camera, L. L. A., Castaneda-Orjuela, C. A., Catala-Lopez, F., Cevik, M., Chattu, V. K., Dandona, L., Dandona, R., Dianatinasab, M., Do, H. T., Doshmangir, L., El Tantawi, M., Eskandarieh, S., Esmaeilzadeh, F., Faraj, A., Farzadfar, F., Fischer, F., Foigt, N. A., Fullman, N., Gad, M. M., Ghafourifard, M., Ghashghaee, A., Gholamian, A., Goharinezhad, S., Grada, A., Haghparast Bidgoli, H., Hamidi, S., Harb, H. L., Hasanpoor, E., Hay, S. I., Hendrie, D., Henry, N. J., Herteliu, C., Hole, M. K., Hosseinzadeh, M., Hostiuc, S., Huda, T. M., Humayun, A., Hwang, B. -F., Ilesanmi, O. S., Iqbal, U., Irvani, S. S. N., Islam, S. M. S., Islam, M. M., Jahani, M. A., Jakovljevic, M., James, S. L., Javaheri, Z., Jonas, J. B., Joukar, F., Jozwiak, J. J., Jurisson, M., Kalhor, R., Karami Matin, B., Karimi, S. E., Kayode, G. A., Kazemi Karyani, A., Kinfu, Y., Kisa, A., Kohler, S., Komaki, H., Kosen, S., Kotlo, A., Koyanagi, A., Kumar, G. A., Kusuma, D., Lansingh, V. C., Larsson, A. O., Lasrado, S., Lee, S. W. H., Lim, L. -L., Lozano, R., Magdy Abd El Razek, H., Mahdavi, M. M., Maleki, S., Malekzadeh, R., Mansour-Ghanaei, F., Mansournia, M. A., Mantovani, L. G., Martinez, G., Masoumi, S. Z., Massenburg, B. B., Menezes, R. G., Mengesha, E. W., Meretoja, T. J., Meretoja, A., Mestrovic, T., Milevska Kostova, N., Miller, T. R., Mirica, A., Mirrakhimov, E. M., Moghadaszadeh, M., Mohajer, B., Mohamadi, E., Mohammad Darwesh, A., Mohammadian-Hafshejani, A., Mohammadpourhodki, R., Mohammed, S., Mohebi, F., Mokdad, A. H., Morrison, S. D., Mosser, J. F., Mousavi, S. M., Muriithi, M. K., Muthupandian, S., Myint, C. -Y., Naderi, M., Nagarajan, A. J., Nguyen, C. T., Nguyen, H. L. T., Nonvignon, J., Noubiap, J. J., Oh, I. -H., Olagunju, A. T., Olusanya, J. O., Olusanya, B. O., Omar Bali, A., Onwujekwe, O. E., Otstavnov, S. S., Otstavnov, N., Owolabi, M. O., Padubidri, J. R., Palladino, R., Panda-Jonas, S., Pandey, A., Postma, M. J., Prada, S. I., Pribadi, D. R. A., Rabiee, M., Rabiee, N., Rahim, F., Ranabhat, C. L., Rao, S. J., Rathi, P., Rawaf, S., Rawaf, D. L., Rawal, L., Rawassizadeh, R., Rezapour, A., Sabour, S., Sahraian, M. A., Salman, O. M., Salomon, J. A., Samy, A. M., Sanabria, J., Santos, J. V., Santric Milicevic, M. M., Sao Jose, B. P., Savic, M., Schwendicke, F., Senthilkumaran, S., Sepanlou, S. G., Servan-Mori, E., Setayesh, H., Shaikh, M. A., Sheikh, A., Shibuya, K., Shrime, M. G., Simonetti, B., Singh, J. A., Singh, P., Skryabin, V. Y., Soheili, A., Soltani, S., Stefan, S. C., Tabares-Seisdedos, R., Topor-Madry, R., Tovani-Palone, M. R., Tran, B. X., Travillian, R., Undurraga, E. A., Valdez, P. R., van Boven, J. F. M., Vasankari, T. J., Violante, F. S., Vlassov, V., Vos, T., Wolfe, C. D. A., Wu, J., Yaya, S., Yazdi-Feyzabadi, V., Yip, P., Yonemoto, N., Younis, M. Z., Yu, C., Zaidi, Z., Zaman, S. B., Zastrozhin, M. S., Zhang, Z. -J., Zhao, Y., Murray, C. J. L., Dieleman, J. L., Global Burden of Disease Health Financing Collaborator Network, Violante FS, Micah, A, Su, Y, Bachmeier, S, Chapin, A, Cogswell, I, Crosby, S, Cunningham, B, Harle, A, Maddison, E, Moitra, M, Sahu, M, Schneider, M, Simpson, K, Stutzman, H, Tsakalos, G, Zende, R, Zlavog, B, Abbafati, C, Abebo, Z, Abolhassani, H, Abrigo, M, Ahmed, M, Akinyemi, R, Alam, K, Ali, S, Alinia, C, Alipour, V, Aljunid, S, Almasi, A, Alvis-Guzman, N, Ancuceanu, R, Andrei, T, Andrei, C, Anjomshoa, M, Antonio, C, Arabloo, J, Arab-Zozani, M, Aremu, O, Atnafu, D, Ausloos, M, Avila-Burgos, L, Ayanore, M, Azari, S, Babalola, T, Bagherzadeh, M, Baig, A, Bakhtiari, A, Banach, M, Banerjee, S, Barnighausen, T, Basu, S, Baune, B, Bayati, M, Berman, A, Bhageerathy, R, Bhardwaj, P, Bohluli, M, Busse, R, Cahuana-Hurtado, L, Camera, L, Castaneda-Orjuela, C, Catala-Lopez, F, Cevik, M, Chattu, V, Dandona, L, Dandona, R, Dianatinasab, M, Do, H, Doshmangir, L, El Tantawi, M, Eskandarieh, S, Esmaeilzadeh, F, Faraj, A, Farzadfar, F, Fischer, F, Foigt, N, Fullman, N, Gad, M, Ghafourifard, M, Ghashghaee, A, Gholamian, A, Goharinezhad, S, Grada, A, Haghparast Bidgoli, H, Hamidi, S, Harb, H, Hasanpoor, E, Hay, S, Hendrie, D, Henry, N, Herteliu, C, Hole, M, Hosseinzadeh, M, Hostiuc, S, Huda, T, Humayun, A, Hwang, B, Ilesanmi, O, Iqbal, U, Irvani, S, Islam, S, Islam, M, Jahani, M, Jakovljevic, M, James, S, Javaheri, Z, Jonas, J, Joukar, F, Jozwiak, J, Jurisson, M, Kalhor, R, Karami Matin, B, Karimi, S, Kayode, G, Kazemi Karyani, A, Kinfu, Y, Kisa, A, Kohler, S, Komaki, H, Kosen, S, Kotlo, A, Koyanagi, A, Kumar, G, Kusuma, D, Lansingh, V, Larsson, A, Lasrado, S, Lee, S, Lim, L, Lozano, R, Magdy Abd El Razek, H, Mahdavi, M, Maleki, S, Malekzadeh, R, Mansour-Ghanaei, F, Mansournia, M, Mantovani, L, Martinez, G, Masoumi, S, Massenburg, B, Menezes, R, Mengesha, E, Meretoja, T, Meretoja, A, Mestrovic, T, Milevska Kostova, N, Miller, T, Mirica, A, Mirrakhimov, E, Moghadaszadeh, M, Mohajer, B, Mohamadi, E, Mohammad Darwesh, A, Mohammadian-Hafshejani, A, Mohammadpourhodki, R, Mohammed, S, Mohebi, F, Mokdad, A, Morrison, S, Mosser, J, Mousavi, S, Muriithi, M, Muthupandian, S, Myint, C, Naderi, M, Nagarajan, A, Nguyen, C, Nguyen, H, Nonvignon, J, Noubiap, J, Oh, I, Olagunju, A, Olusanya, J, Olusanya, B, Omar Bali, A, Onwujekwe, O, Otstavnov, S, Otstavnov, N, Owolabi, M, Padubidri, J, Palladino, R, Panda-Jonas, S, Pandey, A, Postma, M, Prada, S, Pribadi, D, Rabiee, M, Rabiee, N, Rahim, F, Ranabhat, C, Rao, S, Rathi, P, Rawaf, S, Rawaf, D, Rawal, L, Rawassizadeh, R, Rezapour, A, Sabour, S, Sahraian, M, Salman, O, Salomon, J, Samy, A, Sanabria, J, Santos, J, Santric Milicevic, M, Sao Jose, B, Savic, M, Schwendicke, F, Senthilkumaran, S, Sepanlou, S, Servan-Mori, E, Setayesh, H, Shaikh, M, Sheikh, A, Shibuya, K, Shrime, M, Simonetti, B, Singh, J, Singh, P, Skryabin, V, Soheili, A, Soltani, S, Stefan, S, Tabares-Seisdedos, R, Topor-Madry, R, Tovani-Palone, M, Tran, B, Travillian, R, Undurraga, E, Valdez, P, van Boven, J, Vasankari, T, Violante, F, Vlassov, V, Vos, T, Wolfe, C, Wu, J, Yaya, S, Yazdi-Feyzabadi, V, Yip, P, Yonemoto, N, Younis, M, Yu, C, Zaidi, Z, Zaman, S, Zastrozhin, M, Zhang, Z, Zhao, Y, Murray, C, Dieleman, J, University of Helsinki, Clinicum, HUS Comprehensive Cancer Center, HUS Neurocenter, Helsinki University Hospital Area, University of St Andrews. School of Medicine, University of St Andrews. Infection and Global Health Division, Groningen Research Institute for Asthma and COPD (GRIAC), Value, Affordability and Sustainability (VALUE), and Real World Studies in PharmacoEpidemiology, -Genetics, -Economics and -Therapy (PEGET)

Subjects
Economic growth, Financing, Government, Psychological intervention, HIV Infections, burden of disease, 030204 cardiovascular system & hematology, DISEASE, ALLOCATION, 0302 clinical medicine, RA0421, RA0421 Public health. Hygiene. Preventive Medicine, Sustainable development, Global health, health economics, Healthcare Financing, HIV Infection, 030212 general & internal medicine, 10. No inequality, 11 Medical and Health Sciences, DALY, Healthy lives, 1. No poverty, Public Health, Global Health, Social Medicine and Epidemiology, 3rd-DAS, General Medicine, Sustainable Development, 3. Good health, tuberculosis, IMPOVERISHMENT, TERRITORIES, Financing, Human, Financing, Personal, Resource (biology), Tuberculosi, 195 COUNTRIES, Developing Countrie, 03 medical and health sciences, SDG 3 - Good Health and Well-being, Acquired immunodeficiency syndrome (AIDS), General & Internal Medicine, SYSTEMATIC ANALYSIS, medicine, Humans, Burden, HIV/AIDS, tubercolosis, malaria, Human resources, Developing Countries, Government, Acquired Immunodeficiency Syndrome, Health economics, business.industry, DISABILITY, CATASTROPHE, Global Burden of Disease Health Financing Collaborator Network, GLOBAL BURDEN, medicine.disease, Malaria, SDG, health sector spending, development assistant for health, Health Expenditure, Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi, 3121 General medicine, internal medicine and other clinical medicine, NA, Health Expenditures, business, EXPENDITURE
Abstract

BACKGROUND: Sustainable Development Goal (SDG) 3 aims to "ensure healthy lives and promote well-being for all at all ages". While a substantial effort has been made to quantify progress towards SDG3, less research has focused on tracking spending towards this goal. We used spending estimates to measure progress in financing the priority areas of SDG3, examine the association between outcomes and financing, and identify where resource gains are most needed to achieve the SDG3 indicators for which data are available. METHODS: We estimated domestic health spending, disaggregated by source (government, out-of-pocket, and prepaid private) from 1995 to 2017 for 195 countries and territories. For disease-specific health spending, we estimated spending for HIV/AIDS and tuberculosis for 135 low-income and middle-income countries, and malaria in 106 malaria-endemic countries, from 2000 to 2017. We also estimated development assistance for health (DAH) from 1990 to 2019, by source, disbursing development agency, recipient, and health focus area, including DAH for pandemic preparedness. Finally, we estimated future health spending for 195 countries and territories from 2018 until 2030. We report all spending estimates in inflation-adjusted 2019 US$, unless otherwise stated. FINDINGS: Since the development and implementation of the SDGs in 2015, global health spending has increased, reaching $7·9 trillion (95% uncertainty interval 7·8-8·0) in 2017 and is expected to increase to $11·0 trillion (10·7-11·2) by 2030. In 2017, in low-income and middle-income countries spending on HIV/AIDS was $20·2 billion (17·0-25·0) and on tuberculosis it was $10·9 billion (10·3-11·8), and in malaria-endemic countries spending on malaria was $5·1 billion (4·9-5·4). Development assistance for health was $40·6 billion in 2019 and HIV/AIDS has been the health focus area to receive the highest contribution since 2004. In 2019, $374 million of DAH was provided for pandemic preparedness, less than 1% of DAH. Although spending has increased across HIV/AIDS, tuberculosis, and malaria since 2015, spending has not increased in all countries, and outcomes in terms of prevalence, incidence, and per-capita spending have been mixed. The proportion of health spending from pooled sources is expected to increase from 81·6% (81·6-81·7) in 2015 to 83·1% (82·8-83·3) in 2030. INTERPRETATION: Health spending on SDG3 priority areas has increased, but not in all countries, and progress towards meeting the SDG3 targets has been mixed and has varied by country and by target. The evidence on the scale-up of spending and improvements in health outcomes suggest a nuanced relationship, such that increases in spending do not always results in improvements in outcomes. Although countries will probably need more resources to achieve SDG3, other constraints in the broader health system such as inefficient allocation of resources across interventions and populations, weak governance systems, human resource shortages, and drug shortages, will also need to be addressed. For complete list of authors see http://dx.doi.org/10.1016/S0140-6736(20)30608-5

Published
2020
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6. Comparison of skin closure techniques in patients undergoing open pancreaticoduodenectomy: A single center experience.

Author

Flick KF, Simpson RE, Soufi M, Fennerty ML, Yip-Schneider MT, Colgate CL, Ceppa EP, House MG, Zyromski NJ, Nakeeb A, and Schmidt CM

Subjects
Aged, Female, Follow-Up Studies, Humans, Incidence, Male, Middle Aged, Prognosis, Retrospective Studies, United States epidemiology, Pancreaticoduodenectomy methods, Postoperative Complications epidemiology, Wound Closure Techniques
Abstract

Background: This study evaluated closure techniques and incisional surgical site complications (SSCs) and incisional surgical site infections (SSIs) after pancreaticoduodenectomy (PD)., Methods: Retrospective review of open PDs from 2015 to 2018 was performed. Outcomes were compared among closure techniques (subcuticular + topical skin adhesive (TSA); staples; subcuticular only). SSCs were defined as abscess, cellulitis, seroma, or fat necrosis. SSIs were defined according to the National Surgical Quality Improvement Program (NSQIP)., Results: Patients with subcuticular + TSA (n = 205) were less likely to develop an incisional SSC (9.8%) compared to staples (n = 139) (20.1%) and subcuticular (n = 74) (16.2%) on univariable analysis (P = 0.024). Multivariable analysis revealed no statistically significant difference in incisional SSC between subcuticular + TSA and subcuticular (P = 0.528); a significant difference remained between subcuticular + TSA and staples (P = 0.014). Unadjusted median length of stay (LOS) (days) was significantly longer for staples (9) vs. subcuticular (8) vs. subcuticular + TSA (7); P < 0.001. Incisional SSIs were evaluated separately according to the NSQIP definition. When comparing rates, the subcuticular + TSA group experienced lower incisional SSIs compared to the other two techniques (4.9% vs. 10.1%, 10.8%). However, this difference was not statistically significant by either univariable or multivariable analysis., Conclusions: Subcuticular suture + TSA reduces the risk of incisional SSCs when compared to staples alone after pancreaticoduodenectomy., Competing Interests: Declaration of competing interest None declared., (Copyright © 2020 Elsevier Inc. All rights reserved.)

Published
2020
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8. Early morphologic changes in trapeziometacarpal joint bones with osteoarthritis.

Author

Schneider MTY, Zhang J, Walker CG, Crisco JJ, Weiss AC, Ladd AL, Nielsen PMF, and Besier T

Subjects
Carpometacarpal Joints physiopathology, Disease Progression, Female, Follow-Up Studies, Humans, Male, Middle Aged, Osteoarthritis physiopathology, Thumb diagnostic imaging, Time Factors, Carpometacarpal Joints diagnostic imaging, Osteoarthritis diagnosis, Range of Motion, Articular physiology, Thumb physiopathology, Tomography, X-Ray Computed methods
Abstract

Objective: Characterising the morphological differences between healthy and early osteoarthritic (EOA) trapeziometacarpal (TMC) joints is important for understanding osteoarthritis onset, and early detection is important for treatment and disease management. This study has two aims: first, to characterise morphological differences between healthy and EOA TMC bones. The second aim was to determine the efficacy of using a statistical shape model (SSM) to detect early signs of osteoarthritis (OA)., Methods: CT image data of TMC bones from 22 asymptomatic volunteers and 47 patients with EOA were obtained from an ongoing study and used to generate a SSM. A linear discriminant analysis (LDA) classifier was trained on the principal component (PC) weights to characterise features of each group. Multivariable statistical analysis was performed on the PC to investigate morphologic differences. Leave-one-out classification was performed to evaluate the classifiers performance., Results: We found that TMC bones of EOA subjects exhibited a lower aspect ratio (P = 0.042) compared with healthy subjects. The LDA classifier predicted that protrusions (up to 1.5 mm) at the volar beak of the first metacarpal were characteristic of EOA subjects. This was accompanied with widening of the articular surface, deepening of the articular surface, and protruding bone growths along the concave margin. These characteristics resulted in a leave-one-out classification accuracy of 73.9% (95% CI [61.9%, 83.8%]), sensitivity of 89.4%, specificity of 40.9%, and precision of 75.9%., Conclusion: Our findings indicate that morphological degeneration is well underway in the EOA TMC joint, and shows promise for a clinical tool that can detect these features automatically., (Copyright © 2018 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.)

Published
2018
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9. Men and women have similarly shaped carpometacarpal joint bones.

Author

Schneider MT, Zhang J, Crisco JJ, Weiss AP, Ladd AL, Nielsen P, and Besier T

Subjects
Adult, Carpometacarpal Joints anatomy & histology, Carpometacarpal Joints diagnostic imaging, Female, Humans, Male, Middle Aged, Radiography, Sex Characteristics, Thumb anatomy & histology, Thumb diagnostic imaging, Trapezium Bone diagnostic imaging, Young Adult, Trapezium Bone anatomy & histology
Abstract

Characterizing the morphology of the carpometacarpal (CMC) joint bones and how they vary across the population is important for understanding the functional anatomy and pathology of the thumb. The purpose of this paper was to develop a statistical shape model of the trapezium and first metacarpal bones to characterize the size and shape of the whole bones across a cohort of 50. We used this shape model to investigate the effects of sex and age on the size and shape of the CMC joint bones and the articulating surface area of the CMC joint. We hypothesized that women have similar shape trapezium and first metacarpal bones compared to men, following scaling for overall size. We also hypothesized that age would be a significant predictor variable for CMC joint bone changes. CT image data and segmented point clouds of 50 CMC bones from healthy adult men and women were obtained from an ongoing study and used to generate two statistical shape models. Statistical analysis of the principal component weights of both models was performed to investigate morphological sex and age differences. We observed sex differences, but were unable to detect any age differences. Between men and women the only difference in morphology of the trapezia and first metacarpal bones was size. These findings confirm our first hypothesis, and suggest that the women have similarly shaped trapezium and first metacarpal bones compared to men. Furthermore, our results reject our second hypothesis, indicating that age is a poor predictor of CMC joint morphology., (Copyright © 2015 Elsevier Ltd. All rights reserved.)

Published
2015
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