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1. Past, present, and future of global health financing: A review of development assistance, government, out-of-pocket, and other private spending on health for 195 countries, 1995-2050

Author

Chang, A, Cowling, K, Micah, A, Chapin, A, Chen, C, Ikilezi, G, Sadat, N, Tsakalos, G, Wu, J, Younker, T, Zhao, Y, Zlavog, B, Abbafati, C, Ahmed, A, Alam, K, Alipour, V, Aljunid, S, Almalki, M, Alvis-Guzman, N, Ammar, W, Andrei, C, Anjomshoa, M, Antonio, C, Arabloo, J, Aremu, O, Ausloos, M, Avila-Burgos, L, Awasthi, A, Ayanore, M, Azari, S, Azzopardi-Muscat, N, Bagherzadeh, M, Barnighausen, T, Baune, B, Bayati, M, Belay, Y, Belete, H, Berbada, D, Berman, A, Beuran, M, Bijani, A, Busse, R, Cahuana-Hurtado, L, Camera, L, Catala-Lopez, F, Chauhan, B, Constantin, M, Crowe, C, Cucu, A, Dalal, K, De Neve, J, Deiparine, S, Demeke, F, Do, H, Dubey, M, Tantawi, M, Eskandarieh, S, Esmaeili, R, Fakhar, M, Fazaeli, A, Fischer, F, Foigt, N, Fukumoto, T, Fullman, N, Galan, A, Gamkrelidze, A, Gezae, K, Ghajar, A, Ghashghaee, A, Goginashvili, K, Haakenstad, A, Bidgoli, H, Hamidi, S, Harb, H, Hasanpoor, E, Hassen, H, Hay, S, Hendrie, D, Henok, A, Heredia-Pi, I, Herteliu, C, Hoang, C, Hole, M, Rad, E, Hossain, N, Hosseinzadeh, M, Hostiuc, S, Ilesanmi, O, Irvani, S, Jakovljevic, M, Jalali, A, James, S, Jonas, J, Jurisson, M, Kadel, R, Matin, B, Kasaeian, A, Kasaye, H, Kassaw, M, Karyani, A, Khabiri, R, Khan, J, Khan, M, Khang, Y, Kisa, A, Kissimova-Skarbek, K, Kohler, S, Koyanagi, A, Krohn, K, Leung, R, Lim, L, Lorkowski, S, Majeed, A, Malekzadeh, R, Mansourian, M, Mantovani, L, Massenburg, B, Mckee, M, Mehta, V, Meretoja, A, Meretoja, T, Kostova, N, Miller, T, Mirrakhimov, E, Mohajer, B, Darwesh, A, Mohammed, S, Mohebi, F, Mokdad, A, Morrison, S, Mousavi, S, Muthupandian, S, Nagarajan, A, Nangia, V, Negoi, I, Nguyen, C, Nguyen, H, Nguyen, S, Nosratnejad, S, Oladimeji, O, Olgiati, S, Olusanya, J, Onwujekwe, O, Otstavnov, S, Pana, A, Pereira, D, Piroozi, B, Prada, S, Qorbani, M, Rabiee, M, Rabiee, N, Rafiei, A, Rahim, F, Rahimi-Movaghar, V, Ram, U, Ranabhat, C, Ranta, A, Rawaf, D, Rawaf, S, Rezaei, S, Roro, E, Rostami, A, Rubino, S, Salahshoor, M, Samy, A, Sanabria, J, Santos, J, Milicevic, M, Jose, B, Savic, M, Schwendicke, F, Sepanlou, S, Sepehrimanesh, M, Sheikh, A, Shrime, M, Sisay, S, Soltani, S, Soofi, M, Srinivasan, V, Tabares-Seisdedos, R, Torre, A, Tovani-Palone, M, Tran, B, Tran, K, Undurraga, E, Valdez, P, Van Boven, J, Vargas, V, Veisani, Y, Violante, F, Vladimirov, S, Vlassov, V, Vollmer, S, Vu, G, Wolfe, C, Yonemoto, N, Younis, M, Yousefifard, M, Zaman, S, Zangeneh, A, Zegeye, E, Ziapour, A, Chew, A, Murray, C, Dieleman, J, Chang A. Y., Cowling K., Micah A. E., Chapin A., Chen C. S., Ikilezi G., Sadat N., Tsakalos G., Wu J., Younker T., Zhao Y., Zlavog B. S., Abbafati C., Ahmed A. E., Alam K., Alipour V., Aljunid S. M., Almalki M. J., Alvis-Guzman N., Ammar W., Andrei C. L., Anjomshoa M., Antonio C. A. T., Arabloo J., Aremu O., Ausloos M., Avila-Burgos L., Awasthi A., Ayanore M. A., Azari S., Azzopardi-Muscat N., Bagherzadeh M., Barnighausen T. W., Baune B. T., Bayati M., Belay Y. B., Belay Y. A., Belete H., Berbada D. A., Berman A. E., Beuran M., Bijani A., Busse R., Cahuana-Hurtado L., Camera L. A., Catala-Lopez F., Chauhan B. G., Constantin M. -M., Crowe C. S., Cucu A., Dalal K., De Neve J. -W., Deiparine S., Demeke F. M., Do H. P., Dubey M., Tantawi M. E., Eskandarieh S., Esmaeili R., Fakhar M., Fazaeli A. A., Fischer F., Foigt N. A., Fukumoto T., Fullman N., Galan A., Gamkrelidze A., Gezae K. E., Ghajar A., Ghashghaee A., Goginashvili K., Haakenstad A., Bidgoli H. H., Hamidi S., Harb H. L., Hasanpoor E., Hassen H. Y., Hay S. I., Hendrie D., Henok A., Heredia-Pi I., Herteliu C., Hoang C. L., Hole M. K., Rad E. H., Hossain N., Hosseinzadeh M., Hostiuc S., Ilesanmi O. S., Irvani S. S. N., Jakovljevic M., Jalali A., James S. L., Jonas J. B., Jurisson M., Kadel R., Matin B. K., Kasaeian A., Kasaye H. K., Kassaw M. W., Karyani A. K., Khabiri R., Khan J., Khan M. N., Khang Y. -H., Kisa A., Kissimova-Skarbek K., Kohler S., Koyanagi A., Krohn K. J., Leung R., Lim L. -L., Lorkowski S., Majeed A., Malekzadeh R., Mansourian M., Mantovani L. G., Massenburg B. B., Mckee M., Mehta V., Meretoja A., Meretoja T. J., Kostova N. M., Miller T. R., Mirrakhimov E. M., Mohajer B., Darwesh A. M., Mohammed S., Mohebi F., Mokdad A. H., Morrison S. D., Mousavi S. M., Muthupandian S., Nagarajan A. J., Nangia V., Negoi I., Nguyen C. T., Nguyen H. L. T., Nguyen S. H., Nosratnejad S., Oladimeji O., Olgiati S., Olusanya J. O., Onwujekwe O. E., Otstavnov S. S., Pana A., Pereira D. M., Piroozi B., Prada S. I., Qorbani M., Rabiee M., Rabiee N., Rafiei A., Rahim F., Rahimi-Movaghar V., Ram U., Ranabhat C. L., Ranta A., Rawaf D. L., Rawaf S., Rezaei S., Roro E. M., Rostami A., Rubino S., Salahshoor M., Samy A. M., Sanabria J., Santos J. V., Milicevic M. M. S., Jose B. P. S., Savic M., Schwendicke F., Sepanlou S. G., Sepehrimanesh M., Sheikh A., Shrime M. G., Sisay S., Soltani S., Soofi M., Srinivasan V., Tabares-Seisdedos R., Torre A., Tovani-Palone M. R., Tran B. X., Tran K. B., Undurraga E. A., Valdez P. R., Van Boven J. F. M., Vargas V., Veisani Y., Violante F. S., Vladimirov S. K., Vlassov V., Vollmer S., Vu G. T., Wolfe C. D. A., Yonemoto N., Younis M. Z., Yousefifard M., Zaman S. B., Zangeneh A., Zegeye E. A., Ziapour A., Chew A., Murray C. J. L., Dieleman J. L., Chang, A, Cowling, K, Micah, A, Chapin, A, Chen, C, Ikilezi, G, Sadat, N, Tsakalos, G, Wu, J, Younker, T, Zhao, Y, Zlavog, B, Abbafati, C, Ahmed, A, Alam, K, Alipour, V, Aljunid, S, Almalki, M, Alvis-Guzman, N, Ammar, W, Andrei, C, Anjomshoa, M, Antonio, C, Arabloo, J, Aremu, O, Ausloos, M, Avila-Burgos, L, Awasthi, A, Ayanore, M, Azari, S, Azzopardi-Muscat, N, Bagherzadeh, M, Barnighausen, T, Baune, B, Bayati, M, Belay, Y, Belete, H, Berbada, D, Berman, A, Beuran, M, Bijani, A, Busse, R, Cahuana-Hurtado, L, Camera, L, Catala-Lopez, F, Chauhan, B, Constantin, M, Crowe, C, Cucu, A, Dalal, K, De Neve, J, Deiparine, S, Demeke, F, Do, H, Dubey, M, Tantawi, M, Eskandarieh, S, Esmaeili, R, Fakhar, M, Fazaeli, A, Fischer, F, Foigt, N, Fukumoto, T, Fullman, N, Galan, A, Gamkrelidze, A, Gezae, K, Ghajar, A, Ghashghaee, A, Goginashvili, K, Haakenstad, A, Bidgoli, H, Hamidi, S, Harb, H, Hasanpoor, E, Hassen, H, Hay, S, Hendrie, D, Henok, A, Heredia-Pi, I, Herteliu, C, Hoang, C, Hole, M, Rad, E, Hossain, N, Hosseinzadeh, M, Hostiuc, S, Ilesanmi, O, Irvani, S, Jakovljevic, M, Jalali, A, James, S, Jonas, J, Jurisson, M, Kadel, R, Matin, B, Kasaeian, A, Kasaye, H, Kassaw, M, Karyani, A, Khabiri, R, Khan, J, Khan, M, Khang, Y, Kisa, A, Kissimova-Skarbek, K, Kohler, S, Koyanagi, A, Krohn, K, Leung, R, Lim, L, Lorkowski, S, Majeed, A, Malekzadeh, R, Mansourian, M, Mantovani, L, Massenburg, B, Mckee, M, Mehta, V, Meretoja, A, Meretoja, T, Kostova, N, Miller, T, Mirrakhimov, E, Mohajer, B, Darwesh, A, Mohammed, S, Mohebi, F, Mokdad, A, Morrison, S, Mousavi, S, Muthupandian, S, Nagarajan, A, Nangia, V, Negoi, I, Nguyen, C, Nguyen, H, Nguyen, S, Nosratnejad, S, Oladimeji, O, Olgiati, S, Olusanya, J, Onwujekwe, O, Otstavnov, S, Pana, A, Pereira, D, Piroozi, B, Prada, S, Qorbani, M, Rabiee, M, Rabiee, N, Rafiei, A, Rahim, F, Rahimi-Movaghar, V, Ram, U, Ranabhat, C, Ranta, A, Rawaf, D, Rawaf, S, Rezaei, S, Roro, E, Rostami, A, Rubino, S, Salahshoor, M, Samy, A, Sanabria, J, Santos, J, Milicevic, M, Jose, B, Savic, M, Schwendicke, F, Sepanlou, S, Sepehrimanesh, M, Sheikh, A, Shrime, M, Sisay, S, Soltani, S, Soofi, M, Srinivasan, V, Tabares-Seisdedos, R, Torre, A, Tovani-Palone, M, Tran, B, Tran, K, Undurraga, E, Valdez, P, Van Boven, J, Vargas, V, Veisani, Y, Violante, F, Vladimirov, S, Vlassov, V, Vollmer, S, Vu, G, Wolfe, C, Yonemoto, N, Younis, M, Yousefifard, M, Zaman, S, Zangeneh, A, Zegeye, E, Ziapour, A, Chew, A, Murray, C, Dieleman, J, Chang A. Y., Cowling K., Micah A. E., Chapin A., Chen C. S., Ikilezi G., Sadat N., Tsakalos G., Wu J., Younker T., Zhao Y., Zlavog B. S., Abbafati C., Ahmed A. E., Alam K., Alipour V., Aljunid S. M., Almalki M. J., Alvis-Guzman N., Ammar W., Andrei C. L., Anjomshoa M., Antonio C. A. T., Arabloo J., Aremu O., Ausloos M., Avila-Burgos L., Awasthi A., Ayanore M. A., Azari S., Azzopardi-Muscat N., Bagherzadeh M., Barnighausen T. W., Baune B. T., Bayati M., Belay Y. B., Belay Y. A., Belete H., Berbada D. A., Berman A. E., Beuran M., Bijani A., Busse R., Cahuana-Hurtado L., Camera L. A., Catala-Lopez F., Chauhan B. G., Constantin M. -M., Crowe C. S., Cucu A., Dalal K., De Neve J. -W., Deiparine S., Demeke F. M., Do H. P., Dubey M., Tantawi M. E., Eskandarieh S., Esmaeili R., Fakhar M., Fazaeli A. A., Fischer F., Foigt N. A., Fukumoto T., Fullman N., Galan A., Gamkrelidze A., Gezae K. E., Ghajar A., Ghashghaee A., Goginashvili K., Haakenstad A., Bidgoli H. H., Hamidi S., Harb H. L., Hasanpoor E., Hassen H. Y., Hay S. I., Hendrie D., Henok A., Heredia-Pi I., Herteliu C., Hoang C. L., Hole M. K., Rad E. H., Hossain N., Hosseinzadeh M., Hostiuc S., Ilesanmi O. S., Irvani S. S. N., Jakovljevic M., Jalali A., James S. L., Jonas J. B., Jurisson M., Kadel R., Matin B. K., Kasaeian A., Kasaye H. K., Kassaw M. W., Karyani A. K., Khabiri R., Khan J., Khan M. N., Khang Y. -H., Kisa A., Kissimova-Skarbek K., Kohler S., Koyanagi A., Krohn K. J., Leung R., Lim L. -L., Lorkowski S., Majeed A., Malekzadeh R., Mansourian M., Mantovani L. G., Massenburg B. B., Mckee M., Mehta V., Meretoja A., Meretoja T. J., Kostova N. M., Miller T. R., Mirrakhimov E. M., Mohajer B., Darwesh A. M., Mohammed S., Mohebi F., Mokdad A. H., Morrison S. D., Mousavi S. M., Muthupandian S., Nagarajan A. J., Nangia V., Negoi I., Nguyen C. T., Nguyen H. L. T., Nguyen S. H., Nosratnejad S., Oladimeji O., Olgiati S., Olusanya J. O., Onwujekwe O. E., Otstavnov S. S., Pana A., Pereira D. M., Piroozi B., Prada S. I., Qorbani M., Rabiee M., Rabiee N., Rafiei A., Rahim F., Rahimi-Movaghar V., Ram U., Ranabhat C. L., Ranta A., Rawaf D. L., Rawaf S., Rezaei S., Roro E. M., Rostami A., Rubino S., Salahshoor M., Samy A. M., Sanabria J., Santos J. V., Milicevic M. M. S., Jose B. P. S., Savic M., Schwendicke F., Sepanlou S. G., Sepehrimanesh M., Sheikh A., Shrime M. G., Sisay S., Soltani S., Soofi M., Srinivasan V., Tabares-Seisdedos R., Torre A., Tovani-Palone M. R., Tran B. X., Tran K. B., Undurraga E. A., Valdez P. R., Van Boven J. F. M., Vargas V., Veisani Y., Violante F. S., Vladimirov S. K., Vlassov V., Vollmer S., Vu G. T., Wolfe C. D. A., Yonemoto N., Younis M. Z., Yousefifard M., Zaman S. B., Zangeneh A., Zegeye E. A., Ziapour A., Chew A., Murray C. J. L., and Dieleman J. L.

Abstract

Background: Comprehensive and comparable estimates of health spending in each country are a key input for health policy and planning, and are necessary to support the achievement of national and international health goals. Previous studies have tracked past and projected future health spending until 2040 and shown that, with economic development, countries tend to spend more on health per capita, with a decreasing share of spending from development assistance and out-of-pocket sources. We aimed to characterise the past, present, and predicted future of global health spending, with an emphasis on equity in spending across countries. Methods: We estimated domestic health spending for 195 countries and territories from 1995 to 2016, split into three categories-government, out-of-pocket, and prepaid private health spending-and estimated development assistance for health (DAH) from 1990 to 2018. We estimated future scenarios of health spending using an ensemble of linear mixed-effects models with time series specifications to project domestic health spending from 2017 through 2050 and DAH from 2019 through 2050. Data were extracted from a broad set of sources tracking health spending and revenue, and were standardised and converted to inflation-adjusted 2018 US dollars. Incomplete or low-quality data were modelled and uncertainty was estimated, leading to a complete data series of total, government, prepaid private, and out-of-pocket health spending, and DAH. Estimates are reported in 2018 US dollars, 2018 purchasing-power parity-adjusted dollars, and as a percentage of gross domestic product. We used demographic decomposition methods to assess a set of factors associated with changes in government health spending between 1995 and 2016 and to examine evidence to support the theory of the health financing transition. We projected two alternative future scenarios based on higher government health spending to assess the potential ability of governments to generate more reso

Published
2019

2. Past, present, and future of global health financing : A review of development assistance, government, out-of-pocket, and other private spending on health for 195 countries, 1995-2050

Author

Chang, A. Y., Cowling, K., Micah, A. E., Chapin, A., Chen, C. S., Ikilezi, G., Sadat, N., Tsakalos, G., Wu, J., Younker, T., Zhao, Y., Zlavog, B. S., Abbafati, C., Ahmed, A. E., Alam, K., Alipour, V., Aljunid, S. M., Almalki, M. J., Alvis-Guzman, N., Ammar, W., Andrei, C. L., Anjomshoa, M., Antonio, C. A. T., Arabloo, J., Aremu, O., Ausloos, M., Avila-Burgos, L., Awasthi, A., Ayanore, M. A., Azari, S., Azzopardi-Muscat, N., Bagherzadeh, M., BÀrnighausen, T. W., Baune, B. T., Bayati, M., Belay, Y. B., Belay, Y. A., Belete, H., Berbada, D. A., Berman, A. E., Beuran, M., Bijani, A., Busse, R., Cahuana-Hurtado, L., Cámera, L. A., Catalá-López, F., Chauhan, B. G., Constantin, M. -M, Crowe, C. S., Cucu, A., Dalal, Koustuv, De Neve, J. -W, Deiparine, S., Demeke, F. M., Do, H. P., Dubey, M., Tantawi, M. E., Eskandarieh, S., Esmaeili, R., Fakhar, M., Fazaeli, A. A., Fischer, F., Foigt, N. A., Fukumoto, T., Fullman, N., Galan, A., Gamkrelidze, A., Gezae, K. E., Ghajar, A., Ghashghaee, A., Goginashvili, K., Haakenstad, A., Bidgoli, H. H., Hamidi, S., Harb, H. L., Hasanpoor, E., Hassen, H. Y., Hay, S. I., Hendrie, D., Henok, A., Heredia-Pi, I., Herteliu, C., Hoang, C. L., Hole, M. K., Rad, E. H., Hossain, N., Hosseinzadeh, M., Hostiuc, S., Ilesanmi, O. S., Irvani, S. S. N., Jakovljevic, M., Jalali, A., James, S. L., Jonas, J. B., JÌrisson, M., Kadel, R., Matin, B. K., Kasaeian, A., Kasaye, H. K., Kassaw, M. W., Karyani, A. K., Khabiri, R., Khan, J., Khan, M. N., Khang, Y. -H, Kisa, A., Kissimova-Skarbek, K., Kohler, S., Koyanagi, A., Krohn, K. J., Leung, R., Lim, L. -L, Lorkowski, S., Majeed, A., Malekzadeh, R., Mansourian, M., Mantovani, L. G., Massenburg, B. B., Mckee, M., Mehta, V., Meretoja, A., Meretoja, T. J., Kostova, N. M., Miller, T. R., Mirrakhimov, E. M., Mohajer, B., Darwesh, A. M., Mohammed, S., Mohebi, F., Mokdad, A. H., Morrison, S. D., Mousavi, S. M., Muthupandian, S., Nagarajan, A. J., Nangia, V., Negoi, I., Nguyen, C. T., Nguyen, H. L. T., Nguyen, S. H., Nosratnejad, S., Oladimeji, O., Olgiati, S., Olusanya, J. O., Onwujekwe, O. E., Otstavnov, S. S., Pana, A., Pereira, D. M., Piroozi, B., Prada, S. I., Qorbani, M., Rabiee, M., Rabiee, N., Rafiei, A., Rahim, F., Rahimi-Movaghar, V., Ram, U., Ranabhat, C. L., Ranta, A., Rawaf, D. L., Rawaf, S., Rezaei, S., Roro, E. M., Rostami, A., Rubino, S., Salahshoor, M., Samy, A. M., Sanabria, J., Santos, J. V., Milicevic, M. M. S., Jose, B. P. S., Savic, M., Schwendicke, F., Sepanlou, S. G., Sepehrimanesh, M., Sheikh, A., Shrime, M. G., Sisay, S., Soltani, S., Soofi, M., Srinivasan, V., Tabarés-Seisdedos, R., Torre, A., Tovani-Palone, M. R., Tran, B. X., Tran, K. B., Undurraga, E. A., Valdez, P. R., Van Boven, J. F. M., Vargas, V., Veisani, Y., Violante, F. S., Vladimirov, S. K., Vlassov, V., Vollmer, S., Vu, G. T., Wolfe, C. D. A., Yonemoto, N., Younis, M. Z., Yousefifard, M., Zaman, S. B., Zangeneh, A., Zegeye, E. A., Ziapour, A., Chew, A., Murray, C. J. L., Dieleman, J. L., Network, Global Burden of Disease Health Financing Collaborator, Chang, A. Y., Cowling, K., Micah, A. E., Chapin, A., Chen, C. S., Ikilezi, G., Sadat, N., Tsakalos, G., Wu, J., Younker, T., Zhao, Y., Zlavog, B. S., Abbafati, C., Ahmed, A. E., Alam, K., Alipour, V., Aljunid, S. M., Almalki, M. J., Alvis-Guzman, N., Ammar, W., Andrei, C. L., Anjomshoa, M., Antonio, C. A. T., Arabloo, J., Aremu, O., Ausloos, M., Avila-Burgos, L., Awasthi, A., Ayanore, M. A., Azari, S., Azzopardi-Muscat, N., Bagherzadeh, M., BÀrnighausen, T. W., Baune, B. T., Bayati, M., Belay, Y. B., Belay, Y. A., Belete, H., Berbada, D. A., Berman, A. E., Beuran, M., Bijani, A., Busse, R., Cahuana-Hurtado, L., Cámera, L. A., Catalá-López, F., Chauhan, B. G., Constantin, M. -M, Crowe, C. S., Cucu, A., Dalal, Koustuv, De Neve, J. -W, Deiparine, S., Demeke, F. M., Do, H. P., Dubey, M., Tantawi, M. E., Eskandarieh, S., Esmaeili, R., Fakhar, M., Fazaeli, A. A., Fischer, F., Foigt, N. A., Fukumoto, T., Fullman, N., Galan, A., Gamkrelidze, A., Gezae, K. E., Ghajar, A., Ghashghaee, A., Goginashvili, K., Haakenstad, A., Bidgoli, H. H., Hamidi, S., Harb, H. L., Hasanpoor, E., Hassen, H. Y., Hay, S. I., Hendrie, D., Henok, A., Heredia-Pi, I., Herteliu, C., Hoang, C. L., Hole, M. K., Rad, E. H., Hossain, N., Hosseinzadeh, M., Hostiuc, S., Ilesanmi, O. S., Irvani, S. S. N., Jakovljevic, M., Jalali, A., James, S. L., Jonas, J. B., JÌrisson, M., Kadel, R., Matin, B. K., Kasaeian, A., Kasaye, H. K., Kassaw, M. W., Karyani, A. K., Khabiri, R., Khan, J., Khan, M. N., Khang, Y. -H, Kisa, A., Kissimova-Skarbek, K., Kohler, S., Koyanagi, A., Krohn, K. J., Leung, R., Lim, L. -L, Lorkowski, S., Majeed, A., Malekzadeh, R., Mansourian, M., Mantovani, L. G., Massenburg, B. B., Mckee, M., Mehta, V., Meretoja, A., Meretoja, T. J., Kostova, N. M., Miller, T. R., Mirrakhimov, E. M., Mohajer, B., Darwesh, A. M., Mohammed, S., Mohebi, F., Mokdad, A. H., Morrison, S. D., Mousavi, S. M., Muthupandian, S., Nagarajan, A. J., Nangia, V., Negoi, I., Nguyen, C. T., Nguyen, H. L. T., Nguyen, S. H., Nosratnejad, S., Oladimeji, O., Olgiati, S., Olusanya, J. O., Onwujekwe, O. E., Otstavnov, S. S., Pana, A., Pereira, D. M., Piroozi, B., Prada, S. I., Qorbani, M., Rabiee, M., Rabiee, N., Rafiei, A., Rahim, F., Rahimi-Movaghar, V., Ram, U., Ranabhat, C. L., Ranta, A., Rawaf, D. L., Rawaf, S., Rezaei, S., Roro, E. M., Rostami, A., Rubino, S., Salahshoor, M., Samy, A. M., Sanabria, J., Santos, J. V., Milicevic, M. M. S., Jose, B. P. S., Savic, M., Schwendicke, F., Sepanlou, S. G., Sepehrimanesh, M., Sheikh, A., Shrime, M. G., Sisay, S., Soltani, S., Soofi, M., Srinivasan, V., Tabarés-Seisdedos, R., Torre, A., Tovani-Palone, M. R., Tran, B. X., Tran, K. B., Undurraga, E. A., Valdez, P. R., Van Boven, J. F. M., Vargas, V., Veisani, Y., Violante, F. S., Vladimirov, S. K., Vlassov, V., Vollmer, S., Vu, G. T., Wolfe, C. D. A., Yonemoto, N., Younis, M. Z., Yousefifard, M., Zaman, S. B., Zangeneh, A., Zegeye, E. A., Ziapour, A., Chew, A., Murray, C. J. L., Dieleman, J. L., and Network, Global Burden of Disease Health Financing Collaborator

Abstract

Background: Comprehensive and comparable estimates of health spending in each country are a key input for health policy and planning, and are necessary to support the achievement of national and international health goals. Previous studies have tracked past and projected future health spending until 2040 and shown that, with economic development, countries tend to spend more on health per capita, with a decreasing share of spending from development assistance and out-of-pocket sources. We aimed to characterise the past, present, and predicted future of global health spending, with an emphasis on equity in spending across countries. Methods: We estimated domestic health spending for 195 countries and territories from 1995 to 2016, split into three categories-government, out-of-pocket, and prepaid private health spending-and estimated development assistance for health (DAH) from 1990 to 2018. We estimated future scenarios of health spending using an ensemble of linear mixed-effects models with time series specifications to project domestic health spending from 2017 through 2050 and DAH from 2019 through 2050. Data were extracted from a broad set of sources tracking health spending and revenue, and were standardised and converted to inflation-adjusted 2018 US dollars. Incomplete or low-quality data were modelled and uncertainty was estimated, leading to a complete data series of total, government, prepaid private, and out-of-pocket health spending, and DAH. Estimates are reported in 2018 US dollars, 2018 purchasing-power parity-adjusted dollars, and as a percentage of gross domestic product. We used demographic decomposition methods to assess a set of factors associated with changes in government health spending between 1995 and 2016 and to examine evidence to support the theory of the health financing transition. We projected two alternative future scenarios based on higher government health spending to assess the potential ability of governments to generate more reso

Published
2019
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3. Estimating global injuries morbidity and mortality

Author

Zohreh Arefi, Rasmus Havmoeller, Pietro Ferrara, Vijay Kumar Chattu, Payman Salamati, Agegnehu Bante Getenet, Seyedeh Zahra Masoumi, Alexander C. Tsai, Andrew T Olagunju, Carl Abelardo T. Antonio, Morteza Abdullatif Khafaie, Tim Driscoll, Reza Rawassizadeh, Vishnu Renjith, Taras Kavetskyy, Ejaz Ahmad Khan, Gebreamlak Gebremedhn Gebremeskel, Richard C. Franklin, Naznin Hossain, Bhaskaran Unnikrishnan, Fariborz Mansour-Ghanaei, Arash Tehrani-Banihashemi, Morteza Naserbakht, Sangram Kishor Patel, Vera Marisa Costa, Suzanne Polinder, Ziad El-Khatib, Ashish Pathak, Mika Shigematsu, Bryan L. Sykes, David M. Pigott, Zeleke Aschalew Melketsedik, Hadi Hassankhani, Nuworza Kugbey, Lal B. Rawal, Masoud Foroutan, Dejana Braithwaite, Muluken Bekele Sorrie, Grant M. A. Wyper, Joht Singh Chandan, Akbar Barzegar, Hamid Safarpour, Kate E. LeGrand, Giulio Castelpietra, Dina Nur Anggraini Ningrum, Seth Christopher Yaw Appiah, Amin Soheili, Azeem Majeed, Akshaya Srikanth Bhagavathula, Nikolay Ivanovich Briko, Vahid Yazdi-Feyzabadi, Walter Mendoza, Ghulam Mustafa, Cuong Tat Nguyen, Pengpeng Ye, Mahesh P A, Carlos Miguel Rios González, Ahmad Daryani, Ibrahim Abdollahpour, Masoud Moradi, Haileab Fekadu Wolde, Mohammad Rabiee, Jaya Prasad Tripathy, Jack T Fox, Diep Ngoc Nguyen, Pallab K. Maulik, Ai-Min Wu, Félix Carvalho, Yun Jin Kim, Fatemeh Rajati, Nathaniel J Henry, David C. Schwebel, Ali H. Mokdad, Akine Eshete Abosetugn, Leonardo Roever, Ketema Bizuwork Gebremedhin, Khalid A Altirkawi, Hayimro Edemealem Merie, Farhad Ghamari, Ramesh Holla, Arash Sarveazad, Devasahayam J. Christopher, Kedir Hussein Abegaz, Suresh Jungari, Rohan Borschmann, Irfan Ullah, Nitin Joseph, Catalina Liliana Andrei, Abdallah M. Samy, Roman Topor-Madry, Michal Grivna, Ivo Rakovac, Mohammad Zamani, Antonio Maria Borzì, Atif Amin Baig, Mohsen Bayati, Mohammad Ali Mansournia, Fatemeh Heydarpour, Juanita A. Haagsma, Segun Emmanuel Ibitoye, Mehdi Sayyah, Teshome Abegaz Kamil, Fakher Rahim, Dillon O Sylte, Feng Sha, Palash Chandra Banik, Mohan Bairwa, Mariya Vladimirovna Titova, Yong Yu, Delia Hendrie, Spencer L. James, Anusha Ganapati Bhat, Seok Jun Yoon, Siavash Rahimi, Jost B. Jonas, Michael R. Phillips, Diana Silva, Amir Hossein Goudarzian, Samath D Dharmaratne, Roba Khundkar, Jemal Abdu Mohammed, Joemer C. Maravilla, Eleonora Dubljanin, Arun Balachandran, Arman Latifi, Randah R. Hamadeh, G. K. Mini, Alessandra C. Goulart, Andreea Mirica, Fatemeh Zarei, Habte Belete, Telma Zahirian Moghadam, Maseer Khan, Morenike Oluwatoyin Folayan, Atte Meretoja, Jasvinder A. 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Brugha, T., Budhathoki, S.S., Car, J., Cárdenas, R., Carvalho, F., Castaldelli-Maia, J.M., Castañeda-Orjuela, C.A., Castelpietra, G., Catalá-López, F., Cerin, E., Chandan, J.S., Chapman, J.R., Chattu, V.K., Chattu, S.K., Chatziralli, I., Chaudhary, N., Cho, D.Y., Choi, J.-Y.J., Chowdhury, M.A.K., Christopher, D.J., Chu, D.-T., Cicuttini, F.M., Coelho, J.M., Costa, V.M., Dahlawi, S.M.A., Daryani, A., Dávila-Cervantes, C.A., De Leo, D., Demeke, F.M., Demoz, G.T., Demsie, D.G., Deribe, K., Desai, R., Nasab, M.D., Da Silva, D.D., Forooshani, Z.S.D., Do, H.T., Doyle, K.E., Driscoll, T.R., Dubljanin, E., Adema, B.D., Eagan, A.W., Elemineh, D.A., El-Jaafary, S.I., El-Khatib, Z., Ellingsen, C.L., El Sayedzaki, M., Eskandarieh, S., Eyawo, O., Faris, P.S., Faro, A., Farzadfar, F., Fereshtehnejad, S.-M., Fernandes, E., Ferrara, P., Fischer, F., Folayan, M.O., Fomenkov, A.A., Foroutan, M., Francis, J.M., Franklin, R.C., Fukumoto, T., Geberemariyam, B.S., Gebremariam, H., Gebremedhin, K.B., 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Z.A., Memiah, P.T.N., Mendoza, W., Menezes, R.G., Mengesha, M.M., Meretoja, T.J., Meretoja, A., Merie, H.E., Mestrovic, T., Miazgowski, B., Miazgowski, T., Miller, T.R., Mini, G.K., Mirica, A., Mirrakhimov, E.M., Mirzaei-Alavijeh, M., Mithra, P., Moazen, B., Moghadaszadeh, M., Mohamadi, E., Mohammad, Y., Darwesh, A.M., Mohammadian-Hafshejani, A., Mohammadpourhodki, R., Mohammed, S., Mohammed, J.A., Mohebi, F., Bandpei, M.A.M., Molokhia, M., Monasta, L., Moodley, Y., Moradi, M., Moradi, G., Moradi-Lakeh, M., Moradzadeh, R., Morawska, L., Velásquez, I.M., Morrison, S.D., Mossie, T.B., Muluneh, A.G., Musa, K.I., Mustafa, G., Naderi, M., Nagarajan, A.J., Naik, G., Naimzada, M.D., Najaf, F., Nangia, V., Nascimento, B.R., Naserbakht, M., Nayak, V., Nazari, J., Ndwandwe, D.E., Negoi, I., Ngunjiri, J.W., Nguyen, T.H., Nguyen, C.T., Nguyen, D.N., Nguyen, H.L.T., Nikbakhsh, R., Ningrum, D.N.A., Nnaji, C.A., Ofori-Asenso, R., Ogbo, F.A., Oghenetega, O.B., Oh, I.-H., Olagunju, A.T., Olagunju, T.O., Bali, A.O., Onwujekwe, O.E., Orpana, H.M., Ota, E., Otstavnov, N., Otstavnov, S.S., Mahesh, A.P., Padubidri, J.R., Pakhale, S., Pakshir, K., Panda-Jonas, S., Park, E.-K., Patel, S.K., Pathak, A., Pati, S., Paulos, K., Peden, A.E., Pepito, V.C.F., Pereira, J., Phillips, M.R., Polibin, R.V., Polinder, S., Pourmalek, F., Pourshams, A., Poustchi, H., Prakash, S., Pribadi, D.R.A., Puri, P., Syed, Z.Q., Rabiee, N., Rabiee, M., Radfar, A., Rafay, A., Rafee, A., Rafei, A., Rahim, F., Rahimi, S., Rahman, M.A., Rajabpour-Sanati, A., Rajati, F., Rakovac, I., Rao, S.J., Rashedi, V., Rastogi, P., Rathi, P., Rawaf, S., Rawal, L., Rawassizadeh, R., Renjith, V., Resnikoff, S., Rezapour, A., Ribeiro, A.I., Rickard, J., González, C.M.R., Roever, L., Ronfani, L., Roshandel, G., Saddik, B., Safarpour, H., Safdarian, M., Sajadi, S.M., Salamati, P., Salem, M.R.R., Salem, H., Salz, I., Samy, A.M., Sanabria, J., Riera, L.S., Milicevic, M.M.S., Sarker, A.R., Sarveazad, A., Sathian, B., Sawhney, M., 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Yazdi-Feyzabadi, V., Ye, P., Yip, P., Yisma, E., Yonemoto, N., Yoon, S.-J., Youm, Y., Younis, M.Z., Yousef, Z., Yu, C., Yu, Y., Moghadam, T.Z., Zaidi, Z., Zaman, S.B., Zamani, M., Zandian, H., Zarei, F., Zhang, Z.-J., Zhang, Y., Ziapour, A., Zodpey, S., Dandona, R., Dharmaratne, S.D., Hay, S.I., Mokdad, A.H., Pigott, D.M., Reiner, R.C., Vos, T., Instituto de Saúde Pública da Universidade do Porto, James, Spencer L, Castle, Chris D, Dingels, Zachary V, Fox, Jack T, Adema, Bereket Duko, Yisma, Engida, Vos, Theo, and Public Health

Subjects
Male, Populations/contexts, 1106 Human Movement and Sports Sciences, Global injuries, population, 030204 cardiovascular system & hematology, Global Health, contexts, context, Global Burden of Disease, 0302 clinical medicine, Quality-Adjusted Life Year, Global health, 030212 general & internal medicine, Original Research, Data, populations/contexts, Incidence (epidemiology), Incidence, methodology, 3142 Public health care science, environmental and occupational health, Female, Public Health, TERRITORIES, Quality-Adjusted Life Years, descriptive epidemiology, Human, Disabilities, 195 COUNTRIES, statistical issue, 1117 Public Health and Health Services, 03 medical and health sciences, AGE, Life Expectancy, Environmental health, Injury prevention, SYSTEMATIC ANALYSIS, statistical issues, Humans, Mortality, Estimation, SEX-SPECIFIC MORTALITY, DISABILITY, Public Health, Environmental and Occupational Health, populations, Morbidity, Wounds and Injuries, 1106 Human Movement and Sports Sciences, 1117 Public Health and Health Services, 1701 Psychology, Quality-adjusted life year, Years of potential life lost, 1701 Psychology, Life expectancy, Estimates, Human medicine, populations/context
Abstract

Background. While there is a long history of measuring death and disability from injuries, modern research methods must account for the wide spectrum of disability that can occur in an injury, and must provide estimates with sufficient demographic, geographical and temporal detail to be useful for policy makers. The Global Burden of Disease (GBD) 2017 study used methods to provide highly detailed estimates of global injury burden that meet these criteria. Methods. In this study, we report and discuss the methods used in GBD 2017 for injury morbidity and mortality burden estimation. In summary, these methods included estimating cause-specific mortality for every cause of injury, and then estimating incidence for every cause of injury. Non-fatal disability for each cause is then calculated based on the probabilities of suffering from different types of bodily injury experienced. Results. GBD 2017 produced morbidity and mortality estimates for 38 causes of injury. Estimates were produced in terms of incidence, prevalence, years lived with disability, cause-specific mortality, years of life lost and disability-adjusted life-years for a 28-year period for 22 age groups, 195 countries and both sexes. Conclusions. GBD 2017 demonstrated a complex and sophisticated series of analytical steps using the largest known database of morbidity and mortality data on injuries. GBD 2017 results should be used to help inform injury prevention policy making and resource allocation. We also identify important avenues for improving injury burden estimation in the future. Seyed Aljunid acknowledges the Department of Health Policy and Management, Faculty of Public Health, Kuwait University and International Centre for Casemix and Clinical Coding, Faculty of Medicine, National University of Malaysia for the approval and support to participate in this research project. Alaa Badawi acknowledges support by the Public Health Agency of Canada. Till Bärnighausen acknowledges support by the Alexander von Humboldt Foundation through the Alexander von Humboldt Professor award, funded by the German Federal Ministry of Education and Research. Traolach Brugha received support from NatCen Social Research (http://natcen.ac.uk/) via NHS Digital and Department of Health and Social Care London, for the Adult Psychiatric Morbidity Survey (APMS) programme. Felix Carvalho received support from UID/MULTI/04378/2019 with funding from FCT/MCTES through national funds. Vera M Costa acknowledges support from grant (SFRH/BHD/110001/2015), received by Portuguese national funds through Fundação para a Ciência e Tecnologia (FCT), IP, under the Norma Transitória DL57/2016/CP1334/CT0006. Kebede Deribe is supported by a grant from the Wellcome Trust [grant number 201900] as part of his International Intermediate Fellowship. Tim Driscoll acknowledges that work on occupational risk factors was partially supported by funds from the World Health Organization. Eduarda Fernandes acknowledges support from UID/QUI/50006/2019 with funding from FCT/MCTES through national funds. Yuming Guo acknowledges support from Career Development Fellowships of the Australian National Health and Medical Research Council (numbers APP1107107 and APP1163693). Sheikh Mohammed Shariful Islam is funded by a Fellowship from National Heart Foundation of Australia and Institute for Physical Activity and Nutrition, Deakin University. Mihajlo Jakovljevic acknowledges support by the Ministry of Education Science and Technological Development of the Republic of Serbia through the Grant number OI175014; publication of results was not contingent upon Ministry's censorship or approval. Sudha Jayaraman acknowledges support from: NIH R21: 1R21TW010439-01A1 (PI); Rotary Foundation Global Grant #GG1749568 (PI); NIH P20: 1P20CA210284-01A1 (Co-PI) and DOD grant W81XWH-16-2-0040 (Co-I), during the period of this study. Yun Jin Kim acknowledges support from a grant from the Research Management Centre, Xiamen University Malaysia [grant number: XMUMRF/2018-C2/ITCM/0001]. Kewal Krishan is supported by UGC Centre of Advanced Study (CAS II) awarded to the Department of Anthropology, Panjab University, Chandigarh, India. Mansai Kumar acknowledges support from FIC/ NIH K43 1K43MH114320-01. Amanda Mason-Jones acknowledges support by the University of York. Mariam Molokhia is supported by the National Institute for Health Research Biomedical Research Center at Guy’s and St Thomas’s National Health Service Foundation Trust and King’s College London. Ilais Moreno Velasquez is supported by the Sistema Nacional de Investigación (SNI, Senacyt, Panama). Mukhammad David Naimzada acknowledges support from Government of the Russian Federation (Agreement No – 075-02-2019-967). Duduzile Ndwandwe acknowledges support from Cochrane South Africa, South African Medical Research Council. Stanislav S. Otstavnov acknowledges the support from the Government of the Russian Federation (Agreement No – 075-02-2019-967). Ashish Pathak acknowledges support from Indian Council of Medical Research (ICMR), New Delhi, India (Grant number 2013-1253). Michael R Phillips acknowledges support in part by a grant from the National Natural Science Foundation of China (No.81761128031). Abdallah M. Samy received a fellowship from the Egyptian Fulbright Mission Program. Milena Santric Milicevic acknowledges the support from the Ministry of Education, Science and Technological Development, Republic of Serbia (Contract No. 175087). Seyedmojtaba Seyedmousavi was supported by the Intramural Research Program of the National Institutes of Health, Clinical Center, Department of Laboratory Medicine, Bethesda, MD, USA. Rafael Tabarés-Seisdedos was supported in part by the national grant PI17/00719 from ISCIII-FEDER. Sojib Bin Zaman acknowledges support from an "Australian Government Research Training Program (RTP) Scholarship.

Published
2020

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