Open Access BASE2018
Trends in future health financing and coverage: future health spending and universal health coverage in 188 countries, 2016–40
Dieleman, Joseph L; Sadat, Nafis; Chang, Angela Y; Fullman, Nancy; Abbafati, Cristiana; Acharya, Pawan; Adou, Arsène Kouablan; Ahmad Kiadaliri, Aliasghar; Alam, Khurshid; Alizadeh-Navaei, Reza; Alkerwi, Ala'a; Ammar, Walid; Antonio, Carl Abelardo T; Aremu, Olatunde; Asgedom, Solomon Weldegebreal; Atey, Tesfay Mehari; Avila-Burgos, Leticia; 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; Catalá-López, Ferrán; Chapin, Abigail; Chen, Catherine S; Dandona, Lalit; Dandona, Rakhi; Daryani, Ahmad; Dharmaratne, Samath D; Dubey, Manisha; Edessa, Dumessa; Eldrenkamp, Erika; Eshrati, Babak; Faro, André; Feigl, Andrea B; Fenny, Ama P; Fischer, Florian; Foigt, Nataliya; Foreman, Kyle J; 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; Magdy Abd El Razek, Hassan; Magdy Abd El Razek, Mohammed; 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; Moses, Mark; Mousavi, Seyyed Meysam; Naghavi, Mohsen; Nangia, Vinay; Ngalesoni, Frida Namnyak; Nguyen, Cuong Tat; Nguyen, Trang Huyen; 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, João 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; Tadesse, Henok; Tao, Tianchan; Templin, Tara; Tesema, Azeb Gebresilassie; Thapa, Subash; Tobe-Gai, Ruoyan; Topor-Madry, Roman; Tran, Bach Xuan; Tran, Khanh Bao; Tran, Tung Thanh; 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; Murray, Christopher J L
Abstract
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.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.
