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http://hdl.handle.net/1843/52081| Type: | Artigo de Periódico |
| Title: | Trends in future health financing and coverage: future health spending and universal health coverage in 188 countries, 2016-40 |
| Authors: | Joseph Ldieleman Reza Alizadeh-navaei Alireza Rafiei Vafa Rahimi-movaghar Rajesh Kumar Rai Usha Ram Chhabi Lal Ranabhat Sarah e Ray Robert c Reiner Haniye Sadat Sajadi Rocco Santoro Nafis Sadat Maciej Banach Amrit Banstola Aleksandra Barac Abate Bekele Belachew Charles Birungi Nicola l Bragazzi Nicholas j k Breitborde Lucero Cahuana-hurtado Josip Car Pawan Acharya Ferrán Catalá-lópez Angela y Chang Abigail Chapin Catherine s Chen Lalit Dandona Rakhi Dandona Ahmad Daryani Samath d Dharmaratne Manisha Dubey Dumessa Edessa Ibrahim a Khalil Erika Eldrenkamp Babak Eshrati Nancy Fullman André Faro Andrea b Feigl Ama p Fenny Florian Fischer Nataliya Foigt Kyle j Foreman Mamata Ghimire Young-ho Khang Srinivas Goli Alemayehu Desalegne Hailu Samer Hamidi Cristiana Abbafati Hilda l Harb Simon i Hay Delia Hendrie Gloria Ikilezi Mehdi Javanbakht Denny John Jagdish Khubchandani Jost b Jonas Alexander Kaldjian Amir Kasaeian Yawukal Chane Kasahun Yun Jin Kim Jonas m Kinge Soewarta Kosen Kristopher j Krohn g Anil Kumar Alessandra Lafranconi João Vasco Santos Hilton Lam Arsène Kouablan Adou Stefan Listl Hassan Magdy Abd el Razek Mohammed Magdy Abd el Razek Azeem Majeed Reza Malekzadeh Deborah Carvalho Malta Gabriel Martinez George a Mensah Ala'a Alkerwi Atte Meretoja Angela Micah Aliasghar Ahmad Kiadaliri Ted r Miller Erkin m Mirrakhimov Fitsum Weldegebreal Mlashu Ebrahim Mohammed Shafiu Mohammed Mark Moses Seyyed Meysam Mousavi Abdur Razzaque Sarker Mohsen Naghavi Vinay Nangia Frida Namnyak Ngalesoni Khurshid Alam Cuong Tat Nguyen Trang Huyen Nguyen Yirga Niriayo Mehdi Noroozi Mayowa o Owolabi Tejas Patel Benn Sartorius David m Pereira Suzanne Polinder Mostafa Qorbani Anwar Rafay Maheswar Satpathy Sadaf g Sepanlou Masood Ali Shaikh Mehdi Sharif Jun She Aziz Sheikh Mark g Shrime Mekonnen Sisay Walid Ammar Samir Soneji Moslem Soofi Reed j d Sorensen Henok Tadesse Tianchan Tao Tara Templin Azeb Gebresilassie Tesema Subash Thapa Ruoyan Tobe-gai Roman Topor-madry Carl Abelardo t Antonio Bach Xuan Tran Khanh Bao Tran Tung Thanh Tran Eduardo a Undurraga Tommi Vasankari Francesco s Violante Andrea Werdecker Tissa Wijeratne Gelin xu Naohiro Yonemoto Olatunde Aremu Mustafa z Younis Chuanhua yu Maysaa el Sayed Zaki Bianca Zlavog Christopher j l Murray Solomon Weldegebreal Asgedom Tesfay Mehari Atey Leticia Avila-burgos Rakesh Ayer Hamid Badali |
| Abstract: | 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 of a country’s UHC service coverage. Finally, we estimated future UHC performance and the number ofpeople 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 $1699 (711–3423) in lower-middle-income countries. Globally, the share of health spending covered by pooled resources would range widely, from 19·8% (10·3–38·6) in Nigeria to 97·9% (96·4–98·5) in Seychelles. Historical performance on the UHC index was significantly associated with pooled resources per capita. Across the alternative scenarios, we estimate UHC reaching between 5·1 billion (4·9 billion to 5·3 billion) and 5·6 billion (5·3 billion to 5·8 billion) lives in 2030.Interpretation We chart future scenarios for health spending and its relationship with UHC. Ensuring that all countries have sustainable pooled health resources is crucial to the achievement of UHC.Interpretação Traçamos cenários futuros para os gastos em saúde e sua relação com a UHC. Garantir que todos países têm recursos de saúde agrupados sustentáveis é crucial para a realização da UHC. |
| Abstract: | Antecedentes Alcançar a cobertura universal de saúde (UHC) requer sistemas de financiamento da saúde que forneçam pré-pagos reuniram recursos para os principais serviços de saúde sem colocar pressão financeira indevida sobre as famílias. Entendimento As trajetórias atuais e futuras do financiamento da saúde são vitais para o avanço em direção à UHC. Utilizou-se a saúde histórica dados de financiamento para 188 países de 1995 a 2015 para estimar cenários futuros de gastos em saúde e saúde conjunta gastos até 2040.Métodos Extraímos dados históricos sobre o produto interno bruto (PIB) e os gastos com saúde de 188 países de 1995-2015, e projetado PIB anual, assistência ao desenvolvimento para a saúde, e governo, out-of-pocket, e gastos privados pré-pagos em saúde de 2015 a 2040 como cenário de referência. Essas estimativas foram geradas usando um conjunto de modelos que variaram os principais determinantes demográficos e socioeconômicos. Conclusões No cenário de referência, projeta-se que os gastos globais com saúde aumentem de US$ 10 trilhões (intervalo de incerteza de 95% de 10 trilhões a 10 trilhões) em 2015 a US$ 20 trilhões (18 trilhões a 22 trilhões) em 2040. Per capita os gastos com saúde foram projetados para aumentar mais rapidamente nos países de renda média-alta, em 4,2% (3,4-5,1) por ano, seguidos por países de renda média-baixa (4,0%, 3,6–4,5) e países de baixa renda (2,2%, 1,7–2,8). Globalmente, A parcela dos gastos com saúde cobertos por recursos agrupados variaria amplamente, de 19,8% (10,3-38,6) na Nigéria a 97·9% (96·4–98·5) em Seychelles. O desempenho histórico no índice UHC foi significativamente associado com o pooled recursos per capita. Em todos os cenários alternativos, estimamos que a UHC atinja entre 5,1 bilhões (4,9 bilhões a 5,3 bilhões) e 5,6 bilhões (5,3 bilhões a 5,8 bilhões) vivem em 2030. |
| Subject: | Saúde Coletiva Iniquidades em Saúde Financiamento da Assistência à Saúde |
| language: | eng |
| metadata.dc.publisher.country: | Brasil |
| Publisher: | Universidade Federal de Minas Gerais |
| Publisher Initials: | UFMG |
| metadata.dc.publisher.department: | ENF - DEPARTAMENTO DE ENFERMAGEM MATERNO INFANTIL E SAÚDE PÚBLICA |
| Rights: | Acesso Aberto |
| metadata.dc.identifier.doi: | 10.1016/S0140-6736(18)30697-4 |
| URI: | http://hdl.handle.net/1843/52081 |
| Issue Date: | 2018 |
| metadata.dc.url.externa: | https://doi.org/10.1016/S0140-6736(18)30697-4 |
| metadata.dc.relation.ispartof: | The Lancet |
| Appears in Collections: | Artigo de Periódico |
Files in This Item:
| File | Description | Size | Format | |
|---|---|---|---|---|
| Trends in future health financing and coverage future health spending and universal health coverage in 188 countries pdfa.pdf | 6.48 MB | Adobe PDF | View/Open |
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