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

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dc.creatorJoseph Ldieleman
dc.creatorReza Alizadeh-navaei
dc.creatorAlireza Rafiei
dc.creatorVafa Rahimi-movaghar
dc.creatorRajesh Kumar Rai
dc.creatorUsha Ram
dc.creatorChhabi Lal Ranabhat
dc.creatorSarah e Ray
dc.creatorRobert c Reiner
dc.creatorHaniye Sadat Sajadi
dc.creatorRocco Santoro
dc.creatorNafis Sadat
dc.creatorMaciej Banach
dc.creatorAmrit Banstola
dc.creatorAleksandra Barac
dc.creatorAbate Bekele Belachew
dc.creatorCharles Birungi
dc.creatorNicola l Bragazzi
dc.creatorNicholas j k Breitborde
dc.creatorLucero Cahuana-hurtado
dc.creatorJosip Car
dc.creatorPawan Acharya
dc.creatorFerrán Catalá-lópez
dc.creatorAngela y Chang
dc.creatorAbigail Chapin
dc.creatorCatherine s Chen
dc.creatorLalit Dandona
dc.creatorRakhi Dandona
dc.creatorAhmad Daryani
dc.creatorSamath d Dharmaratne
dc.creatorManisha Dubey
dc.creatorDumessa Edessa
dc.creatorIbrahim a Khalil
dc.creatorErika Eldrenkamp
dc.creatorBabak Eshrati
dc.creatorNancy Fullman
dc.creatorAndré Faro
dc.creatorAndrea b Feigl
dc.creatorAma p Fenny
dc.creatorFlorian Fischer
dc.creatorNataliya Foigt
dc.creatorKyle j Foreman
dc.creatorMamata Ghimire
dc.creatorYoung-ho Khang
dc.creatorSrinivas Goli
dc.creatorAlemayehu Desalegne Hailu
dc.creatorSamer Hamidi
dc.creatorCristiana Abbafati
dc.creatorHilda l Harb
dc.creatorSimon i Hay
dc.creatorDelia Hendrie
dc.creatorGloria Ikilezi
dc.creatorMehdi Javanbakht
dc.creatorDenny John
dc.creatorJagdish Khubchandani
dc.creatorJost b Jonas
dc.creatorAlexander Kaldjian
dc.creatorAmir Kasaeian
dc.creatorYawukal Chane Kasahun
dc.creatorYun Jin Kim
dc.creatorJonas m Kinge
dc.creatorSoewarta Kosen
dc.creatorKristopher j Krohn
dc.creatorg Anil Kumar
dc.creatorAlessandra Lafranconi
dc.creatorJoão Vasco Santos
dc.creatorHilton Lam
dc.creatorArsène Kouablan Adou
dc.creatorStefan Listl
dc.creatorHassan Magdy Abd el Razek
dc.creatorMohammed Magdy Abd el Razek
dc.creatorAzeem Majeed
dc.creatorReza Malekzadeh
dc.creatorDeborah Carvalho Malta
dc.creatorGabriel Martinez
dc.creatorGeorge a Mensah
dc.creatorAla'a Alkerwi
dc.creatorAtte Meretoja
dc.creatorAngela Micah
dc.creatorAliasghar Ahmad Kiadaliri
dc.creatorTed r Miller
dc.creatorErkin m Mirrakhimov
dc.creatorFitsum Weldegebreal Mlashu
dc.creatorEbrahim Mohammed
dc.creatorShafiu Mohammed
dc.creatorMark Moses
dc.creatorSeyyed Meysam Mousavi
dc.creatorAbdur Razzaque Sarker
dc.creatorMohsen Naghavi
dc.creatorVinay Nangia
dc.creatorFrida Namnyak Ngalesoni
dc.creatorKhurshid Alam
dc.creatorCuong Tat Nguyen
dc.creatorTrang Huyen Nguyen
dc.creatorYirga Niriayo
dc.creatorMehdi Noroozi
dc.creatorMayowa o Owolabi
dc.creatorTejas Patel
dc.creatorBenn Sartorius
dc.creatorDavid m Pereira
dc.creatorSuzanne Polinder
dc.creatorMostafa Qorbani
dc.creatorAnwar Rafay
dc.creatorMaheswar Satpathy
dc.creatorSadaf g Sepanlou
dc.creatorMasood Ali Shaikh
dc.creatorMehdi Sharif
dc.creatorJun She
dc.creatorAziz Sheikh
dc.creatorMark g Shrime
dc.creatorMekonnen Sisay
dc.creatorWalid Ammar
dc.creatorSamir Soneji
dc.creatorMoslem Soofi
dc.creatorReed j d Sorensen
dc.creatorHenok Tadesse
dc.creatorTianchan Tao
dc.creatorTara Templin
dc.creatorAzeb Gebresilassie Tesema
dc.creatorSubash Thapa
dc.creatorRuoyan Tobe-gai
dc.creatorRoman Topor-madry
dc.creatorCarl Abelardo t Antonio
dc.creatorBach Xuan Tran
dc.creatorKhanh Bao Tran
dc.creatorTung Thanh Tran
dc.creatorEduardo a Undurraga
dc.creatorTommi Vasankari
dc.creatorFrancesco s Violante
dc.creatorAndrea Werdecker
dc.creatorTissa Wijeratne
dc.creatorGelin xu
dc.creatorNaohiro Yonemoto
dc.creatorOlatunde Aremu
dc.creatorMustafa z Younis
dc.creatorChuanhua yu
dc.creatorMaysaa el Sayed Zaki
dc.creatorBianca Zlavog
dc.creatorChristopher j l Murray
dc.creatorSolomon Weldegebreal Asgedom
dc.creatorTesfay Mehari Atey
dc.creatorLeticia Avila-burgos
dc.creatorRakesh Ayer
dc.creatorHamid Badali
dc.date.accessioned2023-04-17T19:32:58Z
dc.date.accessioned2025-09-09T01:33:42Z
dc.date.available2023-04-17T19:32:58Z
dc.date.issued2018
dc.description.abstractAntecedentes 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.
dc.format.mimetypepdf
dc.identifier.doi10.1016/S0140-6736(18)30697-4
dc.identifier.issn01406736
dc.identifier.urihttps://hdl.handle.net/1843/52081
dc.languageeng
dc.publisherUniversidade Federal de Minas Gerais
dc.relation.ispartofThe Lancet
dc.rightsAcesso Aberto
dc.subjectSaúde Coletiva
dc.subjectIniquidades em Saúde
dc.subjectFinanciamento da Assistência à Saúde
dc.subject.otherhealth financing systems
dc.subject.otherinequalities
dc.titleTrends in future health financing and coverage: future health spending and universal health coverage in 188 countries, 2016-40
dc.typeArtigo de periódico
local.citation.epage1798
local.citation.issue10132
local.citation.spage1783
local.citation.volume391
local.description.resumoBackground 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.
local.identifier.orcidhttps://orcid.org/0000-0002-8214-5734
local.publisher.countryBrasil
local.publisher.departmentENF - DEPARTAMENTO DE ENFERMAGEM MATERNO INFANTIL E SAÚDE PÚBLICA
local.publisher.initialsUFMG
local.url.externahttps://doi.org/10.1016/S0140-6736(18)30697-4

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