Basic patterns in national health expenditure

Area of Science:

• Health Economics
• Public Health Policy
• Global Health Financing

Background:

• National health accounts data from 191 WHO Member States in 1997 were analyzed.
• Spending on health and its financing sources were examined using comparisons and linear regressions.
• Data included out-of-pocket, social insurance, government general revenue, and private insurance financing.

Purpose of the Study:

• To describe health spending patterns across different income levels.
• To analyze how health expenditure is financed globally.
• To identify disparities in financial protection against health-related costs.

Main Methods:

• Analysis of national health accounts estimates for 191 WHO Member States (1997).
• Utilized simple comparisons and linear regressions to assess health spending and financing.
• Classified financing sources by completeness and reliability.

Main Results:

• Total health spending as a percentage of GDP increases with income, from 2-3% in low-income to 8-9% in high-income countries.
• Significant relative variation in health spending share and absolute amounts exists across countries, even within income groups.
• Low-income countries show high and variable out-of-pocket spending (20-80%), with limited prepayment or risk-sharing, increasing financial catastrophe risk.
• Public financing and its share of GDP increase with income, while private insurance remains marginal except in high-income nations.

Conclusions:

• Low-income countries are least protected from financial catastrophe due to high out-of-pocket health spending.
• Public financing plays an increasing role in health expenditure as national income rises.
• Despite increased public spending, disparities in financing mechanisms persist, and private insurance offers limited protection in poorer nations.