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Charting the course:India's health expenditure projections for 2035

Global health Journal 2024年第2期8卷 58-66页

作者： Pragyan Monalisa Sahoo Himanshu Sekhar Rout Department of Analytical&Applied Economics Utkal UniversityBhubaneswarOdishaIndia Department of Analytical and Applied Economics&RUSA Centre of Excellence in Public Policy and Governance Utkal UniversityVani ViharBhubaneswarOdishaIndia

Objectives Understanding past trends and forecasting future changes in health spending is vital for planning and reducing reliance on out-of-pocket(OOP)*** current study analyzed health expenditure patterns in India and forecasted future trends and patterns until *** Data on health expenditure in India from 2000 to 2019 was collected from the Organisation for Economic Co-operation and Development(OECD)iLibrary and National health Accounts 2019 *** domestic product(GDP)data from the World Bank was also *** statistics analyzed the composition and pattern,while the exponential smoothing model forecasted future health *** The findings revealed that expenditure made by OOP is the primary health financing source,followed by government and pre-paid private *** percentage of GDP allocated to total health expenditure remains stable,while the per capita health expenditure *** in expenditure among states are observed,with Karnataka relying heavily on pre-paid private *** projections suggest a decline in per capita and total health expenditure as a share of GDP,with a slight increase in the government’s ***-paid private expenditure per capita and OOP health expenditure as a share of the total is projected to remain relatively constant but still high in absolute *** The study highlights variations in health spending in India,characterized by high OOP spending,limited public coverage,and a need for investments,and reforms to improve healthcare access and equity.

关键词： health expenditure health spending health financing Forecasting Exponential smoothing India

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Determinants and Equity Evaluation for health expenditure Among Patients with Rare Diseases in China

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Chinese Medical Journal 2016年第12期129卷 1387-1393页

作者： Xiao-Xiong Xin Liang Zhao Xiao-Dong Guan Lu-Wen Shi Department of Pharmacy Administration and Clinical Pharmacy School of Pharmaceutical Sciences Peking University Health Science Center Peking University Beijing 100191 China International Research Center of Medicinal Administration Peking University Beijing 100191 China

Background： China has not established social security system for rare diseases. Rare diseases could easily impoverish patients and their families. Little research has studied the equity and accessibility of health services for patients with rare diseases in China. This study aimed to explore the factors that influence health expenditure of rare diseases and evaluate its equity. Methods： Questionnaire survey about living conditions and cost burden of patients with rare diseases was conducted. Individual and family information, health expenditure and reimbursement in 2014 of 982 patients were collected. The impact of medical insurance, individual sociodemographic characteristics, family characteristics, and healthcare need on total and out-of-pocket （OOP） health expenditures was analyzed through the generalized linear model. Equity of health expenditure was evaluated by both concentration index and Lorenz curve. Results： Of all the surveyed patients, 11.41% had no medical insurance and 92.10% spent money to seek medical treatment in 2014. It was suggested female （P = 0.048）, over 50 years of age （P = 0.062）, high-income group （P = 0.021）, hospitalization （P- 0.000）, and reimbursement ratio （RR）（P = 0.000） were positively correlated with total health expenditure. Diseases not needing long-term treatment （P = 0.000） was negatively correlated with total health expenditure. Over 50 years of age （P = 0.065）, high-income group （P = 0.018）, hospitalization （P = 0.000） and having Urban Employee Basic Medical Insurance （UEBMI）（P - 0.022） were positively correlated with OOP health expenditure. Patient or the head of the household having received higher education （P = 0.044 and P = 0.08 l） and reimbursement ratio （P = 0.078） were negatively correlated with OOP health expenditure. The equity evaluation found concentration indexes of health expenditure before and after reimbursement were 0.0550 and 0.0539, respectively. Conclusions： OOP health expenditure of patients with UEBMI

关键词： Determinant Equity Evaluation health expenditure Rare Disease

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A decomposition analysis of recent health expenditure growth in China: is population ageing a significant effecting factor?

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China Population and Development Studies 2020年第4期4卷 45-57页

作者： Tiemin Zhai Quan Wan Peipei Chai Feng Guo Yan Li Rongrong Wang Chunmei Chen Tao Li Runguo Gao Extended author information available on the last page of the article

Since the new round of health system reform,the annual average growth rate of health expenditure in real term in China was 10.5%,which is much faster than that of any other Asian *** aim of this study is to analyze major effect-ing factors include population ageing’s contribution to health expenditure growth,as population ageing is accelerating and considered as a major driver of health expenditure growth in China.A component based health expenditure model was developed in this study and five major factors were employed,namely popula-tion size,population structure,disease prevalence rate,excess health price infla-tion(EHPI)and expenditure per prevalent *** Das Gupta’s decomposition method was applied to decompose the health expenditure growth into the five *** shows that expenditure per prevalent case was the major factor,which accounted for 59.6%of the health expenditure growth.21.2%of the health expenditure growth was driven by population ageing,followed by EHPI(11.2%),population growth(5.4%)and disease prevalence rate(2.6%).Population age-ing affected circulatory diseases the most,which caused 5.2%of the difference in health expenditure,followed by neoplasms(2.9%),respiratory diseases(2.0%),digestive diseases(1.8%),and endocrine(1.5%).Our work highlights that meas-ures should be taken to reduce risk factors of major non-communicable disease to promote healthy ageing,and it is fundamental to address growth in expenditure per case,especially for circulatory,respiratory,digestive,genitourinary diseases,and endocrine,nutritional and metabolic to contain the rapid health expenditure growth in China.

关键词： health expenditure Decomposition Population ageing

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Analysis on Inpatient health expenditures of Renal Cell Carcinoma in a Grade-A Tertiary Hospital in Beijing

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Chinese Medical Journal 2017年第20期130卷 2447-2452页

作者： Xin Liu Yong-Hui Mao Xue-Mei He Yan-Jing Zhang Ying Sun Department of Nephrology Beijing Hospital National Center of Gerontology Beijing 100730 China Clinical Pharmacology Center Beijing Hospital National Center of Gerontology BeJjing 100730 China

Background： Renal cell carcinoma （RCC） is the most common type of malignant renal tumors with a growing incidence in tile recent years. This study aimed to investigate the influencing factors and variation trend of hospitalization expenditures among RCC patients in a single-centered hospital in Beijing during 5 consecutive years and to find the major cost items and fluctuation tendency of inpatient medical expenditures. Methods： The inlbrmation of medical expenditures among RCC patients in a Grade-A tertiary hospital during the years 2012-2016 was investigated to find the main cost items and changes affecting the medical cost structure. Gray correlation method was adopted in quantitative analysis to analyze the composition of medical expenditures, and the variation of hospitalization expense structure during tile five years was studied by analyzing the degree of structural variation. Results： The cost item constitution of the hospitalization expenditures among RCC patients was relatively stable in the sample hospital during the past five years. To be specific, drug costs accounted for tile largest proportion of medical expenditures each year, with the highest of 37.81% in 2012, and showed a slowly declining tendency in the coming years. The cost item with the highest correlation degree ~as drug costs, with the value of 1.0000; followed by the costs of surgeries, 0.8423. Furthermore, drug costs shared the largest proportion （40.95%） of structural variation, followed by the costs of surgeries （18.35%）. Conclusions： Drug costs are the major influencing factors of the hospitalization expenditures among RCC patients. Thus, reasonable control on excessive drugs as well as the standardization of the diagnosis and treatment behaviors is conducive in reducing medical expenditures as well as easing patients＇ economic burdens. Besides, the positive growth on surgery costs suggests that the labor value of medical staffs has been gradually recognized.

关键词： Degree of Structural Variation health expenditure Renal Cell Carcinoma

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The Impact of Income on health expenditures of the Older Population in China

The Impact of Income on Health Expenditures of the Older Pop...

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作者：冯钰琪湖南大学

学位级别：硕士

Nowadays,China has become the country with the largest number of the older in the world and one of the countries with the fastest population *** compared with many countries and regions in the world,such as Japan and Europe,China's aging problem has not appeared for a long time,but in recent years it has become more and more *** the same time,due to the relevant policies implemented by China,the growth rate of the young population has been lower than the natural growth *** the combined influence of these two factors,China's aging problem has become more severe,it has attracted worldwide *** a long-term perspective,the older population will maintain a relatively high level both in terms of the overall number and the proportion of the *** older are the most vulnerable and most in need of care among the entire population,so health and medical services are extremely important to *** is worth noting that the older are under increasing pressure on health *** this paper,we mainly study the impact of income on the health expenditure of middle-aged and elderly people in *** data used in this study are from the China health and Retirement Longitudinal Survey(CHARLS),a longitudinal study of people over 45 years old in China,using data from Harmonized CHARLS 2011,2013 and 2015 to construct panel *** this study,firstly,we explore the relationship between income and health expenditure by using pooled OLS and fixed effect model,finding that there has significant effect of income on health expenditure of respondents,and income elasticity of health expenditure is approximately 0.023,which implies that health care is still a necessity for *** addition,because there are quite a few health expenditures that are zero,hence we consider using Tobit model for regression to analyze the influencing factors of respondent's health *** explore both Tobit analysis of OLS model and random Tobit analysis,

关键词： health expenditure Income Income elasticity Tobit model CHARLS

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Determinants of household catastrophic costs for drug sensitive tuberculosis patients in Kenya

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Infectious Diseases of Poverty 2021年第4期10卷 18-32页

作者： Beatrice Kirubi Jane Ong'angto Peter Nguhiu Knut Lonnroth Aiban Rono Kristi Sidney-Annerstedt Department of Global Public health Karolinska InstitutetStockholmSweden WHO Collaborating Centre for Tuberculosis and Social Medicine StockholmSweden The health and Social Protection Action Research&Knowledge Sharing Network(SPARKS) StockholmSweden Centre for Respiratory Disease Research Kenya Medical Research InstituteNairobiKenya health Economics Research Unit KEMRI-WellcomeTrust Research ProgramNairobiKenya Monitoring Evaluation&ResearchNational TuberculosisLeprosy and Lung Disease ProgramMinistry of HealthNairobiKenya

Background::Despite free diagnosis and treatment for tuberculosis(TB),the costs during treatment impose a significant financial burden on patients and their *** study sought to identify the determinants for cata-strophic costs among patients with drug-sensitive TB(DSTB)and their households in ***::The data was collected during the 2017 Kenya national patient cost survey from a nationally representative sample(n=1071).Treatment related costs and productivity losses were *** costs exceeding 20%of household income were defined as catastrophic and used as the *** Poisson regression analysis was performed to measure the association between selected individual,household and disease characteristics and occurrence of catastrophic costs.A deterministic sensitivity analysis was carried using different thresholds and the significant predictors were ***::The proportion of catastrophic costs among DSTB patients was 27%(n=294).Patients with catastrophic costs had higher median productivity losses,39 h[interquartile range(IQR):20-104],and total median costs of USD 567(IQR:299-1144).The incidence of catastrophic costs had a dose response with household *** poorest quintile was 6.2 times[95%confidence intervals(CI):4.0-9.7]more likely to incur catastrophic costs compared to the *** prevalence of catastrophic costs decreased with increasing household expenditure quintiles(proportion of catastrophic costs:59.7%,32.9%,23.6%,15.9%,and 9.5%)from the lowest quintile(Q1)to the highest quintile(Q5).Other determinants included hospitalization:prevalence ratio(PR)=2.8(95%CI:1.8-4.5)and delayed treatment:PR=1.5(95%CI:1.3-1.7).Protective factors included receiving care at a public health facility:PR=0.8(95%CI:0.6-1.0),and a higher body mass index(BMI):PR=0.97(95%CI:0.96-0.98).Pre TB expenditure,hospitalization and BMI were significant predictors in all sensitivity analysis ***::There are signif

关键词： Tuberculosis health expenditure Income loss Social protection Kenya

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中国与世界经合组织OECD成员国医疗保障开支比较研究

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社会保障制度 2014年第8期

作者：徐光毅邱小丹

中国已成为世界第二大经济体，社会福利发展与改善方面却并未达到与经济发展相似的高速度，在医疗保障领域亦是如此。本文研究以世界经济合作与发展组织(OECD)参考标准评估中国医疗保障开支在总量、公共以及政府三个层次的开支水平，并... 详细信息

中国已成为世界第二大经济体，社会福利发展与改善方面却并未达到与经济发展相似的高速度，在医疗保障领域亦是如此。本文研究以世界经济合作与发展组织(OECD)参考标准评估中国医疗保障开支在总量、公共以及政府三个层次的开支水平，并与典型的OECD国家进行比较研究，包括德国、美国、英国、日本、韩国和墨西哥等。结果表明，中国医疗保障开支所有评测指标均低于OECD平均水平，但部分指标评测结果优于观测域内的其他OECD国家，值得肯定。

关键词：医疗保障开支贡献分析世界经济合作与发展组织比较研究 health expenditure contribution evaluation OECD comparative research

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