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  • Title: National health expenditures: a global analysis.
    Author: Murray CJ, Govindaraj R, Musgrove P.
    Journal: Bull World Health Organ; 1994; 72(4):623-37. PubMed ID: 7923542.
    Abstract:
    As part of the background research to the World development report 1993: investing in health, an effort was made to estimate public, private and total expenditures on health for all countries of the world. Estimates could be found for public spending for most countries, but for private expenditure in many fewer countries. Regressions were used to predict the missing values of regional and global estimates. These econometric exercises were also used to relate expenditure to measures of health status. In 1990 the world spent an estimated US$ 1.7 trillion (1.7 x 10(12) on health, or $1.9 trillion (1.9 x 10(12)) in dollars adjusted for higher purchasing power in poorer countries. This amount was about 60% public and 40% private in origin. However, as incomes rise, public health expenditure tends to displace private spending and to account for the increasing share of incomes devoted to health. Public, private, and total expenditures on health for all countries of the world were estimated as part of the World Development Report 1993: Investing in Health. Regressions were used to predict the missing values of regional and global estimates and to relate expenditure to measures of health status. Data were obtained on government, parastatal, and private health expenditure directly from governments, supplemented with reports and data from The World Health Organization, the World Bank, the International Labor Organization, regional development banks, and the United Nations Statistics Division, as well as material from nearly 1000 different reports, articles, and budgets. Information on government health expenditures was available for 138 countries. These expenditures were for the years from 1977 to 1990, with 119 countries having data for the period 1986-90. Information for the 24 OECD (Organization for Economic Cooperation and Development) countries for 1990 was obtained from the national health accounts. Data on government health expenditures from 43 other countries came from national budgets. Information for another 45 countries was taken from an International Monetary Fund (IMF) yearbook. Data for 21 countries not covered by these sources were obtained through the World Bank health and public sector studies. Finally, data for five countries came from ad hoc studies. The Established Market Economies (EME) accounted for over 87% of the total; inclusion of the Formerly Socialist Economies (FSE) of Europe raised the share to 90% or US$ 1532 billion. Spending on health in the US alone was 41% of global health expenditures, while spending in developing regions was only 10% or US$ 167 billion. In 1990 the world spent an estimated US$ 1.7 trillion on health, which constituted 8% of the global GDP. This amount was about 60% public and 40% private in origin. When expenditures are corrected for purchasing power parity, global spending amounted to a little under $ 1.9 trillion. This made developing country expenditure 380 versus 167 billion dollars, but there was little change in estimated spending by the EME and FSE countries.
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