Resources search

The economic burden of dementia in China, 1990–2030: implications for health policy

WORLD HEALTH ORGANIZATION
January 2017

Expand view

Objective To quantify and predict the economic burden of dementia in China for the periods 1990–2010 and 2020–2030, respectively, and discuss the potential implications for national public health policy. Methods Using a societal, prevalence-based, gross cost-of-illness approach and data from multiple sources, we estimated or predicted total annual economic costs of dementia in China. We included direct medical costs in outpatient and inpatient settings, direct non-medical costs – e.g. the costs of transportation – and indirect costs due to loss of productivity. We excluded comorbidity-related costs.

Findings The estimated total annual costs of dementia in China increased from 0.9 billion United States dollars (US$) in 1990 to US$47.2 billion in 2010 and were predicted to reach US$ 69.0 billion in 2020 and US$ 114.2 billion in 2030. The costs of informal care accounted for 94.4%, 92.9% and 81.3% of the total estimated costs in 1990, 2000 and 2010, respectively. In China, population ageing and the increasing prevalence of dementia were the main drivers for the increasing predicted costs of dementia between 2010 and 2020, and population ageing was the major factor contributing to the growth of dementia costs between 2020 and 2030.

Conclusion In China, demographic and epidemiological transitions have driven the growth observed in the economic costs of dementia since the 1990s. If the future costs of dementia are to be reduced, China needs a nationwide dementia action plan to develop an integrated health and social care system and to promote primary and secondary prevention.

Health financing country diagnostic: a foundation for national strategy development

MCINTYRE, Diane
KUTZIN, Joseph
2016

Expand view

Health systems’ analysis is not an exact science in the sense that it is not a case of calculating an indicator and comparing that to a target that is set in stone. Instead, the analysis rests on describing elements of the existing system and critically assessing this on the basis of a clear understanding of health financing policy, the objectives associated with UHC, and relevant comparisons with and lessons from other countries. The paper attempts to provide guidance on how this can be done by highlighting the key issues that should be considered and some of the specific questions that should be addressed. It is not intended to provide a strict chapter-bychapter outline for a system assessment, but instead to foster and guide a systematic approach to the analysis of the health financing system. The health financing country diagnostic is written for Ministries of Health, advisors and others actors responsible for developing and implementing health financing policies, and provides step-by-step guidance on how to undertake a situation analysis of a country’s health financing system. Topics considered include: key contextual factors that influence health financing policy and attainment of policy goals; overview of health expenditure patterns; review of health financing arrangements; analysis UHC goals and intermediate objectives; and overall assessment - priorities for health financing reform.

Public financing for health in Africa: from Abuja to the SDGs

BARROY, Helene
VAN DE MAELE, Nathalie
MUSANGO, Laurent
HSU, Justine
et al
2016

Expand view

"This report takes stock of the main public financing for health trends over the past fifteen years in the African region, and highlights opportunities for accelerated progress toward universal health coverage (UHC) based on better-informed budget planning and utilization decisions. The report presents new evidence on the critical role played by domestic public financial management systems on the level, effectiveness and quality of public spending on health in Africa. It argues that these systems should be reconsidered if countries are to move towards UHCCountry experience in reforming public finance systems to support progress towards UHC indicates that success depends on more than simply increasing the level of public budgets. Rather, it requires appropriately targeted health budget allocations, complete execution of health’s public budgets, and improved efficiency in the use of public resources for health.

The report is composed of three sections. The first section is articulated around three policy highlights: aligning budget resources and health priorities; closing the gap between health budget allocation and expenditure; and maximizing UHC performance with the money available. Section 2 is dedicated to providing detailed health financing information on countries, and includes 48 country profiles focused on key health financing trends. The last section includes information on progress towards the development of health financing strategies in the region, as well as regional and country benchmarks on key health financing indicators"

WHO/HIS/HGF/Tech.Report/16.2

Brief - Financial access to rehabilitation services

Handicap International
October 2015

Expand view

Presentations from the seminar are reported on the themes of: a diagnostic tool, universal health coverage, financial access experiences, Madagascar’s experience and advocacy. Presentations included: The economic diagnostic tool for physical and functional rehabilitation and its deployment in Burkhina Faso, Colombia and Laos;  Equity funds and cash transfers, link with UHC; Universal Health Coverage, contributory and case management schemes usable in order to finance physical and functional rehabilitation; Vietnam: Orthopaedic devices and fair cost recovery system;  Burundi: Financial access to healthcare and performance-based financing; Burkhina Faso: Equity fund for rehabilitation projects; Mali, Rwanda, Togo: Evaluation of three rehabilitation equity funds; Nepal: Cost calculation of assistive devices; Madagascar Experience (Operating and financial access of orthopaedic devices and physical rehabilitation services of Pzaga Mahajanga University Hospital,  Social Welfare Policy and Universal health coverage in Madagascar, Mutual Health Insurances)

Methods for the economic evaluation of health care programmes. 4th edition. Chapter 1 to 3)

DRUMMOND. Michael
et al
September 2015

Expand view

The analytical and policy challenges that face health systems in seeking to allocate resources efficiently and fairly are discussed. A critical appraisal framework is employed, which is useful both to researchers conducting studies and to decision-makers assessing them. Practical examples are provided throughout to aid learning and understanding. A key part of evidence-based decision making is the analysis of all the relevant evidence to make informed decisions and policy.

Universal health coverage for inclusive and sustainable development. A synthesis of 11 country case studies.

MAEDA, Akiko
ARAUJO, Edson
CASHIN, Cheryl
HARRIS, Joseph
IKEGAMI, Naoki
REICH, Michael R.
et al
2014

Expand view

Universal health coverage (UHC) for inclusive and sustainable development synthesises the experiences from 11 countries—Bangladesh, Brazil, Ethiopia, France, Ghana, Indonesia, Japan, Peru, Thailand, Turkey, and Vietnam—in implementing policies and strategies to achieve and sustain UHC. These countries represent diverse geographic and economic conditions, but all have committed to UHC as a key national aspiration and are approaching it in different ways. The UHC policies for each country are examined around three common themes: (1) the political economy and policy process for adopting, achieving, and sustaining UHC; (2) health financing policies to enhance health coverage; and (3) human resources for health policies for achieving UHC. The path to UHC is specific to each country, but countries can benefit from experiences of others and avoid potential risks

Moving towards universal health coverage: health insurance reforms in nine developing countries in Africa and Asia

Lagomarsion G.
Garabrant A.
Adyas A.
Otoo N.
Muga R.
et al
September 2012

Expand view

The implementation of national health insurance reforms designed to move towards universal health coverage by 9 low-income and lower-middle-income countries in Africa and Asia  is reported. Five countries at intermediate stages of reform (Ghana, Indonesia, the Philippines, Rwanda, and Vietnam) and four at earlier stages (India, Kenya, Mali, and Nigeria) are considered. These countries’ approaches to raising prepaid revenues, pooling risk, and purchasing services are described using the functions-of-health-systems framework. Their progress across three dimensions of coverage: who, what services, and what proportion of health costs is assessed using the coverage-box framework. Patterns in the structure of these countries’ reforms including use of tax revenues to subsidise target populations and steps towards broader risk pools are identified. Trends in progress towards universal coverage, including increasing enrolment in government health insurance and a movement towards expanded benefits packages are reported. Common, comparable indicators of progress towards universal coverage are needed.

The labour market for human resources for health in low and middle-income countries

SCHEFFLER, Richard
BRUCKNER, Tim
SPETZ, Joanne
July 2012

Expand view

This paper provides an introduction to the terms and tools of labour market analysis and connects these labour market principles to real-world case studies from LMIC. Three examples are provided of issues: workforce shortage in Thailand; unfilled posts in Kenya; and ghost workers in Rwanda. The labour market for health workers is considered and an integrated framework is provided. The technical structure and dynamics of the health worker market is discussed and applied to the first two examples. Task shifting, health worker performance and health worker productivity are also discussed.

Human Resources for Health Observer, No. 11

Universal coverage of health services: tailoring its implementation

CARRIN, Guy
MATHAUER, Inke
XU, Ke
EVANS, David
2008

Expand view

In 2005, the Member States of WHO adopted a resolution encouraging countries to develop health financing systems capable of achieving and/or maintaining universal coverage of health services – where all people have access to needed health services without the risk of severe financial consequences. In doing this, a major challenge for many countries will be to move away from out-of-pocket payments, which are often used as an important source of fund collection. Prepayment methods will need to be developed or expanded but, in addition to questions of revenue collection, specific attention will also have to be paid to pooling funds to spread risks and to enable their efficient and equitable use. Developing prepayment mechanisms may take time, depending on countries’ economic, social and political contexts. Specific rules for health financing policy will need to be developed and implementing organizations will need to be tailored to the level that countries can support and sustain. In this paper we propose a comprehensive framework focusing on health financing rules and organizations that can be used to support countries in developing their health financing systems in the search for universal coverage.

Cost-effectiveness analysis in health. A practical approach (2nd edition)

MUENNIG, Peter
BOUNTHAVONG, Mark
2008

Expand view

Cost-effectiveness analysis is used to evaluate medical interventions worldwide, in both developed and developing countries. This book provides process-specific instruction in a concise, structured format to provide a robust working knowledge of common methods and techniques. Each chapter includes real-world examples and tips that highlight key information. Calculations concerning disability life adjusted years are covered. The third edition contains new discussion on meta-analysis and advanced modelling techniques and a long worked example.

Protecting households from catastrophic health spending

Xu Ke
David B. Evans
Guido Carrin
Ana Mylena Aguilar-Rivera
Philip Musgrove
Timothy Evans
et al
July 2007

Expand view

Many countries rely heavily on patients’ out-of-pocket payments to providers to finance their health care systems. This prevents some people from seeking care and results in financial catastrophe and impoverishment for others who do obtain care.  Data from a large data set (116 surveys covering 89 countries) provided global estimates of the extent of catastrophic spending and impoverishment associated with out-of-pocket payments. Prepayment mechanisms protect people from financial catastrophe, but no strong evidence is reported that social health insurance systems offer better or worse protection than tax-based systems. Health system and population characteristics associated with high levels of catastrophic spending are examined to provide a basis for assessing the policy options available to reduce the incidence of financial catastrophe

 

 

Empowering civil society

DEUTSCHE GESELLSCHAFT FUR TECHNISCHE ZUSAMMENARBEIT (GTZ)
June 2007

Expand view

This booklet looks at the role of civil society organisations (CSOs) in global health financing processes. It describes the strengths of these organisations as well as the challenges they are facing at the national and local level. The section also identifies technical support available to help civil society organisations act and participate effectively in the structures and processes of global financing

Disease control priorities in developing countries. 2nd edition. Chapter 15. Cost-effectiveness analysis for priority setting.

MUSGROVE, Phillip
FOX-RUSHBY, Julia
2006

Expand view

What cost-effectiveness analysis (CEA) does and does not provide, how it is related to the concept of burden of disease, and how it can be used, along with other criteria, in setting priorities is discussed. The several meanings of the term CEA and the way that interventions are classified and evaluated are described. Estimating the effectiveness of an intervention requires specifying the units which in turn requires choices of several parameter values, including, in the analyses reported here, the discount rate applied to future years; the disability weights that describe the severity of diseases and conditions, corresponding to the health losses that they cause; and the life expectancy at different ages. Costs of interventions to include in the analysis, and conversion of costs to equivalents in U.S. dollars for international comparisons are described. Variations of results and uncertainty of estimates are discussed. Two ways are suggested to consider costs and outcomes at the population level, allowing for large differences among countries in the size of population; the incidence or prevalence of a disease, condition, or risk factor; and the amount spent or available to spend on an intervention

Financial sustainability in rehabilitation centers: booklet 1, factors and players of financial sustainability. (La pérennité financière des centres de réadaptation fonctionnelle : fascicule 1, Les facteurs et ateliers de la pérennité financière)

ROUFFE, Frederique
et al
January 2005

Expand view

The purpose of this document is to facilitate the identification of factors contributing to financial sustainability, of key-players of financial sustainability and of internal tools related to financial and economic issues related to rehabilitation centres. Financial sustainability relies on precise knowledge of functioning costs. The differences in the context and constraints of rehabilitation centres is highlighted. Topics discussed include systems of health financing, possible sponsors of rehabilitation centres (including international donors, international and local associations, the state, hospitals), social security and recovery of costs by user fees

Financial sustainability in rehabilitation centers: booklet 2, calculating functioning costs of rehabilitation centres. (La pérennité financière des centres de réadaptation fonctionnelle : fascicule 2, Calculs des coûts des centres de réadaptation)

ROUFFE, Frederick
et al
2005

Expand view

Before presenting accounting tools developed within the frame of HI or partners’ projects, basic accounting concepts (production costs, direct/indirect cost, etc.) are presented, so that a non-specialist can understand the scope of the different tools. The second part presents tools that enable calculation of the costs associated with a rehabilitation centre.  The last part presents two kinds of tools that complement the first parts: provisional budget management methods and a database enabling stock monitoring

Use of Cost-Effectiveness Analysis in Health-Care Resource Allocation Decision-Making: How Are Cost-Effectiveness Thresholds Expected to Emerge?

EICHLER, Hans-Georg
et al
September 2004

Expand view

An overview is presented of the use of cost-effectiveness analysis in healthcare resource allocation decision-making. Threshold figures (i.e. cost per unit of health gain) currently proposed for, or applied to, resource-allocation decisions are reviewed. Disability Adjusted Life-Years (DALY) are mentioned. A table of data provides a summary of cost-effectiveness thresholds and CE ratios in terms of either QALYs (quality-adjusted life-year) or  LYGs (life-year gained). Threshold figures and evolution of thresholds are discussed.

Pages

E-bulletin

Source e-bulletin on Disability and Inclusion

Subscribe to updates