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金砖国家与七国集团历史医疗支出模式比较。

Comparison of historical medical spending patterns among the BRICS and G7.

作者信息

Jakovljevic Mihajlo Michael

机构信息

a Faculty of Medical Sciences University of Kragujevac , Kragujevac , Serbia.

出版信息

J Med Econ. 2016;19(1):70-6. doi: 10.3111/13696998.2015.1093493. Epub 2015 Oct 8.

Abstract

OBJECTIVE

The past few decades have been marked by a bold increase in national health spending across the globe. Rather successful health reforms in leading emerging markets such as BRICS reveal a reshaping of their medical care-related expenditures. There is a scarcity of evidence explaining differences in long-term medical spending patterns between top ranked G7 traditional welfare economies and the BRICS nations.

METHODS

A retrospective observational study was conducted on a longitudinal WHO Global Health Expenditure data-set based on the National Health Accounts (NHA) system. Data were presented in a simple descriptive manner, pointing out health expenditure dynamics and differences between the two country groups (BRICS and G7) and individual nations in a 1995-2013 time horizon.

RESULTS

Average total per capita health spending still remains substantially higher among G7 (4747 Purchase Power Parity (PPP) $PPP in 2013) compared to the BRICS (1004 $PPP in 2013) nations. The percentage point share of G7 in global health expenditure (million current PPP international $US) has been falling constantly since 1995 (from 65% in 1995 to 53.2% in 2013), while in BRICS nations it grew (from 10.7% in 1995 to 20.2% in 2013). Chinese national level medical spending exceeded significantly that of all G7 members except the US in terms of current $PPP in 2013.

CONCLUSIONS

Within a limited time horizon of only 19 years it appears that the share of global medical spending by the leading emerging markets has been growing steadily. Simultaneously, the world's richest countries' global share has been falling constantly, although it continues to dominate the landscape. If the contemporary global economic mainstream continues, the BRICS per capita will most likely reach or exceed the OECD average in future decades. Rising out-of-pocket expenses threatening affordability of medical care to poor citizens among the BRICS nations and a too low percentage of GDP in India remain the most notable setbacks of these developments.

摘要

目的

在过去几十年里,全球各国的医疗卫生支出大幅增加。金砖国家等主要新兴市场相当成功的医疗改革揭示了其医疗相关支出的重塑。关于七国集团(G7)传统福利经济体与金砖国家在长期医疗支出模式上的差异,目前缺乏相关证据。

方法

基于世界卫生组织(WHO)全球卫生支出纵向数据集,采用国民健康账户(NHA)系统进行回顾性观察研究。数据以简单描述的方式呈现,指出了1995 - 2013年期间两个国家集团(金砖国家和G7)以及各个国家的卫生支出动态和差异。

结果

2013年,七国集团人均卫生总支出(4747购买力平价美元)仍远高于金砖国家(2013年为1004购买力平价美元)。自1995年以来,七国集团在全球卫生支出(百万当前购买力平价国际美元)中的百分点份额持续下降(从1995年的65%降至2013年的53.2%),而金砖国家的份额则有所增长(从1995年的10.7%升至2013年的20.2%)。2013年,按当前购买力平价美元计算,中国的国家层面医疗支出显著超过了除美国之外的所有七国集团成员国。

结论

在仅19年的有限时间范围内,新兴市场大国在全球医疗支出中的份额似乎一直在稳步增长。与此同时,世界上最富裕国家的全球份额一直在持续下降,尽管它们仍占据主导地位。如果当代全球经济主流趋势持续下去,金砖国家的人均支出在未来几十年很可能达到或超过经合组织(OECD)的平均水平。金砖国家中自付费用的增加威胁到贫困公民的医疗可及性,以及印度国内生产总值(GDP)占比过低,仍是这些发展中最显著的阻碍。

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