Blake C. Alkire is an instructor in the Program in Global Surgery and Social Change, Harvard Medical School, and an instructor in otolaryngology, Massachusetts Eye and Ear Infirmary, both in Boston, Massachusetts. Alkire and Alexander Peters share credit as co-first authors.
Alexander W. Peters (
Health Aff (Millwood). 2018 Jun;37(6):988-996. doi: 10.1377/hlthaff.2017.1233.
We estimated deaths amenable to high-quality health care globally and then modeled the macroeconomic impact in low- and middle-income countries using two macroeconomic perspectives: a value-of-lost-output approach to project gross domestic product (GDP) losses annually for the period 2015-30, and a value-of-lost-welfare approach to estimate the present value of total economic welfare losses in 2015. We estimated that eight million amenable deaths occurred in 2015, 96 percent of them in low- and middle-income countries. The value of lost output resulted in a projected cumulative loss of $11.2 trillion in these countries during 2015-30, with a potential economic output loss of up to 2.6 percent of GDP in low-income countries by 2030, compared to 0.9 percent in upper-middle-income countries. The value-of-lost-welfare approach estimated welfare losses of $6.0 trillion in 2015. Inadequate access to high-quality health care results in significant mortality and imposes a macroeconomic burden that is inequitably distributed, with the largest relative burden falling on low-income countries. Given that these deaths are unnecessary and the projected GDP losses are avoidable, there is a strong ethical and economic case for promoting high-quality health care as an essential component of universal health coverage.
我们估计了全球可通过高质量医疗获得救治的死亡人数,然后从两种宏观经济角度对中低收入国家的宏观经济影响进行了建模:一种是损失产出价值法,用于预测 2015-2030 年期间每年的国内生产总值 (GDP) 损失;另一种是福利损失价值法,用于估计 2015 年总经济福利损失的现值。我们估计,2015 年有 800 万人的死亡是可以通过医疗获得救治的,其中 96%发生在中低收入国家。产出损失的价值导致这些国家在 2015-2030 年期间预计累计损失 11.2 万亿美元,到 2030 年,低收入国家的潜在经济产出损失可能高达 GDP 的 2.6%,而中上收入国家则为 0.9%。福利损失价值法估计 2015 年的福利损失为 6.0 万亿美元。获得高质量医疗服务的机会不足导致了大量的死亡,并造成了不平等分配的宏观经济负担,其中低收入国家的相对负担最大。鉴于这些死亡是不必要的,并且预计的 GDP 损失是可以避免的,因此,将高质量医疗作为全民健康覆盖的一个基本组成部分来推广,具有强烈的伦理和经济意义。
Health Aff (Millwood). 2018-6
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