Health Technology Assessment Resource Centre, Indian Council of Medical Research-National Institute of Epidemiology, Chennai, India.
Front Public Health. 2022 Jun 28;10:893257. doi: 10.3389/fpubh.2022.893257. eCollection 2022.
Evidence-based resource allocation may help to achieve immense health gains in resource-limited settings like India. Understanding healthcare expenditure and the corresponding disease burden could provide insights to plan optimal allocation of limited resources. Hence, we aimed to investigate the status and trends of state-wise healthcare budget allocation and the corresponding disease burden.
We retrieved state-wise healthcare budget allocation information in India for the years 2015 to 2019. Corresponding state-wise disability-adjusted-life-year (DALY) estimates from the Global Burden of Disease, injuries, and Risk Factors Study (GBD) was used to measure disease burden. The allocated budget (in rupees) per DALY was calculated for overall, communicable, and non-communicable diseases (NCDs). Descriptive statistics, correlation and graphical representations were used to identify and evaluate the trends and relationships between state-wise health budget allocation and disease burden.
The allocated budget per DALY in 2019 was highest for Goa ( 34,260 or US$ 486.66) and lowest for Bihar ( 2,408 or US $ 34.20). Smaller, less populous states had higher budget allocations per DALY than larger states. Health budget allocation had an inverse relationship with infectious diseases and an identical linear relationship with NCDs. Most state-wise health budget allocations, as well as total disease burden, increased over the years except for Assam, Karnataka, and Himachal Pradesh. Also, such trends are not similar for the injuries and NCD disease burden.
The health budget allocation is variable across states as well as between infectious and NCDs. The current increase in the allocated budget is incongruent with the increasing disease burden. There is a need for rapid expansion of healthcare resource allocation guided by evidence in India.
循证资源分配可能有助于在资源有限的环境中（如印度）实现巨大的健康收益。了解医疗保健支出和相应的疾病负担可以为规划有限资源的最佳分配提供深入了解。因此，我们旨在调查印度各州医疗保健预算分配的现状和趋势以及相应的疾病负担。
我们检索了印度 2015 年至 2019 年各州的医疗保健预算分配信息。使用全球疾病、伤害和危险因素研究（GBD）的各州残疾调整生命年（DALY）估计值来衡量疾病负担。按 DALY 计算的每 DALY 分配的预算（卢比）用于计算总体、传染病和非传染性疾病（NCD）。使用描述性统计、相关性和图形表示来识别和评估各州卫生预算分配与疾病负担之间的趋势和关系。
2019 年，果阿（34260 卢比或 486.66 美元）每 DALY 的分配预算最高，而比哈尔邦（2408 卢比或 34.20 美元）最低。人口较少、面积较小的州每 DALY 的预算分配高于较大的州。卫生预算分配与传染病呈负相关，与 NCD 呈相同的线性关系。除了阿萨姆邦、卡纳塔克邦和喜马偕尔邦外，大多数州的卫生预算分配以及总疾病负担都在逐年增加。此外，伤害和 NCD 疾病负担的趋势并不相似。
各州的卫生预算分配以及传染病和 NCD 之间存在差异。目前，分配预算的增加与不断增加的疾病负担不一致。印度需要在证据的指导下迅速扩大医疗保健资源的分配。
