Ali Ahangar; AliMohammad Ahmadi; AmirHossein Mozayani; Sajjad FarajiDizaji; Samaneh Safarani
Volume 21, Issue 12 , 2019, Pages 1-16
Abstract
Context: Health expenditures in the world undergo increasing growth. According to the WHO Report (2000), health financing is one of the main functions of the health system that has a significant impact on its other functions.Objectives: The aim of this study is the systematic review of the changes and ...
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Context: Health expenditures in the world undergo increasing growth. According to the WHO Report (2000), health financing is one of the main functions of the health system that has a significant impact on its other functions.Objectives: The aim of this study is the systematic review of the changes and shifting of health care financing models and cost burden risk-sharing mechanisms in health systems over the past three decades.Data Sources: In this systematic review, data sources of studies on health financing realm in different countries were investigated using a series of keywords, including “health financing”, “health expenditure “, “model”, “financing mechanism/arrangement”, and “cost risk-sharing” from the most important databases such as Google Scholar, Web of Science, Scopus, PubMed, and the Iranian databases, such as Magiran, IranMedx, SID, in 1990 - 2019.Study Selection: According to PRISMA Flow Diagram, with application of inclusion and exclusion criteria (time limitations, lan- guage restrictions, lack of related title abstract, full text), among 86,611 documents, 150 studies were selected. Two pairs of review author’s independently extracted data and assessed the risk of bias.Results: The systematic review of different evidence suggests that with economic growth, since 2001 to 2014, global health expendi- ture trend was increased from $ 3.8 trillion (in 2001) to $ 9.2 trillion (in 2014) and is estimated to reach $ 24.2 trillion (in 2040). Also, all the evidence indicates a tangible change, a 10% increase in public and pre-payments health expenditures and a 16% reduction in private expenditures, in the global health financing model in the current period up to 2040.Conclusions: The review of regional and global studies, across countries and during the time, shows that in the last three decades, health financing systems are in a transition towards pervasive (with high financial risk-sharing) public health policies in the world
