Health expenditure - World Health Organization [PDF]

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39.2. 42.5. 60.8. 57.5. 8.2. 18.8. 52.0. 52.4. Saint Kitts and Nevis. 5.4. 5.8. 60.3. 61.3. 39.7. 38.7. 9.5. 9.5. 5.3. 0.0. Saint Lucia. 5.8. 6.3. 58.5. 57.8. 41.5. 42.2. 11.7.
Table 7

World HealtH StatiSticS 2009

Health expenditure Globally in 2006, expenditure on health was about 8.7% of gross domestic product, with the highest level in the Americas at 12.8% and the lowest in the South-East Asia Region at 3.4%. This translates to about US$ 716 per capita on the average but there is tremendous variation ranging from a very low US$ 31 per capita in the South-East Asia Region to a high of US$ 2636 per capita in the Americas. The share of government in health spending varies from 76% in Europe to 34% in South-East Asia. Where government expenditure in health is low, the shortfall is made up in low-income countries by private spending, about 85% of which is out of pocket. This means that payment is made at the point of accessing health services. Such payment does not allow for pooling of risks and leads to a high probability of catastrophic payments that can result in poverty for the household. External resources are becoming a major source of health funding in low-income countries. From a share of 12% of total health expenditure in 2000, external resources represented 17% of low-income country health expenditure in 2006. Some low-income countries have two thirds of their total health expenditure funded by external resources. In these situations, predictability of aid is an important concern. These data are generated from sources that WHO has been collecting for over 10 years. The most comprehensive and consistent data on health financing are generated from national health accounts that collect expenditure information within an internationally recognized framework. National health accounts trace the financing as it flows from sources which provide the funds to agents who decide on the use of the funds to providers and beneficiaries of health services. Not all countries have or update national health accounts and, in these instances, data are obtained through technical contacts in country or from publicly available documents and reports. Missing values are estimated using various accounting techniques depending on the data available for each country. WHO sends all such estimates to the respective ministries of health every year for validation. 107

7. Health expenditure Member State

Health expenditure ratios

Total expenditure on health as % of gross domestic product

2000 d,e,f

Afghanistan Albania Algeria Andorra d Angola Antigua and Barbuda Argentina Armenia g Australia Austria h Azerbaijan i Bahamas f Bahrain j Bangladesh i Barbados Belarus k Belgium Belize Benin Bhutan Bolivia j Bosnia and Herzegovina Botswana Brazil Brunei Darussalam l Bulgaria Burkina Faso d Burundi j, m Cambodia d Cameroon Canada Cape Verde Central African Republic Chad Chile China Colombia d Comoros Congo i, n Cook Islands Costa Rica Côte d'Ivoire Croatia i Cuba l Cyprus k Czech Republic d,i,o Democratic People's Republic of Korea Democratic Republic of the Congo k Denmark Djibouti

6.1 6.4 3.5 7.6 2.4 4.8 8.9 6.4 8.3 9.9 4.8 6.5 4.0 3.3 6.2 6.4 9.1 5.0 4.6 5.2 6.1 7.0 4.8 7.2 2.5 6.2 5.1 4.1 5.8 4.6 8.8 4.6 3.8 6.3 6.2 4.6 7.7 2.8 2.1 3.8 6.5 5.3 9.1 6.7 5.7 6.5 3.6 3.7 8.3 5.8

2006 9.2 6.5 4.2 7.4 2.6 4.3 10.1 4.7 8.7 10.2 4.1 7.4 3.6 3.2 6.6 6.4 9.9 4.7 4.7 3.5 6.4 9.5 7.1 7.5 1.9 7.2 6.3 8.7 5.9 4.6 10.0 4.9 4.0 4.9 5.3 4.6 7.3 3.2 2.1 4.3 7.7 3.8 8.2 7.7 6.2 6.9 3.5 6.8 10.8 6.8

General government expenditure on health as % of total expenditure on health b 2000

2006

3.1 36.3 73.3 65.0 79.9 69.0 55.4 17.7 67.1 76.8 18.1 47.6 67.5 26.5 65.5 76.6 71.8 48.0 47.6 73.6 60.1 51.8 63.7 40.0 83.5 58.7 39.6 13.2 22.5 22.5 70.4 73.5 41.4 42.5 48.7 38.3 80.9 54.1 57.7 90.6 76.8 24.8 86.1 90.9 41.6 90.3 85.9 1.1 82.4 67.8

32.4 37.3 81.1 70.4 86.8 67.3 45.5 41.2 67.7 75.9 26.1 48.7 68.2 31.8 63.4 74.9 72.5 54.7 50.2 72.1 62.8 55.2 76.5 47.9 80.7 56.7 56.9 8.6 26.0 21.2 70.4 78.3 38.3 53.9 52.7 40.7 85.4 55.1 71.7 91.5 68.4 23.6 86.1 91.6 44.8 88.0 85.6 18.7 85.9 74.1

108

Private expenditure on health as % of total expenditure on health b

2000 96.9 63.7 26.7 35.0 20.1 31.0 44.6 82.3 32.9 23.2 81.9 52.4 32.5 73.5 34.5 23.4 28.2 52.0 52.4 26.4 39.9 48.2 36.3 60.0 16.5 41.3 60.4 86.8 77.5 77.5 29.6 26.5 58.6 57.5 51.3 61.7 19.1 45.9 42.3 9.4 23.2 75.2 13.9 9.1 58.4 9.7 14.1 98.9 17.6 32.2

2006 67.6 62.7 18.9 29.6 13.2 32.7 54.5 58.8 32.3 24.1 73.9 51.3 31.8 68.2 36.6 25.1 27.5 45.3 49.8 27.9 37.2 44.8 23.5 52.1 19.3 43.0 43.1 91.4 74.0 78.8 29.6 21.7 61.7 46.1 47.3 59.3 14.6 44.9 28.3 8.5 31.6 76.4 13.9 8.4 55.2 12.0 14.4 81.3 14.1 25.9

a

General government expenditure on health as % of total government expenditure 2000 6.7 7.1 9.0 19.1 3.2 12.1 14.7 4.6 15.4 14.7 4.2 14.5 10.2 6.1 11.6 10.7 13.4 6.7 11.3 8.6 9.8 6.4 8.3 5.5 5.0 8.6 8.9 2.1 8.7 6.8 15.1 9.6 10.0 13.1 11.3 11.1 16.4 9.5 4.8 9.9 21.7 7.2 14.5 11.9 6.4 14.1 6.0 0.4 12.6 12.0

2006 6.2 8.7 11.9 22.7 5.0 10.4 14.2 9.7 17.0 15.7 3.9 14.3 9.5 7.0 11.9 10.2 14.8 9.0 10.8 7.6 11.6 12.3 17.8 7.2 5.3 11.2 15.8 2.4 10.8 6.7 17.8 11.1 10.9 13.8 14.1 9.9 17.0 8.4 5.4 11.5 21.5 4.2 16.4 11.2 6.4 13.8 6.0 5.8 18.0 13.4

External resources for health as % of total expenditure on health 2000 1.0 6.0 0.1 0.0 3.6 3.6 0.0 8.5 0.0 0.0 3.9 0.0 0.0 19.4 4.0 0.1 0.0 2.9 16.0 27.1 6.0 10.1 0.5 0.5 … 2.0 13.9 21.8 9.4 4.1 0.0 13.5 22.9 24.9 0.1 0.1 0.3 29.7 4.6 2.2 1.0 4.6 0.4 0.1 0.0 0.0 0.8 3.7 0.0 32.6

2006 28.1 3.5 0.1 0.0 7.0 0.2 0.1 14.5 0.0 0.0 0.7 0.0 0.0 15.8 3.0 0.2 0.0 1.4 21.0 10.0 3.6 0.8 5.8 0.1 … 0.2 32.9 47.5 22.2 8.0 0.0 17.5 21.2 17.7 0.1 0.1 0.0 31.9 3.4 23.2 0.1 8.3 0.1 0.2 0.0 0.0 49.6 51.9 0.0 30.1

World HealtH StatiSticS 2009

Social security expenditure on health as % of general government expenditure on health 2000 0.0 20.2 35.5 88.1 0.0 0.0 59.4 0.0 0.0 58.8 0.0 1.8 0.4 0.0 0.0 5.8 79.0 0.0 … 0.0 62.0 95.9 10.5 0.0 … 12.7 0.8 … 0.0 0.1 2.0 36.1 … … 67.2 57.2 60.2 0.0 0.0 0.0 89.6 … 97.6 0.0 0.0 89.5 0.0 0.0 0.0 11.3

2006 0.0 30.2 26.7 87.7 0.0 0.0 58.5 0.0 0.0 59.1 0.0 2.8 0.4 0.0 0.0 2.7 81.6 8.8 … 0.0 75.8 93.4 5.2 0.0 … 65.2 0.2 … 0.0 0.1 2.0 28.6 … … 67.2 57.3 72.3 0.0 0.0 0.0 94.0 … 91.0 0.0 0.2 89.5 0.0 0.0 0.0 10.1

Out-of-pocket expenditure as % of private expenditure on health 2000

2006

98.9 99.9 96.7 76.2 100.0 86.8 63.3 91.6 60.0 66.1 78.3 40.3 68.7 88.1 77.3 57.1 84.7 100.0 99.9 100.0 81.6 100.0 35.5 62.7 98.8 99.1 94.4 79.4 97.1 94.0 53.5 99.6 95.0 96.2 48.7 95.6 59.0 100.0 100.0 100.0 88.2 90.7 100.0 91.9 95.3 100.0 100.0 97.0 91.0 98.4

78.5 94.9 94.6 73.4 100.0 86.9 43.8 87.6 56.4 65.8 86.4 41.1 68.0 88.3 78.6 68.8 79.0 100.0 94.9 100.0 81.0 100.0 27.5 63.8 98.9 97.1 91.5 57.4 84.7 94.8 49.0 99.7 95.0 96.2 54.8 83.1 43.9 100.0 100.0 100.0 86.7 87.8 92.2 93.3 84.3 95.5 100.0 48.9 90.1 98.6

Health expenditure per capita

a

Private prepaid plans as % of private expenditure on health 2000 0.0 0.0 3.1 21.6 0.0 13.2 32.6 … 21.9 20.7 0.3 58.6 25.4 0.0 22.7 0.1 12.3 … 0.1 0.0 8.1 … 3.9 33.9 0.6 0.0 1.0 … 0.0 … 38.9 0.4 … 0.4 51.3 1.0 41.0 0.0 … 0.0 2.3 9.3 … 0.0 4.7 0.0 0.0 … 9.0 1.6

2006 0.0 0.0 5.2 24.4 0.0 13.1 51.1 0.1 23.2 19.2 0.7 57.8 12.6 0.1 21.4 0.1 18.7 … 5.1 0.0 10.2 … 5.2 33.8 0.5 0.8 2.1 … 0.0 … 42.7 0.3 … 0.4 45.1 6.5 56.1 0.0 … 0.0 7.7 12.2 7.8 0.0 12.2 1.8 0.0 … 9.5 1.4

Per capita total expenditure on health at average exchange rate (US$)

Per capita total expenditure on health c (PPP int. $)

a

Per capita government expenditure on health at average exchange rate (US$)

Per capita government expenditure on health c (PPP int. $)

2000

2006

2000

2006

2000

2006

2000

2006

6 75 63 1 284 16 412 689 40 1 734 2 364 31 1 078 488 11 557 66 2 062 153 15 42 61 93 154 267 443 96 11 4 17 27 2 080 55 10 10 302 44 154 8 21 196 265 33 375 183 749 361 16 10 2 479 44

27 187 148 2 822 71 517 551 98 3 302 3 974 102 1 419 788 12 774 243 3 726 205 26 49 79 296 379 427 571 297 27 10 30 45 3 917 112 14 29 473 94 217 16 44 566 402 35 790 362 1 459 953