Analysis of health expenditures in China from 2000 to 2019 compared with the world and upper-middle-income countries

BackgroundFairness in health funding has always been a priority in China. This article aims to study the trends in total health expenditure (THE), government health expenditure (GHE), social health expenditure (SHE), and out-of-pocket health expenditure (OOPHE) among China, the world, and upper-midd...

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Main Authors: Xindian Zeng, Lijie Chen, Lu Chen
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-02-01
Series:Frontiers in Public Health
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Online Access:https://www.frontiersin.org/articles/10.3389/fpubh.2024.1464214/full
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author Xindian Zeng
Xindian Zeng
Lijie Chen
Lu Chen
author_facet Xindian Zeng
Xindian Zeng
Lijie Chen
Lu Chen
author_sort Xindian Zeng
collection DOAJ
description BackgroundFairness in health funding has always been a priority in China. This article aims to study the trends in total health expenditure (THE), government health expenditure (GHE), social health expenditure (SHE), and out-of-pocket health expenditure (OOPHE) among China, the world, and upper-middle-income countries from 2000 to 2019. The goal is to provide a theoretical basis for the Chinese government to adjust and formulate health-related policies.MethodsAggregate time-series data were collected from the World Health Organization (WHO) and the World Bank (WB) Open Data sources from 2000 to 2019. These data were compared and some of it analyzed using cluster analysis methods.ResultsThe financing structure level of THE in China is currently above average among upper-middle-income countries. The proportion of THE in GDP for upper-middle-income countries and China remains relatively stable and slow growth, and is consistently lower than the world average. The proportions of GHE and SHE in THE in China and upper-middle-income countries converged toward the world average level. But the proportion of OOPHE in THE in China is higher than that of two. Overall, the proportions of GHE exhibited an upward trend and the proportion of SHE and OOPHE exhibited a downward trend in China. What's more, the changes in China are more pronounced. The proportion of THE in GDP of China increased by 0.84% from 2000 to 2019, and it ranked 24th among the 51 upper-middle-income countries in 2019, and Compared with it in 2000 there has been a consistently positive increase rate. The per capita health expenditure in China was $42.11 in 2000 and it's $535.13 in 2019, which rapidly grow to the level of upper-middle-income countries and narrow the gap with the level of the world.ConclusionThe financing structure of THE is increasingly optimized, but the level of financing still needs improvement in China. The government should continue to optimize the financing structure of THE, increase GHE, encourage social capital investment, decrease the proportion of OOPHE, diversify financing and reimbursement policies to promote hierarchical medical system, promote health management for an aging population, and formulate health expenditure plans for public health emergencies.
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spelling doaj-art-d81263b56111478daa02a7e9a3f6a1802025-02-06T07:09:19ZengFrontiers Media S.A.Frontiers in Public Health2296-25652025-02-011210.3389/fpubh.2024.14642141464214Analysis of health expenditures in China from 2000 to 2019 compared with the world and upper-middle-income countriesXindian Zeng0Xindian Zeng1Lijie Chen2Lu Chen3The Affiliated Nanhua Hospital, Hengyang Medical School, University of South China, Hengyang, Hunan, ChinaKey Laboratory of Hengyang for Health Hazard Factors Inspection and Quarantine, Hengyang, Hunan, ChinaThe Affiliated Nanhua Hospital, Hengyang Medical School, University of South China, Hengyang, Hunan, ChinaDepartment of Nephrology, First Medical Center of Chinese People's Liberation Army General Hospital, Nephrology Institute of the Chinese People's Liberation Army, State Key Laboratory of Kidney Diseases, National Clinical Research Center for Kidney Diseases, Beijing Key Laboratory of Kidney Disease Research, Beijing, ChinaBackgroundFairness in health funding has always been a priority in China. This article aims to study the trends in total health expenditure (THE), government health expenditure (GHE), social health expenditure (SHE), and out-of-pocket health expenditure (OOPHE) among China, the world, and upper-middle-income countries from 2000 to 2019. The goal is to provide a theoretical basis for the Chinese government to adjust and formulate health-related policies.MethodsAggregate time-series data were collected from the World Health Organization (WHO) and the World Bank (WB) Open Data sources from 2000 to 2019. These data were compared and some of it analyzed using cluster analysis methods.ResultsThe financing structure level of THE in China is currently above average among upper-middle-income countries. The proportion of THE in GDP for upper-middle-income countries and China remains relatively stable and slow growth, and is consistently lower than the world average. The proportions of GHE and SHE in THE in China and upper-middle-income countries converged toward the world average level. But the proportion of OOPHE in THE in China is higher than that of two. Overall, the proportions of GHE exhibited an upward trend and the proportion of SHE and OOPHE exhibited a downward trend in China. What's more, the changes in China are more pronounced. The proportion of THE in GDP of China increased by 0.84% from 2000 to 2019, and it ranked 24th among the 51 upper-middle-income countries in 2019, and Compared with it in 2000 there has been a consistently positive increase rate. The per capita health expenditure in China was $42.11 in 2000 and it's $535.13 in 2019, which rapidly grow to the level of upper-middle-income countries and narrow the gap with the level of the world.ConclusionThe financing structure of THE is increasingly optimized, but the level of financing still needs improvement in China. The government should continue to optimize the financing structure of THE, increase GHE, encourage social capital investment, decrease the proportion of OOPHE, diversify financing and reimbursement policies to promote hierarchical medical system, promote health management for an aging population, and formulate health expenditure plans for public health emergencies.https://www.frontiersin.org/articles/10.3389/fpubh.2024.1464214/fullTHEGHESHEOOPHEthe financing structure
spellingShingle Xindian Zeng
Xindian Zeng
Lijie Chen
Lu Chen
Analysis of health expenditures in China from 2000 to 2019 compared with the world and upper-middle-income countries
Frontiers in Public Health
THE
GHE
SHE
OOPHE
the financing structure
title Analysis of health expenditures in China from 2000 to 2019 compared with the world and upper-middle-income countries
title_full Analysis of health expenditures in China from 2000 to 2019 compared with the world and upper-middle-income countries
title_fullStr Analysis of health expenditures in China from 2000 to 2019 compared with the world and upper-middle-income countries
title_full_unstemmed Analysis of health expenditures in China from 2000 to 2019 compared with the world and upper-middle-income countries
title_short Analysis of health expenditures in China from 2000 to 2019 compared with the world and upper-middle-income countries
title_sort analysis of health expenditures in china from 2000 to 2019 compared with the world and upper middle income countries
topic THE
GHE
SHE
OOPHE
the financing structure
url https://www.frontiersin.org/articles/10.3389/fpubh.2024.1464214/full
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AT lijiechen analysisofhealthexpendituresinchinafrom2000to2019comparedwiththeworldanduppermiddleincomecountries
AT luchen analysisofhealthexpendituresinchinafrom2000to2019comparedwiththeworldanduppermiddleincomecountries