Methods for assessing the need for health financing: international experience (analytical review)

There has been an active discussion on estimating the need for public funding of the domestic health system. An analysis of international experience can be helpful to determine methodological approaches to estimate the market for government spending on the Russian health system.

Aim. To systemize and summarize approaches and methods used in international practice to estimate the need for health financing; to highlight the most important factors dictating the need for additional funding.

Material and methods. A systematic search with the developed protocol for publications, a comprehensive analysis and systematization of the obtained information. The protocol included databases of peer-reviewed publications, search terms, and search restrictions. The search for publications was carried out in the databases of Embase, Pubmed, Medline, Global Health, etc., on the websites of international organizations (World Health Organization (WHO), Organization for Economic Cooperation and Development (OECD), etc.). The search strategy included a combination of the terms “free text” and “Medical subject heading”, which refer to the definition of the need for health financing. The main limitations of the search were the language of publications (English and Russian) and the date of publication (not earlier than 2000).

Results. Of the two used in international practice approaches to estimate the need for health financing, a system based on the use of the current level of funding and its forecasting under several factors is used in developed countries. Forecasting health expenditures is one of the most effective tools to identify critical factors affecting needs for sector financing. Despite the variety of indicators and methods used, most studies agree that non-demographic factors, such as GDP growth and technology development, influence health spending growth to the greatest extent. Demographic factors per se, including population ageing, affect health spending growth to a lesser extent. 

Conclusion. Conducting scenario forecasts contributes to a better understanding of what can happen in the future if the government does not act. This also contributes to a more clear determining of the main spheres for government interventions in the health sector.

Acknowledgments.  The study was conducted within the framework of the Basic Research Program of the National Research University, Higher School of Economics. 

Conflict of interest. The author declares no conflict of interest.