Forecasting analysis of selected health- and economy-related indicators in South Eastern European and Balkan countries
Abstract
Background/Aim. Health indicators provide comparable information relevant to defining health goals. The aim of this study was to perform a forecasting analysis of the selected indicators, which could help anticipate the future necessities in the health economy and prevent the problems that would predictively grow in the future. Methods. Health indicators are collected from publicly available databases of the World Health Organization and Eurostat. We used the quantitative forecasting technique, commonly used for historical data, to predict several years in the future concerning selected health- and economy-related indicators. Results. Total health expenditures as a percentage of gross domestic product (GDP) by 2025 will increase in most of the 17 surveyed countries. The percentage of direct household budget payments (out-of-pocket) for health services will decrease in half of the countries, while values of GDP expressed in US$ will increase significantly compared to the last surveyed year (2017), except in Greece. The infant mortality indicator shows that the numbers will decrease in each surveyed country, while the urban population percentage will rise almost in each country except Estonia. Life expectancy will increase in each surveyed country. Conclusion. Health- and economy-related indicators must be monitored over time, as they provide significant information concerning the relevant issues in the health care system. Moreover, they may indicate changes that should be made in order to accomplish progress in each individual country.
References
1. Larson J. The measurement of health: concepts and indicators. New York: Grenwood Press; 1991.
2. Larson C, Mercer A. Global health indicators: An overview. CMAJ 2004; 171(10): 1199‒200.
3. Smith P, Mossialos E, Papanicolas I, Leatherman S. Performance Measurement for Health System Improvement. Experiences, Challenges and Prospects. Cambridge: Cambridge University Press; 2010.
4. Yusuf S, Reddy S, Ounpuu S, Anand S. Global burden of cardiovascular diseases: Part I: general considerations, the epidemiologic transition, risk factors, and impact of urbanization. Circulation 2001; 104(22): 2746‒53.
5. National Health Service (NHS). NHS Institute for Innovation and Improvement. The Good Indicators Guide: Understanding How to Use and Choose Indicators. Available from: https://www.england.nhs.uk/improvement-hub/publication/
/>the-good-indicators-guide-understanding-how-to-use-and-cho
ose-indicators/ [ updated 2017November 30].
6. World Health Organization. Study Group on the Measurement of Levels of Health & World Health Organization, 1957. Measurement of levels of health: report of a study group [meeting held in Geneva from 24 to 28 October 1955]. Available from: https://apps.who.int/iris/handle/10665/40394
7. Stefko R, Gavurova B, Ivankova V, Rigelsky M. Gender Inequalities in Health and Their Effect on the Economic Prosperity Represented by the GDP of Selected Developed Countries ‒ Empirical Study. Int J Environ Res Public Health 2020; 17(10): 3555.
8. World Health Organization. Health and the Millennium Development Goals. Geneva: World Health Organization; 2005. Available from: https://www.who.int/hdp/publications/mdg
/>_en.pdf?ua=1
9. Saltman R, Rico A, Boerma W. Primary health care in the driver’s seat: organizational reform in European primary care. Maidenhead, England: Open University Press; 2006.
10. Clancy CM, Uchendu US, Jones KT. Excellence and Equality in Health Care. Am J Public Health 2014; 104(Suppl 4): S527‒8.
11. White-Means S, Gaskin DJ, Osmani AR. Intervention and Public Policy Pathways to Achieve Health Care Equity. Int J Environ Res Public Health. 2019; 16(14): 2465.
12. Koehring М. Modernising health systems in the Balkans: Uneven progress. New York, NY: EIU Perspectives; 2016. Available from: https://eiuperspectives.economist.com/healthcare/
/>modernising-health-systems-balkans
13. Jakovljevic MB, Vukovic M, Fontanesi J. Life expectancy and health expenditure evolution in Eastern Europe-DiD and DEA analysis. Expert Rev Pharmacoecon Outcomes Res 2015; 16(4): 537‒46.
14. Rancic N, Jakovljevic M. Long Term Health Spending Alongside Population Aging in N-11 Emerging Nations. East Eur Bus Econ J 2016; 2(1): 2‒26.
15. Jakovljevic M, Potapchik E, Popovich L, Barik D, Getzen TE. Evolving health expenditure landscape of the BRICS nations and projections to 2025. Health Econ 2017; 26(7): 844‒52.
16. Stevens GA, Alkema L, Black RE, Boerma JT, Collins GS, Ezzati M, et al. Correction: Guidelines for Accurate and Transparent Health Estimates Reporting: the GATHER statement. PLOS Med 2016; 13(8): e1002116.
17. Marmot M. Social determinants of health inequalities. Lancet 2005; 365(9464): 1099‒104.
18. Politzer E, Shmueli A, Avni S. The economic burden of health disparities related to socioeconomic status in Israel. Isr J Health Policy Res 2019; 8(1): 46.
19. World Health Organization. Regional Committee for Europe. 64th Session. Investing in children: The European child and adolescent health strategy 2015–2020. Copenhagen, Denmark; 2014 September 15–18; Geneve: World Health Organization; 2014. Available from: http://www.euro.who.int/__data/
/>assets/pdf_file/0006/199536/Health2020-Short.pdf?ua=1 [accessed 2014 July 17].
20. World Health Organization. European health information gateway. Available from: https://gateway.euro.who.int/en/hf
/>a-explorer/#2zvCNKFyac
21. World Health Organization. WHO Regional Office for Europe. Available from: https://www.who.int/medicines/are
/>as/quality_safety/safety_efficacy/gcp1.pdf
22. World Health Organization. WHO Regional Office for Europe. Available from: https://www.euro.who.int/__data/
/>assets/pdf_file/0009/251775/Health-2020-Targets-and-indica
tors-version2-ENG.pdf
23. Lawrence KD, Klimberg RK, Lawrence SM. Fundamentals of Forecasting Using Excel. New York, U S: Industrial Press; 2008.
24. Stepovic M. GDP Growth and Health Care Expenditures Worldwide. Open Pharmacoecon Health Econ J 2019; 7: 9‒18.
25. Stepovic M, Rancic N, Vekic B, Dragojevic-Simic V, Vekic S, Ratkovic N, et al. Gross Domestic Product and Health Expenditure Growth in Balkan and East European Countries-Three-Decade Horizon. Front Public Health 2020; 8: 492.
26. Rancic N, Kovacevic A, Dragojevic-Simic V. Long term health expenditure changes in selected Balkan countries. Front Public Health 2015; 3: 152.
27. Jakovljevic M. Population ageing alongside health care spending growth. Srp Arh Celok Lek 2017; 145(9‒10): 534‒9.
28. Lichtenberg FR, Tatar M, Çalışkan Z. The effect of pharmaceutical innovation on longevity, hospitalization and medical expenditure in Turkey, 1999–2010. Health Policy 2014; 117(3): 361‒73.
29. Jakovljevic MB. Resource allocation strategies in Southeastern European health policy. Eur J Health Econ 2013; 14(2): 153‒9.
30. Kovačević A, Rancic N, Segrt Z, Dragojevic-Simic V. Pharmaceutical expenditure and burden of non-communicable diseases in Serbia. Front Pharmacol 2016; 7: 373.
31. Neumann PJ, Ganiats TG, Russell GD, Sanders GD. Siegel JE. Cost Effectiveness in Health and Medicine. 2nd ed. New York: Oxford University Press; 2017.
32. Lorenzoni L, Marino A, Morgan D, James C. Health Spending Projections to 2030: New results based on a revised OECD methodology. OECD Health Working Papers 2019; No. 110. Paris, France: OECD Publishing; 2019. Available from: https://www.sipotra.it/wpcontent/uploads/2019/06/Health-
/>Spending-Projections-to-2030-New-results-based-on-a-revised
-OECD-methodology.pdf
33. OECD. Projections of health expenditure. Paris, France: OECD Publishing; 2019.
34. Marino A, Morgan D, Lorenzoni L, James C. Future trends in health care expenditure: A modelling framework for cross-country forecasts. OECD Health Working Papers 2017; No. 95. Paris, France: OECD Publishing; 2017.
35. OECD. Fiscal Sustainability of Health Systems. Paris, France; OECD Publishing. 2015. doi: https://doi.org/10.1787/9789264233386-en
36. James C, Berchet C, Muir T. Addressing operational waste by better targeting the use of hospital care, in: Tackling Wasteful Spending on Health.OECD 2017. Paris, France: OECD Library; 2017.
37. Šiška J, Beadle-Brown J. Transition from Institutional Care to Community-Based Services in 27 EU Member States: Final report. Research report for the European Expert Group on Transition from Institutional to Community-based Care. 2020. Available from: https://www.euro.who.int/__data/assets/pdf
/>_file/0009/355986/Health-Profile-Latvia-Eng.pdf?ua=1
38. Tandon A, Cashin C. Assessing Public Expenditure on Health from a Fiscal Space Perspective. Health, Nutrition and Population (HNP) discussion paper. Washington, DC: World Bank; 2010. Available from: https://openknowledge.worldbank.org/
/>handle/10986/13613 License: CC BY 3.0 IGO.
39. Fuhrer R, Shipley MJ, Chastang JF, Schmaus A, Niedhammer I, Stansfeld SA, et al. Socioeconomic position, health, and possible explanations: a tale of two cohorts. Am J Public Health 2002; 92(8): 1290‒4.
40. Merlo J, Gerdtham U, Lynch J, Beckman A, Norlund A, Lithman T. Social inequalities in health ‒ do they diminish with age? Revisiting the question in Sweden 1999. Int J Equity Health 2003; 2(1): 2.
41. Cho HE, Wang L, Chen JS, Liu M, Kuo CF, Chung KC. Investigating the causal effect of socioeconomic status on quality of care under a universal health insurance system - a marginal structural model approach. BMC Health Serv Res 2019; 19(1): 987.
42. Cutler D, Wikler E, Basch P. Reducing administrative costs and improving the health care system. N Engl J Med 2012; 367(20): 1875‒8.
43. The World Bank. Available from: https://data.worldbank.org
/>/country/UA
44. Hsaio WC, Shaw PR. Social Health Insurance for Developing Nations. WBI Development Studies. Washington, DC: World Bank; 2007. Available from: https://openknowledge.worldban
/>k.org/handle/10986/6860 License: CC BY 3.0 IGO.
45. Hsaio WC, Shaw PR. Social Health Insurance for Developing Nations. World Health Organization for the Western Pacific Region. Washington, DC: World Bank; 2007. Available from: https://openknowledge.worldbank.org/bitstream/handle/10986/6860/411710PAPER0So101OFFICIAL0USE0ONLY1.pdf?sequence=1&isAllowed=y
46. Gonzalez RM, Gilleskie D. Infant Mortality Rate as a Measure of a Country’s Health: A Robust Method to Improve Reliability and Comparability. Demography 2017; 54(2): 701‒20.
47. Gupta S, Verhoeven M, Tiongson ER. Public spending on health care and the poor. Health Econ 2003; 12(8): 685‒96.
48. World Health Organization. WHO Library Cataloguing-in-Publication Data. Available from: https://apps.who.int/iris/bi
/>tstream/handle/10665/43444/9241563206_eng.pdf?sequence=1
49. Department of Economic and Social Affairs of the United Nations. Available from: https://www.un.org/millenniumgoals/
/>2015_MDG_Report/pdf/MDG%202015%20rev%20(July%201).pdf
50. The French Institute for Demographic Studies. Available from: https://www.ined.fr/en/everything_about_population/
/>data/europe-developed-countries/birth-death-infant-mortality/
51. Department of Economic and Social Affairs, Population Division. Available from: https://www.un.org/en/development
/>/desa/population/publications/pdf/ageing/WorldPopulationAgeing2019-Highlights.pdf
52. Raleigh V. Trends in life expectancy in EU and other OECD countries: why are improvements slowing?, OECD Health Working Papers, No. 108. Paris, France; OECD Publishing; 2019.
53. Kinsella K, Velkoff V. An Aging World: 2001. Washington, DC: Government Printing Office; 2001. Available from: https://www.census.gov/prod/2001pubs/p95-01-1.pdf
54. Ogura S, Jakovljevic M. Health financing constrained by population aging – an opportunity to learn from Japanese experience. Serbian J Exp Clin Res 2014; 15(4): 175‒81.
55. United Nations, Department of Economic and Social Affairs, Population Division. Available from: https://population.un.or
/>g/wup/Publications/Files/WUP2018-Report.pdf
56. European Commission. Available from: https://knowledge
4policy.ec.europa.eu/foresight/topic/continuing-urbanisation
/developments-and-forecasts-on-continuing-urbanisation_en
57. Seto KC, Güneralp B, Hutyra LR. Global forecasts of urban expansion to 2030. Proceedings of the National Academy of Sciences. Proc Natl Acad Sci USA 2012; 109(40): 16083‒8.
58. The World Bank. Available from: https://www.worldbank.org
/>/en/country/romania/overview
59. Our World in Data. Available from: https://ourworldindata.o
/>rg/urbanization