Health Economics Review最新文献

{"title":"The role of economic evaluation in public health emergency management of disease outbreaks in Africa: a qualitative research.","authors":"Elias Asfaw Zegeye, Josue Mbonigaba, Mahlet Kifle Habtemariam","doi":"10.1186/s13561-026-00815-y","DOIUrl":"10.1186/s13561-026-00815-y","url":null,"abstract":"<p><strong>Background: </strong>Recurrent disease outbreaks impose severe health and economic burdens on Africa, exposing critical gaps in public health emergency management (PHEM). Despite growing recognition of its value, economic evaluation (EE) remains largely absent from PHEM practice on the continent. This study aims to explore the role of EE in public health emergency management and assess its potential to strengthen health security in Africa, with a focus on the Africa Centres for Disease Control and Prevention (Africa CDC).</p><p><strong>Methods: </strong>A qualitative research design was employed, using in-person Key Informant Interviews (KIIs) with 12 purposively selected Africa CDC division heads and senior technical advisors between 15 March and 15 April 2023. Thematic analysis was conducted following the framework of Braun and Clarke (2006), with themes derived inductively from the interview data. A logic modelling framework was applied as a complementary tool to visualise EE's causal chain across the four PHEM phases. Supplementary review of Africa CDC strategic documents, policy frameworks, and programme guidelines was undertaken to contextualise and triangulate the findings.</p><p><strong>Results: </strong>Four themes emerged inductively from the analysis. First, key informants unanimously recognised EE as a critical but underutilised tool across the full PHEM cycle. Second, participants identified a concrete EE research agenda including return-on-investment analyses for preparedness, cost-effectiveness of diagnostic infrastructure, and health budget compliance monitoring. Third, significant barriers to EE integration were identified - principally a shortage of trained health economists, limited financial resources, and inadequate familiarity with health economics among decision-makers - alongside strategic opportunities presented by Africa CDC's institutional positioning. Fourth, key informants framed EE as both a technical decision-support tool and a political communication instrument for influencing high-level policymakers.</p><p><strong>Conclusions: </strong>Mainstreaming EE into PHEM - through investment in health economics capacity, standardised methodologies, and institutionalised evidence use - can optimise the allocation of limited resources across preparedness, response, and recovery. Africa CDC is strategically positioned to lead this agenda continentally.</p>","PeriodicalId":46936,"journal":{"name":"Health Economics Review","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13647543/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148431235","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"经济学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Latent profiles of health insurance literacy, numeracy and supplementary voluntary health insurance enrollment.","authors":"Tong Liu, Lei Liu, Lizheng Xu, Chaofan Li","doi":"10.1186/s13561-026-00814-z","DOIUrl":"10.1186/s13561-026-00814-z","url":null,"abstract":"<p><strong>Background: </strong>Low enrollment threatens the sustainability of China's voluntary health insurance system. Limited health insurance literacy and numeracy may create a cognitive barrier to informed decision-making regarding enrollment. This study aims to identify latent profiles of health insurance literacy and numeracy, and to evaluate their associations with Supplementary Voluntary Health Insurance (SVHI) enrollment.</p><p><strong>Methods: </strong>A cross-sectional survey utilizing face-to-face computer-assisted personal interviews was conducted between July and August 2024 across three Chinese provinces (Shandong, Henan, and Sichuan). Using multistage stratified sampling, 1,326 valid responses were collected from residents aged 18 years or older (out of 1,359 approached). Health insurance literacy was assessed using a validated scale comprising self-rated abilities and an objective knowledge quiz, while numeracy was measured via an adapted 3-item General Numeracy Scale. Latent profile analysis identified unobserved cognitive subgroups. Multivariable logistic regression with robust standard errors evaluated the associations between latent profiles and SVHI enrollment, adjusting for relevant covariates.</p><p><strong>Results: </strong>A total of 1,326 participants were included in the analysis, of whom 369 (27.8%) were male and 610 (46.0%) were aged between 18 and 44 years. Of the participants, 195 (14.7%) had an education level of elementary school or lower. Three distinct cognitive profiles were identified: Profile 1 (\"High health insurance literacy, High numeracy\", 32.9%), Profile 2 (\"High health insurance literacy, Low numeracy\", 52.0%), and Profile 3 (\"Low health insurance literacy, Low numeracy\", 15.1%). In multivariable logistic regression, participants in profile 1 (OR = 2.14; 95% CI, 1.23-3.70) and profile 2 (OR = 2.40; 95% CI, 1.43-4.02) were significantly more likely to enroll in SVHI than those in Profile 3.</p><p><strong>Conclusions: </strong>This study found that distinct cognitive profiles of health insurance literacy and numeracy were associated with SVHI enrollment. Individuals with low health insurance literacy and low numeracy were significantly less likely to enroll in SVHI than those with higher levels of both. These findings may inform targeted communication and support strategies to improve equitable access to SVHI among populations with lower health insurance literacy and numeracy.</p>","PeriodicalId":46936,"journal":{"name":"Health Economics Review","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13595556/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148370471","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"经济学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Beyond spending: nonlinear impacts of health financing and out-of-pocket costs on mortality in Africa.","authors":"Denis Folitse, Christopher Odoom, Alexander Boateng, Luis Alberiko Gil-Alana","doi":"10.1186/s13561-026-00811-2","DOIUrl":"10.1186/s13561-026-00811-2","url":null,"abstract":"<p><strong>Background: </strong>Existing evidence suggests that mortality remains disproportionately high across Africa, where gains in life expectancy continue to lag behind global progress. While health financing is central to health-system performance, its relationship with mortality in African settings remains insufficiently characterized, particularly when public spending, household out-of-pocket (OOP) payments, governance conditions, and demographic pressures are considered jointly. Our objective was to use a non-linear regression method to evaluate how health financing structures are associated with mortality and whether the association depends on the mode of financing.</p><p><strong>Methods: </strong>We use generalized additive mixed models (GAMMs) to allow for potential non-linear relationships between crude mortality rates and public health expenditure, out-of-pocket payments, political stability, and age dependency across 51 African countries from 2002 to 2022 (N = 1,071 country-year observations). A tensor-product interaction assessed whether financial protection modifies the effect of public health spending. Region-specific models were fitted for Central, East, West, Southern, and Northern Africa.</p><p><strong>Results: </strong>Public health spending was associated with lower mortality across Africa, with the steepest reductions below approximately US$80 per capita and diminishing returns thereafter. Out-of-pocket (OOP) spending modified these returns: OOP burdens below 15% of total health expenditure strengthened the estimated mortality benefit of public investment by about 60%, whereas burdens above 40% substantially eroded it. Regionally, the spending-mortality association was strongest in Central, Eastern, and Western Africa, but weaker in Southern and Northern Africa, where age dependency and governance quality were more prominent predictors. The expenditure-OOP interaction was most pronounced in Eastern Africa (EDF = 9.45, F = 4.45, p < 0.001). The continent-wide model showed strong explanatory performance (adjusted R² = 92.8%; deviance explained = 93.4%; N = 1,009).</p><p><strong>Conclusions: </strong>Increasing public health spending alone is unlikely to maximize mortality gains in Africa. Its impact depends on financial protection: reducing household out-of-pocket costs through pooled financing should be accompanied by expanded public investment. In Southern and Northern Africa, policy emphasis should also shift toward governance efficiency and demographic pressures. Subregion-specific strategies are therefore essential.</p>","PeriodicalId":46936,"journal":{"name":"Health Economics Review","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13595764/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148354198","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"经济学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Generative AI in healthcare: redefining clinical practice through digital transformation.","authors":"Jackie Zhanbiao Li, Xin Li, Qifeng Wu, Qianhui Ting, Yingqian Lao","doi":"10.1186/s13561-026-00812-1","DOIUrl":"10.1186/s13561-026-00812-1","url":null,"abstract":"<p><p>Although generative AI (GenAI) has transformative potential for healthcare systems, this timely issue has not yet been sufficiently explored. This study investigates the application effectiveness and underlying mechanisms of GenAI in the healthcare sector, using a dataset comprising 1,440 samples from 160 hospitals across 31 provinces in China, covering the period from 2021 to 2024. The results show that GenAI significantly enhances healthcare effectiveness, including improving diagnostic accuracy, optimizing operational efficiency, and increasing patient satisfaction. The degree of industrial digitalization positively moderates these effects, with highly digitalized regions experiencing greater AI effectiveness. This study not only enriches the theoretical framework of technology diffusion but also provides valuable insights into the practical implementation and policy optimization of GenAI in healthcare.</p>","PeriodicalId":46936,"journal":{"name":"Health Economics Review","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13595637/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148340518","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"经济学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The impact of annual price revision based on external reference pricing on medicines between 2012 and 2023.","authors":"José Zorro Mendes, Inês Teixeira, José Pedro Guerreiro, Klára Dimitrovová, Frederico Silva Leal, António Teixeira Rodrigues","doi":"10.1186/s13561-026-00813-0","DOIUrl":"10.1186/s13561-026-00813-0","url":null,"abstract":"<p><strong>Objectives: </strong>The Annual Price Revision (APR) based on external reference pricing (ERP) is one of the price control measures for the pharmaceutical sector implemented in Portugal. This study evaluates the impact of the APR on branded medicines in the outpatient market in Portugal between 2012 and 2023.</p><p><strong>Methods: </strong>A retrospective longitudinal study with time series was conducted using national sell-out data for branded medicines from the outpatient market subject to the APR between 2012 and 2023. Data were retrieved from a panel of over 82% of community pharmacies and extrapolated to the national level. The impact was measured based on two outcomes: the annual and cumulative impacts, both analysed at current and constant prices. Both outcomes estimate the isolated effect of retail price variations resulting from changes in the maximum retail price. Additionally, the impact was assessed considering the inclusion of medicines in Homogeneous Groups (HGs) and according to payer segmentation.</p><p><strong>Results: </strong>The annual impact ranged from a reduction from 128.4 million euros in 2012 to an increase of 2.7 million euros in 2023. Overall, the value of the total cumulative impact of the APR between 2012 and 2023 amounted to 5.3 billion euros. The impact was greater in patent-protected originator medicines, reaching 81.7% in 2023. The public entities captured 56.9% of the total price reductions.</p><p><strong>Conclusions: </strong>This study provides a valuable contribution to the evaluation of price regulation measures based on ERP and can support decision-making by helping to identify and select specific criteria for future price revisions.</p><p><strong>Jel classification: </strong>I; I1; I11; I18; I19.</p>","PeriodicalId":46936,"journal":{"name":"Health Economics Review","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13595642/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148346785","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"经济学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of the efficiency of county-level medical and health services under the background of county medical community policy: a case study of Sanming, China.","authors":"Lina Zhao, Tangsiwei Xin, Xiaoran Wang, Limeng Zhu, Yafang Li, Hong Tan, Zongjiu Zhang","doi":"10.1186/s13561-026-00747-7","DOIUrl":"10.1186/s13561-026-00747-7","url":null,"abstract":"<p><strong>Background: </strong>Integrated care has become a global focus in efforts to improve health system performance and service delivery. China began exploring the construction of integrated care and the formation of county medical communities to improve county-level medical services in 2017. The Fujian-Sanming model has attracted extensive attention during this process. In this study, we used Sanming as the example, and the data envelopment analysis (DEA) model and Malmquist index were used to analyze the effectiveness and summarize the construction experience of advanced areas. We discuss the overall medical and health service efficiency in the county as it relates to the county medical community policy.</p><p><strong>Method: </strong>We referenced previous studies to select three input indicators and two output indicators that represent the medical and health services in the county. We then conducted an efficiency analysis of 10 counties in Sanming from both the static and dynamic perspectives using a combination of the traditional DEA-BCC model and DEA-Malmquist index. In addition, we measured the efficiency of the primary medical institutions in Sanming.</p><p><strong>Results: </strong>The average technical efficiency (TE), pure technical efficiency (PTE), and scale efficiency (SE) improved from 0.814, 0.907, and 0.898 to 0.917, 0.965, and 0.948, respectively, from 2017 to 2022. These improvements reflected a better use of resources, improved management practices, and more appropriate allocations of the service capacity. The DEA-Malmquist index results showed that the total factor productivity (TFP) of the medical and health services in the counties of Sanming was 0.957 from 2017 to 2022, slightly lower than 1. This result indicated that resource allocation had not yet reached an optimal state, possibly due to the COVID-19 pandemic impact. In addition, disparities between counties persisted, and the primary healthcare institutions generally exhibited lower efficiency levels.</p><p><strong>Conclusions: </strong>The results of this study demonstrated that under the county medical community policy, the efficiency of medical and healthcare services in Sanming improved. The study results suggest that future efforts should focus on strengthening county hospitals, enhancing the capacity of primary care institutions, and promoting coordinated development across counties. The Sanming model offers valuable insights, particularly for developing countries, regarding strategies to advance integrated care reform.</p>","PeriodicalId":46936,"journal":{"name":"Health Economics Review","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13595665/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148340539","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"经济学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reducing breast cancer recurrences with CDK4/6 inhibitor treatment of HR-positive, HER2-negative early stage breast cancer from a societal perspective.","authors":"Stephanie Reitzinger, Thomas Czypionka, Gabriel Rinnerthaler","doi":"10.1186/s13561-026-00809-w","DOIUrl":"10.1186/s13561-026-00809-w","url":null,"abstract":"<p><strong>Background: </strong>Hormone receptor (HR)-positive and HER2 receptor-negative breast cancer accounts for two thirds of all breast cancers. In case of distant recurrences, a non-curative strategy is usually implied. Hence, treatment options for early stage breast cancer to prevent metastatic recurrences are desirable. The aim of our study was to estimate the societal effect of reducing breast cancer recurrences by treating Austrian patients with stage II and III HR + /HER2 - breast cancer with CDK 4/6 inhibitors as an adjuvant treatment.</p><p><strong>Methods: </strong>We developed a 7-state Markov model with a time horizon of 30 years from a societal perspective and compared the follow-up direct and indirect costs between patients who were treated with and without a CDK4/6 inhibitor in the early stage. We distinguished between anatomic stage II/III and nodal status negative/positive subcohorts of patients. We used transition probabilities derived from the clinical trial NATALEE. Based on local registry data, we derived the Austrian female target population and matched it with the target patients of NATALEE.</p><p><strong>Results: </strong>We identified 1,340 Austrian target patients diagnosed in 2022. In the anatomical stage II and stage III subcohorts, approx. 735 and 236 metastatic cancer years could be saved over 30 years, respectively. We estimated that, thereby, societal costs of about €52 million (discount rate = 3%) associated with cancer recurrences could be saved in the 30-year follow-up. Almost 75% of cost savings resulted from reductions in health care costs and about 25% from productivity gains (incl. unpaid work).</p><p><strong>Conclusions: </strong>Treating stage II and III HR + HER2 - breast cancer patients with CDK4/6 inhibitors in Austria reduces metastatic breast cancer recurrences, resulting in considerable medical benefits and economic effects.</p>","PeriodicalId":46936,"journal":{"name":"Health Economics Review","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13595678/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148340563","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"经济学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Formal and informal financial inclusion and its impact on health: empirical evidence from South Africa.","authors":"Lwando Mjacu, Vikela Liso Sithole, Palesa Makhetha-Kosi","doi":"10.1186/s13561-026-00810-3","DOIUrl":"10.1186/s13561-026-00810-3","url":null,"abstract":"<p><strong>Background: </strong>The ability to secure high quality healthcare and access at an affordable cost for the entire population is the principal health objective of many countries on the path to the attainment of Sustainable Development Goals (SDGs). This study addresses the critical, yet understudied, impact of formal and informal financial inclusion on health, directly supporting the objectives of SDG 3 (Good Health and Well-being).</p><p><strong>Methods: </strong>The study employs and modifies South Africa's National Income Dynamic Study microdata by combining all five waves to create panel data. A random effects ordered probit model is used since it is possibly the best approach for panel data on self-rated health outcomes as it takes into consideration the existence of an additional normally distributed cross-section error term which captures individual specific effects.</p><p><strong>Results: </strong>Results for formal financial inclusion dummy variable are statistically significant and positive, suggesting that individuals with access to formal financial services such as savings and credit have a higher probability of reporting better health outcomes. However, results for informal financial inclusion dummy variable are statistically significant and negative, implying that higher reliance on informal finance like stokvel savings and mashonisa credit shifts individuals toward the lower outcomes of health.</p><p><strong>Conclusion: </strong>Given the mixed outcomes of the impact of formal and informal financial inclusion on health, this study recommends policies that could integrate informal savings and credit into the formal digital economy and address structural barriers that limit the effectiveness and efficiency of the financial system.</p>","PeriodicalId":46936,"journal":{"name":"Health Economics Review","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13543536/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148279115","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"经济学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Real-time healthcare staffing optimization using fuzzy logic and genetic algorithm.","authors":"Balveer Saini, Dinesh Kumar Saini","doi":"10.1186/s13561-026-00806-z","DOIUrl":"10.1186/s13561-026-00806-z","url":null,"abstract":"<p><strong>Background: </strong>The field of medical research has advanced remarkably in the twenty-first century; however, the healthcare industry faces significant challenges, including rising costs, increasing demand, and constrained resources. These factors make effective management of healthcare systems crucial. Efficient systems are those that better use resources, deliver services, and reduce waiting times.</p><p><strong>Methods: </strong>The paper addresses the issue of healthcare staffing optimization by presenting a new model, the Fuzzy-Based Time-Dependent Multi-Server, Multi-Queueing (FB-TDMS-MQ) System. This model combines fuzzy logic with a genetic algorithm (GA) to optimize staffing levels based on real-time patient needs and service times, a capability that traditional fixed-staffing models cannot accommodate. To demonstrate the model's application in a real-world setting, a case study is conducted at Dhanwantri Hospital and Research Centre (DHRC) in Jaipur, a multi-specialty hospital. The model's performance is evaluated using simulation studies.</p><p><strong>Results: </strong>The implementation of the FB-TDMS-MQ model led to significant improvements. Simulation studies demonstrated that the average \"peak-hour waiting time\" drastically reduced by 72.73% after incorporating fuzzy logic modifications. Additionally, the GA optimization approach resulted in a 50.2% reduction in average waiting time, showing superior performance compared to static staffing models. The model's sensitivity analysis proved highly useful in the case of unexpected events in the healthcare system.</p><p><strong>Conclusions: </strong>The FB-TDMS-MQ model proved to be adaptable and effective in real-time healthcare staffing optimization. It demonstrated a reduction in waiting times and the ability to handle unexpected events, showing that the model could optimize staffing dynamically in fast-changing healthcare environments. The real-time control and modifications provided by the model have significant potential for improving hospital management and staff allocation.</p>","PeriodicalId":46936,"journal":{"name":"Health Economics Review","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13508271/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148265789","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"经济学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Thailand's health financing resilience during COVID-19: leveraging universal health coverage to tackle the pandemic.","authors":"Aungsumalee Pholpark, Sikarn Issarachaiyos, Ilada Sooknark, Orawan Prasitsiriphon, Praewa Kulatnam, Papada Ranron, Sirithorn Khositchaiwat, Piya Hanvoravongchai, Yot Teerawattananon","doi":"10.1186/s13561-026-00808-x","DOIUrl":"10.1186/s13561-026-00808-x","url":null,"abstract":"<p><strong>Background: </strong>The COVID-19 pandemic constituted a public health emergency in Thailand from March 2020 to October 2022, testing the resilience of the health financing system. This study establishes an analytical framework to examine Thailand's public health financing arrangements and their subsequent impacts on public hospital financial reserves during this crisis.</p><p><strong>Methods: </strong>This mixed-methods study developed an analytical framework to examine Thailand's public health financing response. The study analyzed COVID-19 public health expenditure data (Fiscal Years (FY) 2020-2022) and financial data from 866 Ministry of Public Health hospitals (FY 2015-2022) using descriptive statistics and trend analysis. These quantitative findings were integrated with a thematic analysis of 21 key informant interviews.</p><p><strong>Results: </strong>Thailand enhanced health financing resilience through adaptive revenue mobilization and flexible resource allocation. Between FY 2020 and 2022, the government expanded fiscal space by mobilizing approximately US$13.78 billion via the Emergency Loan Decrees, Central Budget, and Social Security Fund. Universal Health Coverage (UHC) mechanisms expanded service coverage and expedited provider reimbursement. During delayed loan disbursements, public hospitals used internal financial reserves to bridge funding gaps and maintain service continuity. Consequently, net hospital reserves increased substantially by the pandemic's end compared to pre-pandemic baselines.</p><p><strong>Conclusions: </strong>Thailand strategically leveraged its UHC system and mobilized emergency and pre-existing public funds to secure fiscal space and maintain system resilience. However, temporary funding influxes may mask localized resource strains on hospital financial reserves. To enhance future resilience, Thailand should establish a dedicated health emergency reserve fund, streamline extra-budgetary mechanisms, and adopt flexible procurement regulations.</p>","PeriodicalId":46936,"journal":{"name":"Health Economics Review","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13595722/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148265753","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"经济学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}