Global Patterns and Evolution of Health Expenditure-Level Inequality in Major Countries between 2010 and 2021

Abstract

: This study evaluated the global pattern and evolution of health expenditure levels among major countries from 2010 to 2021. Five health-expenditure indicators were extracted for 184 countries. A unified entropy-weighted Health Expenditure Level Index (HELI) was constructed based on five indicators. Gini coefficients, Theil indices, paired Wilcoxon tests, Spearman rank correlation, and Kruskal-Wallis tests were used to assess temporal change and regional inequality. The results show that the mean HELI increased by 4.97 points from 2010 to 2021 (Wilcoxon P≤0.001), indicating that health expenditure levels increased overall between 2010 and 2021. The Gini coefficient and Theil index decreased from 2010 to 2021, indicating that between-country inequality in health expenditure levels narrowed, but the degree of differences remains significant. Countries with low HELI values need to improve both per-capita expenditure capacity and the public-financing priority assigned to health.