Abstract
OBJECTIVES: The rapid growth of health expenditure has always been the focus of health policy. This study aims to project health expenditure in Shanghai and to carry out policy simulations on the impact of chronic disease prevention programs on health costs in the Healthy Shanghai Initiative. METHODS: Based on the Shanghai health accounts, component-based model was used to project Shanghai total health expenditure of 2020-2035, and the policy stimulation was implemented. RESULTS: In 2020-2035, Shanghai's health expenditure is expected to grow continually, the proportion of total health expenditure in GDP will exceed 8.00% in 2023, reach 9.00% in 2025, and 10.03% in 2035. The proportion of current health expenditure in GDP will exceed 8.00% in 2024 and reach 9.55% in 2035. The chronic disease prevention plan help saving the medical expenditure of respiratory diseases,endocrine system diseases, and circulatory system diseases, accounting 3.28% to 10.58% of total health expenditure. CONCLUSIONS: The sustainability of health financing in Shanghai is facing challenges under the new normal of economy. It is necessary to promote the prevention and control of chronic diseases and strengthen cost control from both the supply and demand sides.