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Open research questions in Global Health Care Issues

57 unresolved questions extracted from the limitations and future-work sections of 1,357 Global Health Care Issues papers in our library. Each links back to the study that raised it.

What the literature leaves open

  • A unique health identifier is currently being rolled out in Ireland [56] but the timeline for inclusion within national hospital data is not yet known.

    Estimating national prevalence of life-limiting conditions amongst infants, children, and adolescents using administrative hospital data in the absence of a unique health identifier; evidence from Ireland · 2026 · DOI

  • Future research should address substitution effects, income dynamics, and long- term changes in healthcare costs and consumer behaviour. Fourth, the model does not account for non- combustible tobacco products, such as smokeless tobacco or electronic nico- tine delivery systems. Evidence on substitution away from bidis to these products is limited, and modelling substitution would require credible cross- price elasticity estimates and disease risk relationships linking changes in use of these products to health outcomes, which are not well established in the bidi literature.

    Projected impact of bidi tax reform on health and economic outcomes in India: a modelling study · 2026 · DOI

  • Future studies should explore in detail the effects of infrastructure expansion on the healthcare system in Kuwait, including utilisation and health indicators. Moreover, an indepth analysis of the health workforce’s status, demands, and production must be conducted to assist policymakers in making informed decisions about health workers. Additionally, a comprehensive health economic analysis of the K healthcare system is essential. Finally, the causes and consequences of the discrepancy the health services between Kuwaitis and non-Kuwaitis should be examined.

    Health system development and utilisation in Kuwait, 2011–2022: insights from national healthcare data · 2026 · DOI

  • Despite its empirical contributions, this study is subject to certain limitations. First, the analysis relies on secondary, aggregate level data which may mask intra regional and socio-economic heterogeneity in healthy life expectancy outcomes. As a result, varia- tions across states, income groups, gender and rural urban populations could not be fully captured. Second, while the study incorporates key socioeconomic determinants, data con- straints restrict the inclusion of certain qualitative and institutional factors such as Dar et al. Discover Public Health (2026) 23:1100 Page 16 of 19 healthcare quality, governance effectiveness, lifestyle behaviour’s and environmental conditions, which are known to significantly influence health outcomes.

    Exploring the dynamics of income growth and healthy life expectancy in India · 2026 · DOI

  • Although the findings should be interpreted with caution, this study has several strengths: we updated cross-country evidence on the preventive-care expenditure share; we estimated the slope rate as well. The slope of this share provides complementary information on how the relative prioritization of preventive care evolved over time, because the slope rate is less susceptible to confounding factors such as baseline health risk and the socio-epidemiological characteristics of the population. To our knowledge, this is the first study that examines hypothetical associations between specific types of health systems and different patterns in the relative allocation of health expenditure to preventive care, according to Bohm’s classification for health systems. Regression analyses of each of the three dimensions - regulation, financing, provision - on the percentage of preventive expenditure may represent independent sources of action and interest in health policy, although these dimensions are structurally related and should not be interpreted as independent causal effects. Furthermore, although it was not possible to carry out the analysis on all OECD countries, this study conducts a comparative analysis on a large sample of European countries, allowing the phenomenon to be explored in different health and economic contexts. A limitation of this study is that this analysis has been conducted at the aggregate preventive-care expenditure category level, and has not disaggregated expenditures by specific types (primary, secondary, this potentially could conceal variations among countries on the content and range of services offered to citizens/patients. Consequently, analysis at the national level must be conducted to assist policymakers in making betterinformed decisions about preventive care.

    Does the health system model shape prevention? Evidence from 22 OECD countries (2004–2023) · 2026 · DOI

  • This study, using WHO HEAT, reveals substantial age-based inequities in infectious disease DALYs across Sierra Leone, Burkina Faso, Chad, and CAR, with infants bear- ing a disproportionately heavy burden (35- to 70-fold higher than the least-affected age groups) and older adults showing elevated rates. CAR’s unique young adult burden emphasizing context-specific challenges. Future research should disaggregate by spe- cific pathogens and incorporate intersectional inequities (sex, geography, socioeconomic status) to refine intervention targeting. Longitudinal studies can evaluate the impact of age-targeted policies, while mixed-methods approaches can elucidate systemic barri- ers like financing or access gaps. Embedding age-stratified equity analyses in national surveillance systems will support Sustainable Development Goals and universal health coverage. Integration of age-stratified equity monitoring into national health informa- tion systems is essential for achieving the Sustainable Development Goals and universal health coverage. This study demonstrates the feasibility and policy relevance of applying standardized inequality metrics to DALY data in African settings and provides a tem- plate for similar analyses across other regions and health conditions. Through prioritiz- ing neonatal care, child health packages, and life-course interventions, policymakers can address these inequities, ensuring equitable and effective health outcomes across diverse African contexts. 6.1 Contributions to the literature • Provides one of the first cross-national assessments of age-stratified infectious disease DALY burdens in sub-Saharan Africa using WHO HEAT metrics. • Demonstrates that infants and older adults bear the heaviest age-related disease burden, revealing inequities often hidden in national averages. • Offers a practical framework for integrating age-specific equity indicators into national health monitoring systems. • Highlights how applying standardized WHO equity tools can guide fairer allocation of health resources across age groups.

    Age stratified disability adjusted life year burden from infectious diseases in four African countries for equity oriented health planning · 2026 · DOI

  • This study’s strength lies in its use of WHO GHE and HEAT methodologies, enabling robust, comparable age-stratified DALY analyses across four African nations. The application of validated inequality metrics (R, PAR, PAF) enhances rigor and policy relevance. Publicly available data ensures transparency and replicability. Bai-Sesay et al. Discover Public Health (2026) 23:791 Page 13 of 16 However, several limitations must be considered. First, the cross-sectional design limits trend analysis and causal inference; we cannot determine whether observed age patterns are stable or changing over time. Second, the modeled nature of WHO GHE estimates introduces potential systematic biases that vary by country context. In CAR and Chad particularly, ongoing conflict and political instability disrupt vital registration systems, health service utilization, and disease surveillance. This likely results in greater uncertainty in estimates (reflected in wider confidence intervals) and potential underestimation of true burden in conflictaffected areas where health system access is compromised. Conversely, in more stable settings with better health infrastructure (parts of Burkina Faso and Sierra Leone), estimates may be more reliable. These contextual factors particularly active conflict, internal displacement, and health system fragmentation in CAR and Chad should be considered when interpreting cross-country comparisons. Conversely, in settings with better health infrastructure (parts of Burkina Faso and Sierra Leone), estimates may be more reliable. These contextual factors should be considered when interpreting cross-country comparisons. Third, the analysis did not include sensitivity analyses around key modeling assumptions due to constraints of the HEAT platform, which uses fixed 19-category age stratification. While we examined whether broader age groupings (e.g., < 5 years, 5–14 years, 15–49 years, 50 + years) would alter substantive conclusions about which age groups bear the highest burden, formal sensitivity analyses using alternative age bands are not possible within HEAT. Similarly, we could not assess the impact of different reference populations or counterfactual scenarios on PAR estimates, as these are pre-defined in HEAT algorithms. Future research using microdata or alternative platforms should incorporate such sensitivity analyses to evaluate robustness of findings to methodological choices. Fourth, the aggregated ‘infectious and parasitic diseases’ category obscures specific disease contributions (e.g., malaria vs. HIV vs. lower respiratory infections), limiting intervention specificity. Different diseases have different age patterns and pooling them may mask important heterogeneity. Fifth, the analysis excludes intersecting inequities (e.g., age by sex, socioeconomic status, or geography), which may amplify age-based disparities. For example, female infants in poor households may face compounded disadvantage not captured here. While WHO GHE provides sex-disaggregated estimates, our decision to combine sexes was intentional to maintain focus on age-based patterns. Future research should conduct formal intersectional analyses to examine whether the age patterns observed here differ by sex, particularly for diseases with sex-specific risk factors. Sixth, the wide confidence intervals in infancy and older adulthood, particularly in CAR and Sierra Leone reflect underlying data uncertainty and limited empirical data in these age groups, a common challenge in modeled estimates for low-resource settings. Despite these limitations, the study’s comprehensive approach and application of HEAT metrics provide a valuable framework for equity-focused health planning in resource-constrained settings, highlighting critical age-specific vulnerabilities. Bai-Sesay et al.

    Age stratified disability adjusted life year burden from infectious diseases in four African countries for equity oriented health planning · 2026 · DOI

  • in IGR response Based on the findings, several policy and practice recommendations emerge. First, hospitals should be granted greater financial autonomy within clear regulatory frameworks to enable flexible and timely use to service needs. Second, of accountability and transparency mechanisms such as routine audits, digital revenue tracking, and public financial reporting should be strengthened to reduce inefficiencies and build trust. Third, targeted capacitybuilding programmes for hospital administrators and finance officers are needed revenue management and planning. Fourth, a defined portion of IGR should be consistently reinvested in infrastructure, equipment, and performance monitoring systems. Finally, future research should adopt longitudinal and multistate designs using objective financial and performance data to improve to International Journal of Scientific Reports | June 2026 | Vol 12 | Issue 6 Page 230 Ativie D et al. Int J Sci Rep. 2026 Jun;12(6):221-232 deepen understanding of how IGR influences healthcare outcomes over time.

    Internally generated revenue and perceived performance of public healthcare institutions in Edo state, Nigeria: a cross-sectional analytical study · 2026 · DOI

  • The strong association between IGR and perceived healthcare performance in the simple regression model (r=0.742; B=0.657; R2=0.551; p<0.001) is broadly consistent with related findings in the Nigerian fiscal literature. Alabi et al and Ayebaenemi et al documented similar positive associations between financial resource development mobilization outcomes.18,19 subnational and the regression the multivariate Importantly, (Table 8) strengthens confidence in this finding by demonstrating that the IGR–performance association persists after adjusting for gender, age, education, experience, hospital type, and professional category (Adjusted B=0.521, β=0.611, p<0.001). The adjusted R2 of 0.592 represents a meaningful improvement over the unadjusted model (R2=0.551), and IGR retained the largest standardized effect size among all predictors in the model.

    Internally generated revenue and perceived performance of public healthcare institutions in Edo state, Nigeria: a cross-sectional analytical study · 2026 · DOI

  • Despite the well-known negative economic and social consequences of high OOP spending, there is limited research that thoroughly examines the interplay between key economic variables such as economic growth, population growth, and government healthcare expenditure (GHE) as a proportion of general government expenditure (GGE) in shaping OOP healthcare spending.

    Out-of-Pocket Health Expenditure and Associated Factors: Insights From National Health Accounts (NHA) Using Panel Data Analysis · 2024 · DOI

  • Abstract The uncertainty that the COVID-19 pandemic has brought demonstrates that income redistribution and traditional debt relief mechanisms are insufficient to meet public spending needs, mitigate external debt, and comply with the UN’s Sustainable Development Goals (SDGs), which aim to reduce multilateral debt to sustainable levels.

    Fiscal Space Policies for Sustainable Development and Debt Relief: Empirical Analysis in West African Countries · 2022 · DOI

  • CONTEXT: While the World Health Organization (WHO) has established guidance on COVID-19 surveillance, little is known about implementation of these guidelines in federations, which fragment authority across multiple levels of government.

    Who Counts Where? COVID-19 Surveillance in Federal Countries · 2021 · DOI

  • Research limitations/implications The limitations of the present study included paying attention to one package (evolution in the treatment sector) of three health packages to assess EHCF, as well as the lack of similar national and international evidence in implementation framework.

    Analysis of the Health Sector Evolution Plan from the perspective of equity in healthcare financing: a multiple streams model · 2018 · DOI

  • It is necessary to identify all IM causes and relationships which have not been studied, including the effect of social factors causing inequality between inhabitants of urban and rural areas: - The aim of the study was to determine the IM rate and the main death causes and their differences between rural and urban areas in Latvia (2000-2010).

    Territorial Differences in Infant Mortality in Latvia in the First Decade of the Third Millennium · 2015 · DOI

  • However, the direction of causality remains unclear: do economic resources influence health, or vice versa? Exploiting a new source of exogenous income variation, this study examines the impact of the Alaska Permanent Fund Dividend ( APFD ) on newborns' health outcomes.

    MONEY TRANSFER AND BIRTH WEIGHT: EVIDENCE FROM THE ALASKA PERMANENT FUND DIVIDEND · 2015 · DOI

  • Second, the IMF claims to have relaxed strict spending requirements in response to the 2008-9 financial crisis, but there is no evidence supporting this claim, and some limited evidence from the Center for Economic Policy Research contradicting it.

    An Evaluation of the International Monetary Fund's Claims about Public Health · 2010 · DOI

  • While our evidence on whether MHO membership is associated with higher probability of hospitalization is inconclusive, we find that MHO membership offers protection against the potentially catastrophic expenditures related to hospitalization.

    Impact of mutual health organizations: evidence from West Africa · 2008 · DOI

  • This prediction is based on the observation that policy research tends to rely on available national data, that currently these data provide limited information about health status, and that there appears to be insufficient interest and resources to broaden data collection or to develop methods that incorporate a broad spectrum of health outcomes (e.

    Measurement of Health Status in the 1990s · 1990 · DOI

  • This implies that still-dominant approaches that treat health as an isolated sector remain insufficient, as health policies cannot be effective unless they are articu- lated with mechanisms of financial protection, income security, and the preservation of human capital.

    Evidence on the health–poverty cycle and its mechanisms in low- and middle-income countries · 2026 · DOI

  • In addition to people who remained uninsured because they did not meet the conditions for obtaining insurance, there may also have been people who were insufficiently aware of their health insurance entitlements.

    Limity v přístupu ke zdravotní péči a zdravotnímu pojištění pro migranty a uprchlíky v USA a České republice · 2025 · DOI

  • Many of the general indicators such as health care expenditures, mortality, life expectancy are insufficient in comparing the national healthcare systems, because they explain only a small amount of diversity caused by socio-economic factors.

    The impact of healthcare availability on the amenable mortality: Country study · 2019 · DOI

  • Therefore due to injuries the EMRO countries are lacking high behind their healthcare budget resulting overall shortage of healthcare delivery.

    Economic Burden of Injuries argues for more Safe Communities in Iran and EMRO · 2019 · DOI

  • While it is well documented that severe consumer indebtedness can lead to mental and physical health problems including unhealthy coping mechanisms, the pathways from poor health to financial strain is still an understudied area.

    Poor health as a precursor to consumer debt distress in South Africa · 2019 · DOI

  • Although much has been written about the human resource crisis in the health sector, labour economic frameworks have seldom been applied to analyse the situation and little is known or understood about the operation of labour markets in low- and middle-income countries.

    Why do health labour market forces matter? · 2013 · DOI

  • BACKGROUND: Despite its importance for the planning of future treatment needs and an optimised allocation of health care resources, only little is known about socio-economic inequalities in denture-wearing by late middle-aged and elderly generations.

    Income‐related inequalities in denture‐wearing by Europeans aged 50 and above · 2011 · DOI

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57 open questions have been extracted from the limitations and future-work passages of 1,357 Global Health Care Issues papers in our library. Each one below links back to the study that raised it, so you can read the original claim in context.

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