Evidence map›Paper›PMID 34912557›Full record

ReviewJournal of global health2021

Universal health care in middle-income countries: Lessons from four countries.

Alexander S Preker, Daniel Cotlear, Soonman Kwon, Rifat Atun, Carlos Avila

Open access · goldAbstract readReview
In one paragraph

Review in Journal of global health, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
17citing papers in PubMed, 2 pooled it
6.1field-weighted citation impact, top 3% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

17 citing papers in PubMed, 2 syntheses or guidelines pooled it, 45 citations in OpenAlex.

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  7. Digital pulse: Social media reaction to South Africa's National Health Insurance implementation.African journal of primary health care & family medicine · 2025
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors at 4 institutions in 2 countries.

Alexander S PrekerHealth Investment & Financing, New York, New York, USA.
Daniel CotlearPalladium, Washington, D.C., USA.
Soonman KwonGraduate School of Public Health, Department of Health Policy and Management, Professor and Former Dean, Seoul National University, Seoul, South Korea.
Rifat AtunT.H. Chan School of Public Health, Department of Global Health and Population, Director of Global Health Systems Cluster/Professor of Global Health Systems, Harvard University, Boston, Massachusetts, USA.
Carlos AvilaPalladium, London, UK.
Changes in Health Care Financing & Organization · USFutures Group (United States) · USHarvard University · USSeoul National University · KR

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundIn this paper, we review lessons learned about Universal Health Coverage (UHC) in middle-income countries, with specific reference to achievements and challenges observed during recent years in four middle-income to upper-middle-income countries - Mexico, Turkey, The Republic of Korea and Ukraine. Three of these countries - Mexico, the Republic of Korea, Turkey are members of the Organization for Economic Cooperation and Development (OECD). Ukraine has aspired to join Western institutions like the OECD since its independence in 1991.

methodsThe research included a combination of cross-sectional and longitudinal reviews of both statistical and contextual data, available from both published sources and available "grey literature" reports.

resultsBased on the research, we conclude the following. First, reaching UHC is achievable in middle-income and upper-middle-income countries. It is not an unattainable goal reserved for upper income countries. Second, successes and failures are evident both in the case of countries that pursue a contributory health insurance path to UHC and those that pursue a core government funding path. Third, the devil is often in the detail. De jur

conclusionsWe caution against the pitfalls of over-attribution from drawing too strong conclusion from individual longitudinal country experiences ("over-determinism") and over-generalization from broad sweeping cross-sectional statistical analysis ("reductionism"). Every country is different and needs to find its own path towards UHC considering their contextual specificities, learning from the achievements and failures of others, but not try to copy their experiences.

Indexed as

Developing CountriesUniversal Health CareCross-Sectional StudiesHumansIncomeUniversal Health Insurance

Identifiers

PMID34912557
PMCPMC8645236
OpenAlexW4200516776

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.