ArticleBMJ open2026
Trends in health workforce and spending growth in four countries, 2000-2023: a longitudinal analysis.
Article in BMJ open, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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.
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.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesTo assess how 21st-century healthcare spending grew in four high-income countries, to examine the extent to which healthcare workforce growth is associated with spending growth and to compare how the composition of the healthcare workforce has changed over time and across countries. We hypothesised that (1) healthcare spending growth patterns in the USA, the UK, Australia and Canada would be similar after the Great Recession; (2) healthcare workforce growth would be positively correlated with healthcare spending growth across countries and (3) growth in the healthcare workforce would be driven by non-physician and non-nursing workers across all countries.
designRetrospective, descriptive cross-national longitudinal analysis.
settingNational-level data from four high-income countries (Australia, Canada, the UK, the USA) using 2023 Economic Co-operation and Development Health Statistics and the WHO's National Health Workforce Accounts Data Portal.
participantsAustralia, Canada, the UK, the USA.
interventionsNone. PRIMARY AND SECONDARY OUTCOME MEASURES: Primary outcomes were healthcare spending growth as a per cent of gross domestic product and per capita, and healthcare workers as a per cent of total civilian employment and per capita. Secondary outcomes included growth and composition of practising physicians, nursing personnel and 'other' healthcare workers.
resultsHealthcare employment and healthcare spending grew in all four countries over the study period. Healthcare employment accounted for over 90% of the variance in health spending over time in the USA, Canada and Australia and over 80% in the UK. Spearman correlation coefficients between employment and spending levels were 0.94 for Australia, 0.92 for Canada and 0.90 for both the UK and USA. While the USA led in healthcare spending growth prior to the Great Recession, its post-recession spending growth rate was similar to peer countries. Physicians and nurses collectively comprised less than one-third of total healthcare employment, with 'other' healthcare workers constituting the majority and a fast-growing component.
conclusionsResults were consistent with all three hypotheses. Healthcare workforce growth was strongly correlated with spending growth within each country, reinforcing the centrality of labour force dynamics to healthcare spending trends.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
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.