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01.12.2018 | Research | Ausgabe 1/2018 Open Access

Cost Effectiveness and Resource Allocation 1/2018

Evaluating the health system financing of the Eastern Mediterranean Region (EMR) countries using Grey Relation Analysis and Shannon Entropy

Cost Effectiveness and Resource Allocation > Ausgabe 1/2018
Kimia Pourmohammadi, Payam Shojaei, Hamed Rahimi, Peivand Bastani
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Electronic supplementary material

The online version of this article (https://​doi.​org/​10.​1186/​s12962-018-0151-6) contains supplementary material, which is available to authorized users.



Sufficient and sustainable financing of the health system is essential for improving the health of the community. The health systems financing of the EMR countries is facing the challenge. Assessment and ranking of healthcare financing can help identify and resolve some challenges of health systems. So, the aim of this study is to evaluate and rank the condition of the health sector financing in the EMR countries.


This study was a cross-sectional study. The data was of secondary type, extracted from the official WHO and World Bank data. The six healthcare financing indicators in a 10-year interval (2005–2014) in 19 EMR countries analyzed using Grey Relation Analysis and Shannon Entropy.


On average, the countries in the EMR region spent 4.87% of their GDP on the health sector. Jordan and Qatar allocated the highest (8.313) and the lowest (2.293) percentages of their GDP to the health sector, respectively. The results showed That Qatar was in a better condition than other EMR countries during 2005–2014 in terms of the health system financing and earned the first rank. After that, the UAE and Kuwait were ranked second and third.


There is a lot of inequality among the EMR countries in terms of health financing. However, our findings confirmed that only increasing the total health expenditure in a country would not improve its financing status compared to other countries, but it also depends on financing methods.
Additional file 1: Table S1. Normalized performance matrix and reference sequence. Table S2. The difference matrix. Table S3. The grey relational coefficients.
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