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The remaining 35.5% of funding is from private health insurance plans provided by larger employers to their employees and from personal out-of-pocket expenditures. All healthcare is provided by the Ministry of Health at 100% to all citizens aged 62 or older. By comparison, the average across the CEMA Region is for 77% of funding for healthcare to come from public funds and 23% to come from private sources. 


Since the year 2000, most nations in the region have seen a steady increase in the amount of Total Health Expenditure as a Percentage of (GDP). According to a report from Hospital Care CEMA, these expenditures have increased on average across the CEMA Region from 7.6% of GDP in 2000 to 9.5% of GDP in 2015. This is an increase of 25.4% over the period. These numbers are lower for Healthlandia, where Total Health Expenditure as a Percentage of GDP grew from 8.2% in 2000 to 9.1%, a growth rate of only 11% for the period.  


Healthlandia is a medium-sized nation with a population of 57.2 million people. The economy is primarily industrial and services-driven with approximately 21.3% of Gross Domestic Product (GDP) from agriculture. Healthlandia has experienced relatively flat economic growth of 0.5% to 1.1% GDP for the last ten years. Despite these economic conditions, the country continues to enjoy a good standard of living with a stable government and a strong education system. 

Like most CEMA Region countries, Healthlandia is experiencing an evolution in its healthcare environment. Funding for healthcare in Healthlandia comes from a combination of public and private funding. Approximately 64.5% of funding for healthcare comes from public funds administered through the Ministry of Health. 



There has been a comparable reduction in the number of Hospital Beds Per 100,000 Inhabitants. The CEMA average has declined since 2000 from 590 beds per 100,000 inhabitants to 465 beds per 100,000 inhabitants.  This represents a 21.2% decline in the number of hospital beds. The actual numbers range from Egypt with 244 beds/100,000 inhabitants to United Arab Emirates with 813 beds/100,000 inhabitants. The numbers for Healthlandia fall in the middle of this range. Healthlandia has seen a drop from 653 beds/100,000 to 572 beds/100,000. While this is only a decline of 12.4%, it still reflects a reduction in hospital capacity at a time when the aging population of Healthlandia would indicate increased needs for capacity in the near future.


Healthlandia have seen a reduction in the average length of stay for patients. In fact, Healthlandia has seen a great reduction in length of stay than the average for the rest of the CEMA region. The reduction in Average Length of Stay for the CEMA region is 12.9%, from 7.2 days to 6.3 days.  The reduction in Average Length of Stay from 2000 to 2015 in Healthlandia was 19.4%, from 6.7 days to 5.4 days. 


Finally, in the area of staffing, Healthlandia has seen an increase in the number of care givers over the last 15 years. The average number of Practicing Physicians per 100,000 Inhabitants in the region has increased from 303.8 to 366.4 since 2000.  That is an increase of 20.6%. Over the same period, the number of Practicing Physicians per 100,000 Inhabitants in Healthlandia has increased from 389.0 to 457.0, an increase of 17.4%. While this growth rate was slightly less than the CEMA average, Healthlandia had more physicians per the population than the CEMA average in 2000 and has almost 100 more physicians per 100,000 people than the CEMA region now. There is a fairly significant range across the countries of CEMA, from a low of 279 physicians/100,000 people in Ghana to 510 physicians/100,000 people in Poland.


The situation is similar for nurses. The latest CEMA region average for Practicing Nurses per 100,000 Inhabitants is 953.1, up from 814.8 in 2000. This reflects an increase of 17.0%. The Healthlandia number is 965.0, up from 874.0, an increase of 10.4%.  As with physicians, this rate is below the CEMA average, but the number of nurses per 100,000 people is higher than the CEMA average. The situation for caregivers is that Healthlandia has a good ratio of physicians and nurses to their population. The high number of positions for practicing nurses and physicians has created a high demand for caregivers and a good job market. It also makes it more difficult for Healthlandian health care providers to retain their highly valuable doctors and nurses.


For the past several years, hospitals throughout Healthlandia have been required to act more efficiently and to increase productivity. In most cases, increased performance is clearly visible. Yet, most of Healthlandia’s healthcare systems are facing conflicting trends: short and long-term impacts of an economic and financial crisis; increasing demand of an ever-expanding and ageing population; increasing request and availability of technological innovations; new roles, new skills and new responsibilities for the health workforce.  To adapt to this situation, the role of hospitals is further evolving. Most health systems in Healthlandia have already moved from a traditional hospital-centric and doctor-centric pattern of care to integrated models in which hospitals work closely with primary care, community care and home care.

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