Designing a minimum-cost health system for countrywide universal coverage

Effectiveness of health systems is achieved through universal coverage, while efficiency is reached by minimizing the cost of delivery. This study presents a novel analysis for designing national health systems, considering workforce, equipment, global costs and accessibility in different geographical contexts. Designed to be a medium- and long-term strategic planning tool, our model offers a practical solution by assessing projected health infrastructure and resources and evaluates health requirements using data from the OECD, the World Bank, OpenStreetMap, and national health statistics. Applied to Brazil, Finland, and France, the analysis is in line with UN Sustainable Development Goal 3.8 and the WHO’s Human Resources for Health strategy. The findings suggest that regions with dispersed populations, such as central-western Brazil and northern Finland, would benefit from small hospitals, clinics and health centers. Brazil should hire more health professionals, purchase more radiotherapy equipment and invest $7.95 billion in logistics to reduce patient travel times, particularly for the 1,222 municipalities most affected by low accessibility. Finland would benefit from additional hospital beds and CT scanners, while France could benefit from a more centralized health care model, with municipalities providing all levels of care. France should also invest more in nursing staff and mammography equipment.