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<p>Despite advances in cardiovascular medicine, research output remains concentrated in high-income countries, creating global disparities. The relationship between national health expenditure, research investment, and cardiovascular research productivity requires examination to inform strategies for reducing research inequities. We analyzed cardiovascular research output in ten leading countries (2000–2020) using SCImago, UNESCO, OECD, and WHO data. Health expenditure (CHE) and research expenditure (RDE) were measured as GDP percentages. We calculated medical research proportions and Relative Specialization Index (RSI). Spearman correlations and regression models assessed expenditure-publication relationships. Between 2000 and 2020, the proportion of medical research within total scientific output declined globally, but cardiovascular publications increased from 2.1 to 5.7% of total output. Cardiovascular output was strongly correlated with medical publication volume (<i>r</i> &gt; 0.91) and positively associated with CHE across most countries. Associations with RDE were positive in the global model but varied by country. Multivariate models showed that adding the share of medical research improved model fit in Japan, Canada, and Italy. Incorporating the RSI further enhanced explanatory power in countries like the UK, France, and Netherlands. RSI values revealed differences in national priorities: Italy and the Netherlands had the highest specialization in CV research, while China showed the lowest. Together, these findings highlight the importance of both funding and specialization in shaping CV research trajectories. National cardiovascular research output depends on health expenditure, RDE investment, and strategic specialization rather than funding alone. Targeted investments and international collaboration are essential for addressing research disparities and reducing cardiovascular disease burden.</p>

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The economic basis of global cardiovascular research: analysing the impact of research & development and health expenditure

  • 期刊论文

  • 发表日期：

    2025年9月12日

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  • Alfredo Verastegui,
  • Oliver Antonio Gómez-Gutiérrez,
  • Lexie Pérez-Huerta,
  • Regina Castaneda,
  • Mario Alejandro Fabiani

摘要

Despite advances in cardiovascular medicine, research output remains concentrated in high-income countries, creating global disparities. The relationship between national health expenditure, research investment, and cardiovascular research productivity requires examination to inform strategies for reducing research inequities. We analyzed cardiovascular research output in ten leading countries (2000–2020) using SCImago, UNESCO, OECD, and WHO data. Health expenditure (CHE) and research expenditure (RDE) were measured as GDP percentages. We calculated medical research proportions and Relative Specialization Index (RSI). Spearman correlations and regression models assessed expenditure-publication relationships. Between 2000 and 2020, the proportion of medical research within total scientific output declined globally, but cardiovascular publications increased from 2.1 to 5.7% of total output. Cardiovascular output was strongly correlated with medical publication volume (r > 0.91) and positively associated with CHE across most countries. Associations with RDE were positive in the global model but varied by country. Multivariate models showed that adding the share of medical research improved model fit in Japan, Canada, and Italy. Incorporating the RSI further enhanced explanatory power in countries like the UK, France, and Netherlands. RSI values revealed differences in national priorities: Italy and the Netherlands had the highest specialization in CV research, while China showed the lowest. Together, these findings highlight the importance of both funding and specialization in shaping CV research trajectories. National cardiovascular research output depends on health expenditure, RDE investment, and strategic specialization rather than funding alone. Targeted investments and international collaboration are essential for addressing research disparities and reducing cardiovascular disease burden.