Cross-national disparities in non-communicable disease: a universal health coverage-based service coverage index perspective, 2000–2021

Background: Universal Health Coverage (UHC) has garnered widespread attention since its inception. However, systematic research on the dynamic inequalities in UHC for Non-Communicable Diseases (NCDs) remains limited. Methods: This study investigates the inequalities in UHC for NCDs from 2000 to 2021, offering evidence and policy recommendations to promote global UHC equality for NCDs. Using multiple cross-national datasets, this study examines UHC inequality for NCDs. A panel fixed-effects model analyzes influencing factors, while the Gini coefficient and other indices measure inequality. The Oaxaca-Blinder decomposition method identifies sources of inequality differences among countries with varying income levels. Results: < 0.01), whereas physician density per 10,000 people did not (95% CI included 0). The interaction between resource endowment and return rate contributed up to 53.26% to the SCI gap compared to low-income countries. Higher national income reduced the contribution of resource endowment differences to the SCI gap while increasing interaction effects. Differences between high-income and upper-middle-income countries were mainly due to health expenditure (contribution rate 116.67%), while those with low-income countries were driven by medical resource endowment. Conclusion: This study reveals long-term trends in UHC for NCDs amid global economic disparities and proposes measures to enhance UHC levels and promote equality in different regions.