This research cluster examines how health systems across Asia can deliver value, equity, and sustainability amid rapid demographic and technological change. We study issues including the productivity of health spending, innovations such as AI and robotics for healthy aging, the evolving mix of public and private roles in health service delivery, and the socioeconomic roots of health disparities. Our goal is to produce evidence-based recommendations to guide policies promoting healthier, more resilient, and more inclusive societies.
Lead Researcher
Karen Eggleston
Director, Asia Health Policy Program, Shorenstein Asia-Pacific Research Center Senior Fellow, Freeman Spogli Institute for International Studies Stanford University
Value of Healthcare Spending and Productivity of Health Systems
Measuring the productivity of healthcare spending and prevention investments for population health
Research Focus
This series of collaborative projects examines how effectively healthcare spending translates into better population health outcomes by linking expenditures on specific conditions to corresponding population health outcomes for those conditions. Building on previous work focused on diabetes, the research aims to measure the productivity of healthcare spending and prevention investments for population health.
The findings help policymakers navigate trade-offs in allocating resources across health services as demographics and healthcare technologies change over time. For example, In collaboration with colleagues at Korea University, Seoul National University, and Harvard, Eggleston is developing a “health satellite account” for South Korea to measure productivity growth in medical care.
Researcher
Karen Eggleston, Director, Asia Health Policy Program, APARC
Robotics, AI, digital health, and age-friendly economies
Research Focus
New technologies and organizational innovations hold great promise for sustaining healthcare systems strained by demographic change and high-value but high-cost medical advances. As East Asia leads the world in population aging, this research investigates how its societies adopt and adapt to emerging technologies, design incentives, and adjust their workforces to support older adults. The findings help inform policy in the region and offer lessons for other countries facing the demographic transition and rising health care spending.
In collaboration with partners across Asia and former students (for example, participants in the 2025 seminar AI-Enabled Global Public Health), this research project empirically examines several technologies used in care for older adults, including ones that leverage AI and robotics. One study, AI for Aging-in-Place (AI4AIP), in partnership with colleagues from Stanford’s Computer Science Department and the School of Medicine, as well as others from Seoul National University, explores AI tools for early detection of cognitive decline. Another project collects data to study the increasing adoption of kaigo robots in Japanese long-term care. The findings help understand whether robots help mitigate workforce shortages and enable caregivers to focus more on the "human touch" activities that improve quality of life for frail older adults.
Researcher
Karen Eggleston, Director, Asia Health Policy Program, APARC
Understanding the dynamics of hybrid health systems in Asia
Research Focus
This project examines several aspects of mixed-ownership health service delivery in Asia from a comparative perspective, focusing on how health systems manage the interplay between public and private service providers. Building on previous research on public and private roles in the health sector, it explores topics including the roles of nonprofits and NGOs — for example, why they are central to some systems but absent in others; how government payors interact with private innovators, such as inventors of digital health and AI tools, or biopharmaceutical firms, to support access to health services and improve population health; and how low- and middle-income countries adapt their mixed-ownership health service delivery systems — for instance, using both government-owned and private hospitals serving patients — as they attempt to achieve and sustain universal health coverage.
The research integrates conceptual, historical, and applied approaches. A major component is a book project with Mai Phuong Nguyen (MD, MSc, PhD), a 2024-25 postdoctoral fellow with the Asia Health Policy Program and former official with the Vietnam Ministry of Health. This volume will offer the first comprehensive, mixed-methods analysis of Vietnam’s private health sector, combining national household survey data, in-depth interviews with policymakers and providers, and comparison with the evolution of health service ecosystems in other countries.
Researcher
Karen Eggleston, Director, Asia Health Policy Program, APARC
Health Disparities and the Economics of the Health Gradient
Investigating the roots and evolution of health inequality in Asia
Research Focus
Vulnerable populations with low levels of education or income often tend to experience poorer health and premature mortality. This pattern, known as the health gradient, has been documented in many settings. Less is known, however, about its historical emergence, the relationship to intergenerational transmission of health and socioeconomic status, and how demographic and technological changes shape the geospatial distribution of health disparities.
This research track studies the economics of the health gradient through diverse Asian datasets and international collaborations. One collaborative project with economists Carol Shiue and Wolfgang Keller, both of the University of Colorado at Boulder, uses a century of Chinese genealogical data to show how the “survival dividend” from intergenerational transmission of good health profoundly shaped family fortunes in a historical era when few health technologies existed to protect even rich families from ubiquitous morbidity and premature mortality from infectious disease and injury.
Another project, with demographer K.S. James, traces how the health gradient has evolved across India’s states over the past half-century. Moreover, in partnership with Stanford Professor of Epidemiology and Population Health Michelle Williams and colleagues in China, including at Hainan Medical University and Tsinghua University, related work examines chronic disease outcomes in China's different regions.
Researcher
Karen Eggleston, Director, Asia Health Policy Program, APARC
