Abstract
BackgroundIn times of austerity, the availability of econometric health knowledge assists policy-makers in understanding and balancing health expenditure with health care plans within fiscal constraints. The objective of this study is to explore whether the health workforce supply of the public health care sector, population number, and utilization of inpatient care significantly contribute to total health expenditure.MethodsThe dependent variable is the total health expenditure (THE) in Serbia from the years 2003 to 2011. The independent variables are the number of health workers employed in the public health care sector, population number, and inpatient care discharges per 100 population. The statistical analyses include the quadratic interpolation method, natural logarithm and differentiation, and multiple linear regression analyses. The level of significance is set at P < 0.05.ResultsThe regression model captures 90 % of all variations of observed dependent variables (adjusted R square), and the model is significant (P < 0.001). Total health expenditure increased by 1.21 standard deviations, with an increase in health workforce growth rate by 1 standard deviation. Furthermore, this rate decreased by 1.12 standard deviations, with an increase in (negative) population growth rate by 1 standard deviation. Finally, the growth rate increased by 0.38 standard deviation, with an increase of the growth rate of inpatient care discharges per 100 population by 1 standard deviation (P < 0.001).ConclusionsStudy results demonstrate that the government has been making an effort to control strongly health budget growth. Exploring causality relationships between health expenditure and health workforce is important for countries that are trying to consolidate their public health finances and achieve universal health coverage at the same time.Electronic supplementary materialThe online version of this article (doi:10.1186/s12960-016-0146-3) contains supplementary material, which is available to authorized users.
Highlights
In times of austerity, the availability of econometric health knowledge assists policy-makers in understanding and balancing health expenditure with health care plans within fiscal constraints
Study variables and econometric model presentation This study focus was on three drivers of the total health expenditure (THE) in Serbia from 2003 to 2011
The results of this study have identified the short-term causality relationship between total health expenditure and health workers, population number, and inpatient care discharges based on their direct contribution to the total health expenditure
Summary
The availability of econometric health knowledge assists policy-makers in understanding and balancing health expenditure with health care plans within fiscal constraints. Based on the Organisation for Economic Co-operation and Development (OECD) data for the 35-year period, the lag between the average growth rate of health spending per capita and growth of gross domestic product (GDP) per capita is rising in many European countries. Drivers of health spending are forces at the demand and the supply side of the framework of the health care provision [7]. They have been analyzed in a numerous cross-sectional and time series studies over the last 50 years [8]. The most-studied drivers on the supply side are health care policy and institutional framework (resources, financing, insurance, provision services, and products) and technology (diffusion of specific therapy and equipment, information communication technology) [2, 7, 11, 13, 14, 19]
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