Abstract
BackgroundHuman resources are consistently cited as a leading contributor to health care costs; however the availability of internationally comparable data on health worker earnings for all countries is a challenge for estimating the costs of health care services. This paper describes an econometric model using cross sectional earnings data from the International Labour Organization (ILO) that the World Health Organizations (WHO)-Choosing Interventions that are Cost-effective programme (CHOICE) has used to prepare estimates of health worker earnings (in 2010 USD) for all WHO member states.MethodsThe ILO data contained 324 observations of earnings data across 4 skill levels for 193 countries. Using this data, along with the assumption that data were missing not at random, we used a Heckman two stage selection model to estimate earning data for each of the 4 skill levels for all WHO member states.ResultsIt was possible to develop a prediction model for health worker earnings for all countries for which GDP data was available. Health worker earnings vary both within country due to skill level, as well as across countries. As a multiple of GDP per capita, earnings show a negative correlation with GDP—that is lower income countries pay their health workers relatively more than higher income countries.ConclusionsLimited data on health worker earnings is a limiting factor in estimating the costs of global health programmes. It is hoped that these estimates will support robust health care intervention costings and projections of resources needs over the Sustainable Development Goal period.
Highlights
Human resources are consistently cited as a leading contributor to health care costs; the availability of internationally comparable data on health worker earnings for all countries is a challenge for estimating the costs of health care services
Human resources are consistently cited as a leading contributor to health care costs, responsible for approximately 57% of total expenditure on health according to unpublished ‘raw’ country data in the Global Health Expenditure Database (GHED) [5, 6] In published studies, human resources have been found to account for between 42% and 46% of total health expenditure [7, 8]
Wages data were retrieved from the (ILO) wage estimate database [12] for a variety of job titles across countries, and classified into four skill levels according to ISCO-08 Major Groups [13] (Table 1, The dataset used in the analysis contains, for each country, (a) a pooled data point of monthly wages for the 4 skill levels, (b) GDP per capita for 2010, (c) country income level and (d) World Health Organizations (WHO) region
Summary
Human resources are consistently cited as a leading contributor to health care costs; the availability of internationally comparable data on health worker earnings for all countries is a challenge for estimating the costs of health care services. This paper describes an econometric model using cross sectional earnings data from the International Labour Organization (ILO) that the World Health Organizations (WHO)-Choosing Interventions that are Cost-effective programme (CHOICE) has used to prepare estimates of health worker earnings (in 2010 USD) for all WHO member states. A background paper for the recent High Level Commission on Health Employment and Economic Growth showed projections indicating an estimated shortfall of approximately 18 million health workers by 2030 [3] Such projections are an important contributor to the policy dialogue; important concerns about the related increase in domestic and external financial resources needed to. Editorial: role of Health Economic Data in policy making and reimbursement of new medical technologies.
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