Abstract
The aim of the article is to compare health system outcomes in the BRICS countries, assess the trends of their changes in 2000−2017, and verify whether they are in any way correlated with the economic context. The indicators considered were: nominal and per capita current health expenditure, government health expenditure, gross domestic product (GDP) per capita, GDP growth, unemployment, inflation, and composition of GDP. The study covered five countries of the BRICS group over a period of 18 years. We decided to characterize countries covered with a dataset of selected indicators describing population health status, namely: life expectancy at birth, level of immunization, infant mortality rate, maternal mortality ratio, and tuberculosis case detection rate. We constructed a unified synthetic measure depicting the performance of individual health systems in terms of their outcomes with a single numerical value. Descriptive statistical analysis of quantitative traits consisted of the arithmetic mean (xsr), standard deviation (SD), and, where needed, the median. The normality of the distribution of variables was tested with the Shapiro–Wilk test. Spearman's rho and Kendall tau rank coefficients were used for correlation analysis between measures. The correlation analyses have been supplemented with factor analysis. We found that the best results in terms of health care system performance were recorded in Russia, China, and Brazil. India and South Africa are noticeably worse. However, the entire group performs visibly worse than the developed countries. The health system outcomes appeared to correlate on a statistically significant scale with health expenditures per capita, governments involvement in health expenditures, GDP per capita, and industry share in GDP; however, these correlations are relatively weak, with the highest strength in the case of government's involvement in health expenditures and GDP per capita. Due to weak correlation with economic background, other factors may play a role in determining health system outcomes in BRICS countries. More research should be recommended to find them and determine to what extent and how exactly they affect health system outcomes.
Highlights
BRICS is a term used to describe a group of countries once considered to have similar characteristics of emerging economies
The correlation is negative; interestingly, the strongest correlation in both cases appears to be not with those indicators that are related to health expenditures, but rather in the case of general level of economic development illustrated by gross domestic product (GDP) per capita
In the case of life expectancy, we observed a shift toward general economic indicators, with statistically significant, still relatively weak, correlation with all of them, with the exception of GDP growth and industry share in GDP
Summary
BRICS is a term used to describe a group of countries once considered to have similar characteristics of emerging economies. The term has been created from the first letters of their names, namely: B—Brazil, R—Russia, I—India, C—China, S—South Africa. Together, these countries account for 40% of the world’s population and 25% of the world’s gross domestic product (GDP). The first use of this term took place in 2001 in a paper published by J. O’Neill, not yet including the Republic of South Africa. The term BRIC has become widely used in financial markets, shaping the way investors, financiers, and decision makers view emerging markets [1]
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