Determinants Of Health Expenditure Research Articles

Determinants of Health Expenditures: A Case of High Populated Asian Countries

This study investigates the determinants of health expenditure in high-populated Asian countries, focusing on Pakistan and India, as well as the short and long-term effects of health expenditure on economic growth. The main objectives are as; to identify the determinants of health expenditure in Pakistan and India, and to analyze the short-run determinants of health expenditure on economic growth in high-populated Asian countries. Panel data from 2001 to 2019 sourced from the World Development Indicator (WDI) is utilized. The study employs various variables, including health expenditure, population, urban population, unemployment, GDP growth, and school enrollment. Estimations are conducted using the Autoregressive Distributed Lag (ARDL) approach. Findings reveal a significant long-run relationship between health expenditure and population, GDP growth, school enrollment, and unemployment across Asian countries, while the urban population exhibits insignificance. In the short run, population and school enrollment demonstrate a significant relationship with health expenditure, whereas urban population, unemployment, and GDP growth exhibit insignificance. These findings contribute to understanding the dynamics of health expenditure and its impact on economic growth in high-populated Asian countries, informing policymakers on effective strategies for healthcare investment and economic development.

Determinants of Health Expenditure during Extreme Climate Events: An Ex-post Analysis of Households in Rural Odisha of India

This study is an ex-post analysis of household health expenditure for rural India in the presence of climate shock. Primary data from Odisha state, located on the east coast of India, are collected for empirical analysis. We have also used information from focus group discussions at the village level and the primary data. Further, an adaptive response measure is created to understand household spending behaviour on health better. Econometric techniques such as regression and propensity score matching explain sample households’ ex-post-health spending behaviour. Our findings indicate that mitigation and adaptation strategies must be heterogeneous among villages classified as near or far from the coast. Social status matters in the health spending behaviour of households. Hence, a particular focus must be given to socially backward castes or classes in designing health policies and information at the state and national levels. JEL Codes: D31, I18, Q54, Q56

Testing the Baumol Cost Disease Hypothesis in the Health Sector of Sub-Saharan Africa

ABSTRACT: This paper takes a closer look at the well-researched topic of the determinants of health expenditure. However, as an improvement over previous studies, the current study tested the cost disease hypothesis in the healthcare sector in sub–Saharan Africa to assess the sector’s productivity. The cross-sectional units in the current study comprise forty-eight sub-Saharan African countries; spanning the period 2000 to 2020. The data was sourced from two main sources; namely, World Development Indicators and the ILOSTAT . The main variable of interest ( Baumol variable) was constructed using a combination of various variables. The methodology relied on several econometric techniques i.e., fixed effect, random effects and two-stage least square estimations. The growth rate of gross fixed capital formation was used to control for the potential reverse causation between the growth rate of health expenditure per capita and the Baumol variable. Based on the empirical results from the various estimations, it appears that there is some evidence of the presence of the cost disease in the healthcare sector of sub–Saharan Africa. This effect became stronger when the endogeneity in the model was taken into consideration. However, this effect became greatly diminished after the growth rate of GDP per capita and the growth of the price level were introduced in the model. The statistical significance of the growth rate of these variables reinforces their important roles in the determination of the levels and growth in health expenditure. The confirmation of the basic Baumol model in determining the growth of health expenditure suggests that the growth of health expenditure in sub-Saharan Africa might be a result of health workers’ wages outstripping productivity in the sector. This suggests that the inelastic nature of the demand for health care is the main driver of the growth of health expenditure; thus might not be reflected in improved health care. Furthermore, policymakers need to consider changes in the price level as it may deflate the real value of the budgetary amount.

Determinants of Health Expenditure Among the Informal Workers of India: Is It Always Catastrophic?

The Indian labour market is dominated by informal workers. Out-of-pocket healthcare payments are the principal source of healthcare financing for those workers. This article will try to investigate the determinants of health expenditures across heterogeneous groups of informal workers in India based on the 68th round of National Sample Survey data on Employment and Unemployment for 2011–2012. Across different types of informal workers, mean health expenditure has been highest among ‘employees of informal sectors’. The determining factors for the health expenditure are social group, household head and the number of dependencies. It is also found that health expenditure is not always catastrophic among informal workers. The result obtained is that health expenditure has been catastrophic for almost 30% of informal workers across various heterogeneous groups. Using the probit model, the influencing factors responsible for the incidence of catastrophic health expenditure are age and sex of the household head, the number of senior citizens in the family, possession of assets and expenditure on fuel and electricity.

Determinants of health expenditures: income level countries analysis

A global health phenomenon, in particular, there is a significant difference between health spending in developed and developing countries. This study focuses on modeling health expenditures in short-term and long-term schemes in three categories of countries: low-income countries, moderate-income, and high income from 2000 to 2019. The health expenditure scheme is analyzed using the panel data regression approach as a model of determinants of health expenditures. The results showed relatively significant differences between the determinants of health expenditure variables, including populations variable in low-middle-income countries. The positive and significant influences on middle-income countries, whereas high-income countries have a negative and significant influence. As for the overall GDP variable, low-income, lower-middle, and advanced countries negatively and significantly influence health care. For middle-income countries have a positive and significant influence on health spending.

Health expenditure in households with disabled people

The major goal of a household is to maximise the satisfaction of the needs of its members through the consumption of appropriate goods and services. One of the main needs, especially in households with people with disabilities, is health protection, which entails comparatively large financial outlays. The aim of this study is to recognise regularities in health expenditure of households with disabled people, to assess the significance of health expenditure in the structure of these households' expenditure, and to attempt to identify the determinants of health expenditure. The study is based on data obtained from two editions of Statistics Poland's household budget survey, performed in 2009 and in 2019. The study presents an analysis of the diversification of the level and structure of the health-related expenditure of households in Poland. The power-exponential model was used to identify the determinants of these expenses. The analysis shows that households with disabled people have a lower disposable income and, at the same time, incur higher health expenses. Health-related expenditure in households with disabled people is mainly determined by: age, level of income, the fact whether a household member/members is/are a person/s with a, significant degree of disability, and source of income.

The Real Effect of Aging Population on Health Expenditures in OECD Countries

Background: Most studies in the 1980s and 1990s conclude that population aging is not a major cause of health spending. Advanced countries have been attracting attention as them with the extension of life expectancy, coupled with low income growth but increasing health expenditures in the last 20 years. Whether population aging contributes to health care spending is still an issue that needs to be reexamined.BRMethods: We verify the determinants of health expenditures for 24 Organization for Economic Cooperation and Development (OECD) countries during 1970-2016. To do this, we conducted the three-stage least squares (3SLS) panel regression method to alleviate the endogenous relationship among healthcare expenditures, income, and population aging. The results were compared with those derived by the panel regression method.BRResults: The results for 24 OECD countries show that population aging turned to be negative in the 3SLS analysis, but insignificant in the panel regression. Income was a strongly positive driver (income elasticity=1.74) on 3SLS, and a rather positive (income elasticity=0.58) on panel analysis.BRConclusion: Age did not significantly affect health expenditures in the advanced countries. The reality is that the income thought to cause population aging contributes to higher health expenditure, although advanced countries have experienced decades of sluggish economy.

Discovering the Socio-Economic, and Environmental factors of Health Expenditure: Case Study of Regions

The aim of the current study is to reduce the burden of the government’s spending on health expenditure and also determine the factors which contribute to health spending. For the present examination, the data was collected from World Bank, covering the time span from 2000 to 2016 for regions i.e., East Asia & Pacific (EA&PR), Europe & Central Asia (E&CAR), Middle East & North Africa (ME&NAR), South Asia (SAR), and Sub-Saharan Africa (SSAR). The key goal of this work is to examine the important macroeconomics determinants of health expenditure (MDHE). The outcome of the study is concluded that all the determinants have significantly influenced the health expenditures across the regions. Moreover, the CO2 emission, personal remittances, urbanization, unemployment, and crude birth rate have a twin impact on well-being spending. Whereas trade openness and gross domestic product have an important and adverse impact on health expenditure, literacy, life expectancy at birth, and population age 65 and above have a significant positive impact on health expenditure.

Determinants of China\u2019s health expenditure growth: based on Baumol\u2019s cost disease theory

BackgroundDuring the past four decades, China’s total health expenditure and health expenditure per capita have both experienced a dramatic increase in growth rate. This study aims to explore the determinants of health expenditure growth and the influencing mechanism of these determinants, with considering the productivity efficiency represented by Baumol’s cost disease.MethodsBased on the longitudinal data of 30 provincial-level administrative regions in China, from 2010 to 2017, multi-variates regression models were constructed to assess the determinants, including demography, income, Baumol’s cost disease, technology, their effects on per capital total health expenditure growth and the three financing sources: government, society and out-of-pocket health expenditure. Moreover, the Spatial Durbin Model was used to analyze the influence mechanism of determinants on the increase of health expenditure across provinces.ResultsAmong 210 province-year growth rate observations, all of the average growth rate of total health expenditure (12.78%) was much higher than the growth rate of per capita GDP (8.06%). According to the statistical analysis, we found that:(1) Income and Baumol’s cost disease have a significant positive impact on health expenditure growth(P < 0.01). The impact of technical factors on government health expenditure is significantly positive. (2) The determinants affected the growth of health costs in different regions variably; the eastern region is mainly driven by Baumol’s cost disease and technical factors, while the central and western regions are mainly affected by income factors and Baumol’s cost disease. (3) There is a significant spatial spillover effect on the health expenditure growth between regions. The income factor and Baumol’s cost disease have a positive impact on the health expenditure growth in its own region as well as in other regions.ConclusionsIncome and Baumol’s cost disease significantly contributed to China health expenditure growth. The health expenditure determinants showed spatial varies effect and space spillover effect on the neighborhood areas. Which indicates that a reasonable salary system should be contrasted to meet the changeling from the Baumol’s cost disease, and the necessity of equity in health resource allocation among provinces in China.

Determinants of health expenditures of female-headed households in urban areas of Iran

Determinants of health expenditures of female-headed households in urban areas of Iran

Determinants of health expenditure from global perspective: A panel data analysis

A prominent enhancement in health expenditure is a severe apprehension for the whole world because of the increasing cost of health. Consideration of various aspects that are playing role in the increase of health expenditure need to be considered. Health is one of the significant parts of the world, therefore, improvement in health status has become the main objective of the nations and a top leading goal of the Sustainable Development Goals (SDGs) and Millennium Development Goals (MDGs). The main goal of the present study is to investigate the worldwide, and income-based categorized countries (developed, developing, and transitional countries) macroeconomic determinants of health expenditure. The aim is to estimate the health expenditures, and its impact on demographic, economic, and environmental determinants. For the empirical analysis, the data was retrieved from the World Bank, covering the time span 2000-2016 for developed, developing, and transitional countries. The results of the study concluded that macroeconomic variables significantly affect health expenditures. Moreover, personal remittances have a dual effect on health expenditure, i.e. a positive impact on transitional economies, while a negative impact on developing economies. In the same way, CO2 emission has a negative impact on worldwide, developed countries.

Demographic Correlates of Catastrophic Health Expenditure: An Assessment from Indian Household Survey Data

This study finds out the importance of socio-economic, demographic and health-care-related factors in determining catastrophic health expenditure (CHE) of a household and how they influence its health care expenditure. Rising out-of-pocket (OOP) expenses for health financing in developing countries with different methodologies to assess the associated factors with CHE has been documented. This study contributes to the existing literature from the methodological viewpoint. In the two-step approach, at the first step, the probability of a household incurring CHE has been estimated and in the second the importance of the determinants of health expenditure is examined. An analysis is done to find out whether the situation varies across the quintiles. The database is the 71st round of social consumption of health survey conducted by the NSSO during January-June 2014. Health expenditure in household budgets is the highest among the poorest quintile. Treating a non-communicable disease and opting for private facilities are expensive. Relaxing the budget constraint by financing the healthcare from sources like contributions from friends/relatives and sale of assets lead to high spending on healthcare. The study recommends health expenditure protection schemes for the vulnerable groups, etc.

Determinants of health expenditures during the last year of life of the Mexican population aged 50 or over.

During the last year of life of the elderly health deteriorates the most, thus becoming the period of time when needs of medical services, personal care requirements and related costs are at highest. Using the Mexican Health and Aging Study, differences by sex in the determinants for out-of-pocket health expenditures during the last year of life of people 50 and over are discussed. Three levels of out-of-pocket expenses disbursement are contemplated: none, medium-low, and high. Controlling by sociodemographic variables, findings suggest that the number of hospital nights is the main determinant of health expenses, even above those related to diseases that are regarded as main causes of death. This fact impacts both out-of-pocket expences and the costs for medical institution. It is another issue in the over-hauling of the public health system.

A Researchon The Determinants of Health Expenditures; Example of EU And Turkey

Sağlık harcamaları; insan sağlığının korunması, geliştirilmesi, devamlılığının sağlanması ve var olan hastalıkların tedavisi için yapılan tüm harcamaları kapsamaktadır. Sağlık harcamaları toplumun sağlık düzeyini yükseltirken beşeri sermayeye yaptığı katkılarla da kalkınmayı hızlandırmaktadır. Bu çalışmada 19 Avrupa Birliği ülkesi ve Türkiye’de sağlık harcamalarına etki eden faktörler 1995-2018 dönemi verileri kullanılarak incelenmiştir. Çalışmada, kişi başı sağlık harcaması, kişi başı GSYİH, 65 yaş ve üstü nüfus, doğumda beklenen yaşam süresi ve kişi başına karbondioksit emisyonu değişkenler olarak kullanılmıştır. Analizler için Westerlund (2006) panel eş bütünleşme testinden yararlanılmıştır. Buna göre, 19 Avrupa Birliği ülkesi ve Türkiye’de kişi başı gelirin sağlık harcamaları üzerindeki etkisinin istatistiksel olarak anlamlı olduğu; ancak 65 yaş ve üstü nüfus, karbondioksit emisyonu ve doğuşta yaşam beklentisi değişkenlerinin eş bütünleşme katsayılarının istatistiksel olarak anlamsız olduğu tespit edilmiştir. Elde edilen bulgular, söz konusu 20 ülkede kişi başı gelirde %1’lik bir artışın kişi başı sağlık harcamalarını yaklaşık %0.11 arttırdığını göstermektedir. Ayrıca, 20 ülkede sağlık harcamalarını belirlemede kullanılan her bir değişkenin etkisinin ülkeden ülkeye farklılık gösterdiği tahmin edilirken, sağlık harcamaları ile değişkenler arasında uzun dönemli bir ilişki olduğu bulgusu elde edilmiştir.

The socioeconomic determinants of health expenditure in OECD: An examination on panel data

ABSTRACT In recent years, there have been critical improvements and changes in health systems and health care. These issues have caused a dramatic increase in the cost of health care and health expenditure all around the world. It is, however, not sustainable. Therefore, governments have been seeking ways to reduce the costs of services in the health sector. In this context, it was aimed to figure out the predictors of health expenditure in OECD and a panel data analysis covering the period of 2000–2017 was used to achieve the main objective of the study. It was found that income (β: 1.331) and education (β: 0.062) were the most important factors affecting health expenditure in OECD (p < 0.05) and also, that unemployment rate and dependency ratio had not statically significant effect on health expenditure (p > 0.05). Additionally, it was seen that health expenditure in OECD had increased for years. In this context, it can be concluded that health expenditure will continue to rise. Thus, it is suggested that the following studies should focus on the efficiency and the effectiveness of health expenditure for the sustainability.

Investigating the Determinants of Healthcare Expenditures in Different Healthcare Systems

Background: The rapid growth of health expenditures is a great concern for governments at present. Objectives: The present study aimed to determine the main factors affecting health care expenditures in countries with different types of the healthcare system. Methods: We studied 25 countries with different types of healthcare systems, including national health insurance, traditional sickness insurance, national health services, and mixed systems. Health expenditure per capita was estimated as a function of health care price, out-of-pocket health expenditure, income, and other exogenous factors. A random-effects model was selected instead of a fixed-effects model based on the Hausman test to assess the effect of different factors on health expenditures. Results: Income and health care price had the greatest impacts on health expenditures in countries with national health insurance and countries with mixed health care systems, respectively. Among the variables, mortality and life expectancy had the greatest impacts on health expenditure in all types of the healthcare system. The out-of-pocket health expenditure had the most and least impacts on health expenditures in countries with mixed health care systems and countries with national health insurance systems, respectively. Conclusions: The study showed that health condition and out-of-pocket health expenditure are the most important determinants of health expenditures in all health care systems, especially the mixed health care system.

A Dictator's Gift: Dominant party regimes and health expenditures.

A country's health expenditure significantly improves its population health status. This study aims to examine the determinants of health expenditure in dictatorships. We designed a mixed methods research approach. First, we used panel data from 1995 to 2014 covering 99 countries (n = 1488). Fixed effects regression models were fitted to determine how different types of authoritarianism relate to health expenditure. Second, we chose Ivory Coast to apply the synthetic control methods for a case study. We constructed a synthetic Ivory Coast, combining other dominant party regimes to resemble the values of health expenditure predictors for Ivory Coast prior to a regime change from a dominant party system to personalist dictatorships in 2000. We found that dominant party autocracies, compared with non-dominant party regimes, increased health expenditure (% of GDP) (1.36 percentage point increase, CI = 0.59-2.12). The marginal effect, however, decreased when an autocrat in this type of regime held elections (0.86 percentage point decrease, CI = 0.20-1.52). Furthermore, we found the difference in health expenditure between the actual Ivory Coast and its synthetic version starts to grow following the regime change in 2000 (in 2000, actual: 6.00%, synthetic: 6.04%; in 2001, actual: 4.85%, synthetic: 5.99%), suggesting a pronounced negative effect of the government transition on Ivory Coast health expenditure. The findings suggest that different forms of dictatorship are associated with varying levels of health expenditure. Where dictatorships rely on popular support, as is the case with dominant party dictatorships, health expenditure is generally greater.

The Analysis of Health Expenditure Determinates in Selected Asian Countries

This study examines the effect of environmental externalities on health expenditure, and identifies the determinants of health expenditure in a panel of 35 Asian countries for the period of 1995-2010. The study uses static panel data analysis. The results suggest that carbon monoxide emissions and particulate matter concentration (PM10) have a positive relationship with per capita health expenditure. Evidence also suggests that a change in health expenditure per capita in Asian countries is mainly explained by the change in population aged more than 65 years and above and country’s income affect the health expenditure allocation. The finding of this paper have important implication on the Asian countries policymakers in archiving the sustainability of national development especially on health related expenditure

The Impact of Health Expenditures on Health Outcomes in Sub-Saharan Africa

This article investigates the core macroeconomic and social determinants of health expenditures as well as the effect of health expenditures on select critical health outcomes (life expectancy, under-five mortality and maternal mortality) in recent years in sub-Saharan Africa (SSA). The study utilizes data on 46 sub-Saharan African countries covering the period 2000–2015. The results indicate that gross domestic product (GDP) per capita, physician per 1,000 population, population aged above 65 years and under-five mortality rate are the most significant determinants of health expenditure in the region. Overall, health expenditure is less income-elastic, not rising as a portion of GDP in wealthier nations. Health expenditure was found to exert a positive and significant impact on all three health outcomes. Specifically, a 1 percent increase in health expenditure per capita resulted in a 0.5 percent reduction in under-five mortality and a 0.35 percent fall in maternal mortality, while improving life expectancy by 0.06 percent. The results suggest that steady increases in health expenditures over time have the tendency to improve health outcomes in SSA.

Empirical evidence on the long and short run determinants of health expenditure in the Arab world

This paper empirically examines the determinants of health care spending for 18 Arab world countries for the period 1995–2015 by using recently developed panel cointegration techniques. We conducted the same estimations for 3 sub-samples, namely high-income, upper-middle- and lower-middle-income countries to reduce the heterogeneity among them. Our empirical findings demonstrate that health care expenditure and its determinants are non-stationary, and revealed the existence of a long run relationship among variables. Furthermore, the estimation results suggest that income is not the only driver of health expenditure in the Arab world countries in the long run. Other variables such as medical progress and ageing population are also playing an important role in the increase of health care expenditure with major policy implications for the region in the long run. Furthermore, the results support that health care expenditure is a necessity good for the three income groups. Finally, the Pairwise Dumitrescu-Hurlin panel causality test shows evidence of a bidirectional causal relationship between health care expenditures and income for the full sample, as well as for the groups income.