Effect Of Health Care Expenditure Research Articles

Effect of Health Care Expenditures on Child Mortality Rates: A Case Study of Sub-Saharan Africa

In the process of trying to reduce the risk of child mortality across the world, financing is crucial in the delivery of positive results. This research was carried to evaluate how healthcare expenditures affect child mortality rates in Sub-Saharan Africa (SSA). Some researchers on this topic have claimed healthcare expenditure has an influence on child mortality while others differ with the ideas. This research divided healthcare expenditure into public, private, and total healthcare expenditures and analyzed them differently on how they affect child mortality. Additionally, it employed panel data for 32 SSA states instead of 45 states due to data availability. The data utilized was from the World Bank’s Development Indicators from 2005 to 2016. The data for under-five and infant mortalities were used to represent child mortality rates. The result from the panel linear regression showed that healthcare expenditure has a significant effect on child mortality rates. The elasticity estimation results indicate public and total expenditures are more significant and have high effects on child mortality rates than private expenditure. The findings from the study suggest that healthcare expenditure reduces child mortality rates but after some time to deliver the right as financing is a time dimensional variable. The study recommends that the healthcare expenditure in the health sector in SSA should be continuous and done in effective ways to reduce child mortality rates.

Health care expenditure and health outcomes in sub‐Saharan African countries

AbstractThis paper studies the effect of health care expenditure on health outcomes in sub‐Saharan Africa (SSA) using data from 1995 to 2018 for 45 countries. It uses fixed effects and generalized methods of moments estimation approaches for the analysis. The paper measures health care expenditure using three proxies: namely, total health care expenditure per capita, public health care expenditure to gross domestic product (GDP), and private health care expenditure to total health expenditure. Health outcomes are measured by child health outcomes (under‐5 mortality rate) and life expectancy. The results show that increase in health care expenditure as measured by total health care expenditure per capita and public health care expenditure to GDP leads to decline in under‐5 mortality rates. The results also show that total health care expenditure per capita leads to an increase in life expectancy. The study therefore recommends that governments in SSA increase budget allocations towards the health care sector to achieve better health outcomes.

The effects of health expenditure on infant mortality in sub-Saharan Africa: evidence from panel data analysis

IntroductionAlthough health expenditure in sub-Saharan African countries is the lowest compared with other regions in the world, most African countries have improved their budget allocations to health care over the past 15 years. The majority of health care sources in sub-Saharan Africa are private and largely involve out-of-pocket expenditure, which may prevent healthcare access. Access to healthcare is a known predictor of infant mortality. Therefore the objective of this study is to determine the impact of health care expenditure on infant mortality in sub-Saharan Africa.MethodsThe study used panel data from World Bank Development Indictors (WDI) from 2000 to 2015 covering 46 countries in sub-Saharan Africa. The random effects model was selected over the fixed effects model based on the Hausman test to assess the effect of health care expenditure on infant and neonatal mortality.ResultsBoth public and external health care spending showed a significant negative association with infant and neonatal mortality. However, private health expenditure was not significantly associated with either infant or neonatal mortality. In this study, private expenditure includes funds from households, corporations and non-profit organizations. Public expenditure include domestic revenue as internal transfers and grants, transfers, subsidies to voluntary health insurance beneficiaries, non-profit institutions serving households or enterprise financing schemes as well as compulsory prepayment and social health insurance contributions. External health expenditure is composed of direct foreign transfers and foreign transfers distributed by government encompassing all financial inflows into the national health system from outside the country.ConclusionHealth care expenditure remains a crucial component of reducing infant and neonatal mortality in sub-Saharan African countries. In the region, where health infrastructure is largely underdeveloped, increasing health expenditure will contribute to progress towards reducing infant and neonatal mortality during the Sustainable Development Goals (SDGs) era. Therefore, governments in the region need to increase amounts allocated to health care service delivery in order to reduce infant mortality.

The Effect of Healthcare Expenditure on the Health Outcomes in Sub-Saharan African Countries

Health is a major component for a fulfilled life that everyone in the world desires to acquire. Governments are expected to play a vital role in providing quality health service to their people. Even though an increased health care expenditure is mostly considered as a primary contributor for an improved health outcome, empirical studies however indicate controversial results. The primary objective of this paper is to examine the effect of health expenditure on the selected health outcomes (Life Expectancy, Infant Mortality, Under-Five Mortality and Crude death) in Sub Saharan Africa. The linear dynamic generalized method of moments instrumental variable (GMM-IV) was used on a panel of 39 Sub-Saharan African Countries for the years 1995-2014. Results of this study showed that health expenditure significantly improves life expectancy and lowers infant mortality, under-five mortality & crude death in Sub Saharan Africa. The separate effects of Public and private health expenditures have also shown a significant positive relationship on life expectancy and negative on infant mortality, under-five mortality & crude death. The one period lag of health expenditure was estimated and the regression results indicated statistically significant relationship with health outcomes. In addition to health expenditure, other determinants like Gross Domestic Product (GDP) per capita, urbanization, immunization and basic drinking water brought improvement on life expectancy, infant mortality, under-five mortality & crude death. In contrast, HIV prevalence and unemployment are factors that reduce life expectancy and increase infant mortality, under-five mortality & crude death. This study indicated that health expenditure is an important element in attaining improved health outcome in Sub-Saharan African Countries. Therefore, increasing the amount of health expenditure allocated to the health sector yields a better health status. More on, revising policies to improve GDP per capita, immunization, urbanization and basic drinking water service, and strategies intended to reduce HIV prevalence and unemployment assure a better health outcome.

The structure of public spending and economic growth in Russia

This paper examines how Russia’s GDP growth responds to changes in the structure of general government spending. We consider models with expenditures as a percentage of total spending and expenditures as a percentage of GDP. Each model is constructed as a structural vector autoregression (SVAR). We show that redistribution in favor of productive expenditures (national economy, education, healthcare) increases the rate of economic growth, and an increase in the share of unproductive expenditures (national defense, social policy) reduces it. The maximum positive effect comes from expenditures on the national economy: their increase by 1% of GDP with constant total expenditures increases the growth rate of GDP by 1.1 p.p. An increase in expenditures on education by 1% of GDP with constant total expenses contributes +0.8 p.p. to the growth rate of GDP. The corresponding effect of healthcare expenditures is +0.1 p.p. Defense and social spending make negative contributions: –2.1 and –0.7 p.p. respectively. These results are consistent with existing estimates of fiscal multipliers for Russia and calculations based on data from other countries and cross-country data.

PHP81 - Estimation of Supply Side Cost Effectiveness Threshold in Ukraine: Perspective Use in Health Care Decision-Making

Estimate supply side cost effectiveness threshold (CET) and develop recommendations to guide reimbursement decision-making in Ukraine. Literature review was conducted to identify methods and data sources required to estimate the supply side CET in Ukraine. Methods identified: empirical estimation of CET and evaluation of the effect of health care expenditure on mortality outcomes using cross country level data; analysis of the previous reimbursement decisions; estimates of CET for lower and middle income countries by Ochalek et al. (2015); revised WHO recommendation on setting the CET. The following data sources were used to estimate Ukraine specific CET: mortality rates provided by World Bank, empirical analysis of UK CET by Claxton et al. (2013), expected GDP per capita of USD 2,700 in year 2018. The estimates of Ukraine CET were benchmarked against CET estimates for Ukraine neighbouring countries and countries with similar level of economic development. The cost per QALY CET was estimated at 19%-66% of GDP or USD 513-1,782. The updated WHO recommendation on setting CET indicated that local data needs to be taken into account and that the 1-3 GDP per capita threshold should not be used as a rule of thumb, as this can potentially lead to a wrong reimbursement decision and forgone health. The local analysis of effects of health care expenditures on health gains can't be performed due to lack of detailed country level data in Ukraine. As of 2018 the results reported by Ochalek et al. (2015) is a sole source of CET data for Ukraine. Multi-criteria decision analysis frameworks have also been suggested by WHO. Ukraine should consider establishing a context-specific process for decision-making that is supported by legislation, has stakeholder buy-in and is consistent, fair and transparent.

Trends In Inequalities In Mortality Amenable To Health Care In 17 European Countries.

Little is known about the effectiveness of health care in reducing inequalities in health. We assessed trends in inequalities in mortality from conditions amenable to health care in seventeen European countries in the period 1980-2010 and used models that included country fixed effects to study the determinants of these trends. Our findings show remarkable declines over the study period in amenable mortality among people with a low level of education. We also found stable absolute inequalities in amenable mortality over time between people with low and high levels of education, but widening relative inequalities. Higher health care expenditure was associated with lower mortality from amenable causes, but not from nonamenable causes. The effect of health care expenditure on amenable mortality was equally strong, in relative terms, among people with low levels of education and those with high levels. As a result, higher health care expenditure was associated with a narrowing of absolute inequalities in amenable mortality. Our findings suggest that in the European context, more generous health care funding provides some protection against inequalities in amenable mortality.

The effect of health care expenditure on patient outcomes: Evidence from English neonatal care.

The relationship between health care expenditure and health outcomes has been the subject of recent academic inquiry in order to inform cost-effectiveness thresholds for health technology assessment agencies. Previous studies in public health systems have relied upon data aggregated at the national or regional level; however, there remains debate about whether the supply side effect of changes to expenditure are identifiable using data at this level of aggregation. We use detailed patient data derived from electronic neonatal records across England along with routinely available cost data to estimate the effect of changes to patient expenditure on clinical health outcomes in a well-defined patient population. A panel of 32 neonatal intensive care units for the period 2009-2013 was constructed. Accounting for the potential endogeneity of expenditure a £100 increase in the cost per intensive care cot day (sample average cost: £1,127) is estimated to reduce the risk of mortality of 0.38 percentage points (sample average mortality: 11.0%) in neonatal intensive care. This translates into a cost per life saved in neonatal intensive care of approximately £420,000.

Modeling the Effect of Healthcare Expenditure and Education Expenditure on Labour Productivity: A Study on OIC Countries

Objective - The possibility of healthcare expenditure and education expenditure are becoming a thought-provoking issue for numerous governments globally, in spite of the fact that healthcare is unique and vital rudiments of well-being. On the other hand, education is the strength and spinal column of ground-breaking thoughts. Nevertheless, with an ageing population and ballooning protracted health difficulties, the preservation of the quality of life demands improved healthcare and education expenditure on the part of government. However, this study scrutinizes the effect of healthcare expenditure and education expenditure on labour productivity using Organization of Islamic Cooperation (OIC) countries as a case study. Methodology/Technique - The research utilized pooled-panel data method with data from 1990 to 2015. Findings - The result of the findings shows that there is the statistical significant relationship between healthcare expenditure, education expenditure and labour productivity in OIC countries. Novelty - Research suggests that healthcare and education is a mechanism to stimulate the productivity of labour in OIC countries. Type of Paper: Empirical Keywords: Education Expenditure; Healthcare Expenditure; Labour Productivity; OIC Countries. JEL Classification: H51, H52, J24.

The effect of health care expenditures on self-rated health status and the Health Utility Index: Evidence from Canada.

Studies of the effect of health care expenditures on health status suggest conflicting evidence of a relationship using data from numerous countries. We use data from the Canadian National Population Health Survey and the Canadian Institute for Health Information to estimate the relationship between per capita provincial health care expenditures and both self-assessed health status and the Health Utility Index. Our sample includes all individuals who were 18 years old or over at the beginning of the survey in 1994. We use random effects ordered probits for self-assessed health status and quantile regressions for the Health Utility Index (HUI). Our results show that provincial health care expenditures have a limited effect on self-rated health status and the HUI. It may be that self-rated health status and the HUI are noisy measures of heath status and as such, combined with the small variation observed in health care expenditure trends over the period, make the magnitude of the relationship between health care expenditures and health difficult to estimate.

The effects of public and private health care expenditure on health status in sub-Saharan Africa: new evidence from panel data analysis

BackgroundHealth care expenditure has been low over the years in developing regions of the world. A majority of countries in these regions, especially sub-Saharan Africa (SSA), rely on donor grants and loans to finance health care. Such expenditures are not only unsustainable but also inadequate considering the enormous health care burden in the region. The objectives of this study are to determine the effect of health care expenditure on population health status and to examine the effect by public and private expenditure sources.MethodsThe study used panel data from 1995 to 2010 covering 44 countries in SSA. Fixed and random effects panel data regression models were fitted to determine the effects of health care expenditure on health outcomes.ResultsThe results show that health care expenditure significantly influences health status through improving life expectancy at birth, reducing death and infant mortality rates. Both public and private health care spending showed strong positive association with health status even though public health care spending had relatively higher impact.ConclusionThe findings imply that health care expenditure remains a crucial component of health status improvement in sub-Saharan African countries. Increasing health care expenditure will be a significant step in achieving the Millennium Development Goals. Further, policy makers need to establish effective public-private partnership in allocating health care expenditures.

The effect of health care expenditure on sickness absence

Increased health care expenditure could be used to improve quality of care or reduce waiting time and could therefore be expected to affect the health and sickness absence of a population. Still, based on data from a panel of Swedish municipalities, public health care expenditure was found to have no, or only a negligible effect on absence due to sickness or disability. The same result was obtained when separate estimates were done for men and women and for absence due to sickness and disability.

Long-term economic growth stimulus of human capital preservation in the elderly

Health care is a crucial factor in US economic growth, because growing health care costs have made US corporations less competitive than their counterparts in countries where central governments assume most of those costs. In this paper we illustrate a second, possibly more powerful, effect of health care expenditures on the long term pace of US economic growth, i.e., that such investments in aging populations helps preserve human capital to later ages. In addition, as current investment in health care improves health and functional status, the future demand for health care as well as future health care costs will be constrained. These are crucial factors in countries experiencing rapid population aging. US labor force projections do not directly represent the effects of health care investment on the health of the future labor force, and federal health cost projections do not reflect the trajectory of health changes. Health dynamic projections suggest the effects of health care investment are large and growth stimulating. Projections done for the time period used by the Congressional Budget Office in budget mark-ups (2010-2020) are presented in the supporting information.

The Effect of Health Care Expenditures on Survival in Locally Advanced and Metastatic Non Small Cell Lung Cancer

Context: The significant survival benefit of chemotherapy over best supportive care for locally advanced and metastatic NSCLC has been amply demonstrated in the literature. However, there is no clear evidence of the impact of the type of chemotherapy or of a superiority of combination chemotherapy over single-agent chemotherapy. Objective: The present study empirically examines, in real-life practise and using multiple proxies, the impact of health care expenditures on overall survival in locally advanced and metastatic NSCLC in order to guide medical decision-making. Methods: Disease characteristics, the resources used, the costs of treatment and survival data were retrospectively collected from the records of 175 patients treated between 2000 and 2004 at Leon Berard Regional Cancer Center (Lyon, France). Survival data were modelled using multivariate Cox models and controlled for endogeneity with the instrumental variable method. Results: The median survival for the whole cohort was 289 days. The average total cost of treatment reached €35,160. Survival was significantly shorter for patients with stage IV disease, poor performance status, and past or concomitant cardiovascular disease and/or diabetes, for current smokers, and for patients with adenocarcinoma compared to large cell carcinoma. Survival duration was not significantly associated with the total cost of treatment per day of hospitalisation, the number of chemotherapy drugs administered, nor inpatient length of stay. Conclusion: Higher care expenditures do not appear to improve survival for patients with locally advanced or metastatic NSCLC. Hence, maintaining patient quality of life and tailoring therapy to stage, histology and comorbidities appears to be the less bad choice.