Increase In Health Expenditure Research Articles

Dying well in Aotearoa New Zealand for ethnic minority communities: a time for reclamation?

Despite technological advances and a disproportionate increase in health expenditure at the end-of-life, most New Zealanders die in hospital or in aged residential care. This counters the aspirations espoused by Te Whatu Ora (Health New Zealand) for all New Zealanders "to live well, age well and die well in their homes and communities." Furthermore, despite reported inequities in end-of-life care experienced by ethnic minority communities (EMCs) overseas, and increasing proportions of people identifying with Asian, Middle Eastern, Latin American and African ethnicities in Aotearoa New Zealand, local data, research and policies addressing healthcare needs of EMCs at end-of-life are scant. Acknowledging this invisibility, we reflect on and discuss the current discourses on death and dying, the complex experiences at end-of-life for EMCs, including concepts of a "good death", the impact of recent existential crises (e.g., COVID-19 pandemic, climate change) on death awareness, and the global rise to reclaim dying as an important part of living. We argue for the need: a) to partner with ethnic communities to co-design culturally safe end-of-life health services, and b) to adopt a "compassionate communities" public health approach that can support people of EMCs at the end-of-life to die well.

INTERPLAY OF GLOBAL TECHNOLOGICAL DYNAMICS AND LOCAL REALITIES: DIGITAL HEALTHCARE TRANSFORMATION IN TURKEY

Various trends have driven the digital transformation of health: Developments in digital technologies, pressures for cause reduction in healthcare and increasing demand and expenditures from aging populations. In parallel, Turkey is actively engaged in a great transformative journey with its Health Transformation Program (HTP) since 2003, embracing the age of digitalization in healthcare. This study explores the interplay among historical discourse, political influences, technological advancements which shaped the centralization of Turkey's health system. Specifically, it delves into how Turkey's healthcare system has undergone centralization under the aegis of digital transformation. Amidst this transition, a compelling question arises: How has the positive perception of digital health innovations by both the public and authoritative health institutions converged with the challenges posed by low health and digital literacy levels? This article uses the concept of biomedicalization to encompass the multisited and multidirectional health transformation processes in Turkey. By cultivating a technology-friendly environment, the nation is nurturing (bio)digital citizens through the process of biomedicalization. Drawing on a historical narrative of Turkey's digital health transformation, the article posits that the phenomenon of biomedicalization in the country, molded by intricate multidimensional factors at both micro and macro levels, compels policymakers, privacy advocates, and lawmakers to devise effective and sustainable regulations concerning data utilization, protection, and privacy. By investigating these dynamics, the research provides insights into how a country like Turkey navigates the multifaceted aspects of digital health implementation, shedding light on the potential strategies and mechanisms that enable the successful adoption of digital technologies in healthcare despite existing limitations. This contribution to the broader discourse on digital transformation enriches our understanding of the intricacies involved in leveraging technology to enhance healthcare systems, especially in contexts where there are literacy levels might pose.

Effect of procurement devolution process of medical supplies on the technical efficiency of public health facilities in Nakuru and Baringo Counties of Kenya

This study analyzed the effect of procurement devolution process of medical supplies on the technical efficiency of public health facilities in Nakuru and Baringo Counties of Kenya. Although increased government expenditure was expected to improve efficiency and better health outcomes, Kenya’s public health sector remains inefficient. The study adopted a quantitative descriptive research design that targeted 3199 employees in 401 level 2-5 public health facilities (PHFs). Using Slovin’s formula, a sample size of 355 was proportionately sampled. While secondary data was obtained through desk review, primary data was collected through structured questionnaires that were administered to different cadres of employees. Primary data was coded and analyzed using STATA/SPSS. To compute technical efficiency of PHFs, the two-stage Data envelopment analysis (DEA) and multivariate logistic regression was adopted. Study findings show that devolution has improved demand for medical supplies, enhanced procurement efficiency, and promoted ethical procurement. However, complaints from patients have not reduced while training of procurement personnel has not increased. Regression analysis indicates a significant relationship between human capital and technical efficiency. The coefficient of human capital development was 0.199 (T-value= 9.514, p- value= 0.000< 0.05 significant level); implying a positive effect of procurement devolution process on technical efficiency. This study concludes that despite increased health expenditure in Kenya, public health healthcare services have deteriorated due to inefficiency of the public health sector. This study recommends increased financial and human resource support to Kenya’s public health care.

Health Capital and a Sustainable Economic-Growth Nexus: A High-Frequency-Data Analysis during COVID-19

The recent COVID-19 pandemic effectively concretized the vitality of health expenditure and the economic-growth nexus, and the threat of new pandemics make re-examining this relationship a necessity. Consequently, this paper focuses on this nexus for developed OECD countries, paying particular attention to the effects of the COVID-19 pandemic. The use of stock indices as proxy variables for health expenditure and economic growth enabled the examination of this nexus by using high-frequency data and financial econometric techniques, specifically via rolling correlation and bivariate GARCH analyses. The data span 1170 observations between 15 May 2018 and 11 November 2022. Since the research period overlaps with the outbreak of Ukraine–Russia war, additional insights are obtained regarding the effects of the war as well. It was found that an increase in health expenditure leads to a delayed increase in economic growth even in the short term, and this relationship mainly develops during crises such as epidemics, wars, supply chain breakdowns, etc., for developed OECD countries. Given the aging population of developed countries, which will probably deteriorate the health status of those countries in the near future, the increasing political tensions around the globe and the considerations of a global recession highlight the importance and the inevitability of investments in health capital for developed countries as well.

Does Renewable Energy Consumption Have an Effect on Health Expenditures? Example of EU Countries

Due to the harmful effects of traditional energy sources on the environment and health, the consumption of renewable energy sources has recently come to the fore on the world agenda. In order for national economies to maintain their existence, individuals must ensure their health and welfare. In this context, the priority duty of countries should be to protect public health and ensure its sustainability. There are many factors that determine a country's level of healthcare expenditures; environmental conditions are also one of them. The increase in greenhouse gas emissions resulting from the consumption of non-renewable energy sources can pose a great danger to human welfare and the environment. Environmental problems caused by greenhouse gas emissions negatively affect human health in many ways, such as affecting the nervous system, lungs, and causing respiratory diseases. In addition, environmental pollution resulting from greenhouse gas emissions increases health expenditures and causes a decrease in labor productivity. Considering these negative effects, increasing the use of wind, solar, geothermal, and other environmentally friendly energy sources, which are renewable energy sources, will contribute to environmental improvement by meeting the energy needs of countries. Recently, the increase in the resources allocated to health expenditures from the national income of countries has made the discussion of sustainability in the relevant field a current issue. In this respect, researching the factors affecting health expenditures will provide important information to policy makers. This study examines the health expenditures of renewable energy consumption in 13 EU countries (Belgium, Czech Republic, Denmark, Germany, Austria, Spain, Sweden, Italy, Portugal, Greece, Finland, France, and the Netherlands) selected considering data availability between 2000 and 2020 investigating in which direction it affects. In the study, countries with the highest consumption of renewable energy were selected. Since the sustainability of the recently increasing health expenditures is important, the variables of renewable energy consumption and economic growth were analyzed and the subject was limited. In this context, it is believed that the findings will provide important information to policy makers. The main motivation of the study is that there are limited studies on the relevant subject in the literature and panel cointegration and panel cointegration coefficient estimator tests are not used. Obtaining renewable energy consumption and health expenditure data from 2000 to 2020 constitutes the main limitation of the study. As analysis methods, Lagrange multiplier (LM) cointegration and Common Corelated Effect (CCE) cointegration estimator tests were used. Before the application of these tests, cross-sectional dependence and homogeneity were determined. Fourier LM unit root test was used in examining the unit root process. Then, cointegration test and cointegration coefficient estimators, which is the last stage of the application, were determined. According to the panel cointegration coefficient estimation results, in the general analysis conducted for 13 EU countries, the effect of renewable energy consumption on health expenditures is statistically significant at the 10% level. Accordingly, a 1% increase in renewable energy consumption decreases health expenditures by 0.197%. In country-specific studies, the effect of renewable energy consumption on health expenditures was statistically significant and negative in Denmark, Spain, Sweden, and Greece, reducing health expenditures by 0.132%, 0.111%, 1.288%, and 0.782%, respectively. The effect of GDP on health expenditures appears to be statistically significant at the 1% level. Accordingly, a 1% increase in income increases health expenses by 1.071%. In country-based analyses, the coefficients are statistically significant and positive in Germany, Austria, Belgium, Czech Republic, France, Spain, Sweden, Italy, Portugal, and Greece. These findings indicate that the increase in environmentally friendly, reusable energy consumption will have a positive impact on the environment, reduce health expenditures and contribute positively to the sustainability of health financing. In addition, it emphasizes that increases in GDP are reflected in health expenditures, thus increasing the quality of health.

Effect of procurement devolution process of medical supplies on the technical efficiency of public health facilities in Nakuru and Baringo Counties of Kenya

This study analysed the effect of the procurement devolution process of medical supplies on the technical efficiency of public health facilities in Nakuru and Baringo Counties of Kenya. Although increased government expenditure was expected to improve efficiency and better health outcomes, Kenya's public health sector remains inefficient. The study used a quantitative descriptive research design that targeted 3199 employees in 401 level 2-5 public health facilities (PHFs). Using Slovin’s formula, a sample size of 355 was proportionately sampled. While secondary data was obtained through desk review, primary data was collected through structured questionnaires that were administered to different cadres of employees. Primary data was coded and analysed using STATA/SPSS. To compute the technical efficiency of PHFs, the two-stage Data envelopment analysis (DEA) and multivariate logistic regression were adopted. Study findings show that devolution has improved demand for medical supplies, enhanced procurement efficiency, and promoted ethical procurement. However, complaints from patients have not been reduced, and the training of procurement personnel has not increased. Regression analysis indicates a significant relationship between human capital and technical efficiency. The coefficient of human capital development was 0.199 (T-value= 9.514, p- value= 0.000< 0.05 significant level), implying a positive effect of the procurement devolution process on technical efficiency. This study concludes that despite increased health expenditure in Kenya, public health healthcare services have deteriorated due to the inefficiency of the public health sector. This study recommends increased financial and human resource support for Kenya's public health care.

Health Expenditure, Institutional Quality, and Under-Five Mortality in Sub-Saharan African Countries.

The aim of this study is to examine the relationship between health expenditure, institutional quality, and under-five mortality rates in sub-Saharan African countries. Specifically, the study seeks to explore the mediating role of institutional quality in this relationship, focusing on understanding how variations in healthcare spending and institutional frameworks impact child health outcomes. By examining these dynamics, the study aims to provide valuable insights that can inform evidence-based policy interventions to reduce under-five mortality and improve child health outcomes in the region. Utilizing data spanning the years 2000 to 2021 from 46 sub-Saharan African countries, this study employs a systems GMM model to explore the intricate relationship between health expenditure and under-five mortality rates (U5MRs), with a particular focus on the mediating role of institutional quality. The findings reveal that the quality of institutions significantly influences the impact of health expenditures on the U5MR. Strong institutional quality enhances the effectiveness of health expenditure in improving child health outcomes, particularly concerning the allocation of external health funds. Conversely, poor institutional quality amplifies the positive impact of domestic private and out-of-pocket health expenditures on the U5MR, as these serve as coping mechanisms in the absence of robust public healthcare systems. This research emphasizes the need for strategies that increase health expenditure and prioritize institutional strengthening to ensure efficient resource allocation and healthcare system management, thereby reducing under-five mortality rates. Furthermore, it underscores the importance of policies that minimize reliance on private and out-of-pocket health expenditures, which can lead to financial burdens and worsened health outcomes. Sub-Saharan African countries can make significant strides toward improving child survival and overall public health by addressing these issues.

A financial perspective on the pharmaceutical industry

As a result of the epidemics in the world in recent years the importance of the health sector has once again emerged and countries have started to invest more in the health sector. In addition to developed countries, underdeveloped and developing countries are investing more in the health sector and technology and governments are trying to control increasing health expenditures. One of the important and dynamic sub-sectors of the health sector is the pharmaceutical sector. States and international companies are investing more in the pharmaceutical sector in order to combat the epidemics in recent years and are conducting more R&D studies by utilizing the developing technology. In this study in the light of the data published by the OECD, it is examined whether there is a similar relationship between the change in the share of health expenditures in the GNP (Gross National Product) of OECD countries between 2010 and 2022 and the change in the size of the pharmaceutical sector in OECD countries. The change in the size of the pharmaceutical sector and the change in the share of health expenditures in GNP have not yielded similar results in each OECD country. It is thought that different factors such as demographic characteristics, geographical location and economic conditions of countries should be taken into consideration when evaluating the relationship between these two variables.

The Impact of Health Expenses on Economic Growth: Empirical Evidence from SAARC Countries

This study seeks to empirically explore the influence of health expenditure on economic growth in SAARC countries. Gross domestic product (GDP) the proxy variable of economic growth has been used as a dependent variable and current health expenses (CHE) as the independent variable. The panel dynamic OLS (DOLS), panel fully modified OLS (FMOLS), panel OLS, panel co inte gration test, along with Granger causality test have been used to determine the link between health expenses and economic growth. The result presented that health expenses and economic growth have a bidirectional causa l relationship in the short run. The f indings of the panel fully modified OLS (FMOLS) also showed that long run economic growth is increasingly and significantly affected by health expenses, HDI, infant mortality, and life expectancy. Therefore, this st udy presents empirical evidence to the po licymakers of SAARC nations that increasing health expenditures contribute to a country's economic growth.

Outlook of Diabetic Retinopathy Management through Universal Health Care in Indonesia from 2015 – 2020

Introduction & ObjectivesTo identify the National Health Expenditure associated with diabetic retinopathy (DR) from theperspective of Jaminan Kesehatan Nasional [JKN].
 MethodsA dataset of 1% of all individuals registered in JKN database was used from 2015 to 2020. Weretrieved primary diagnosis with type 2 diabetes mellitus (T2DM) (ICD-10 E11) and/or T2DM withophthalmic complications (E11.3). Further diagnosis with DR (H36) was retrieved. Four groups ofmedical procedures related to DR management were developed according to Indonesian Case BaseGroups (INA-CBGs): diagnostic, laser photocoagulation and cryotherapy, minor (intravitrealinjection), and major surgical procedures (e.g., vitrectomy). We performed descriptive analyses forthe annual costs incurred for procedures, premium classifications, and regions.
 ResultsOverall DR costs were US $41.5 million from 156,752 individuals with DR in JKN database sample.The total cost and per unit procedures cost specifically increased annually from 2015 to 2019 butdeclined substantially in 2020. The largest amount was spent on intravitreal injection ($36.3 million[87.5%]), whereas vitrectomy was the least ($145.0 million [0.3%]). Region 1 (Java Island) with nonbeneficiariesof government subsidies (PBPU and PPU) was the major number of claims ($12.5million [30.1%] and ($7.3 million [17.7%]), while beneficiaries of government subsidies (PBI) outsideJava Island, conversely, were under average.
 ConclusionThere was significant increase in health expenditure associated with DR in Indonesia from 2015 to2019, but decreased in 2020 possibly due to COVID-19 pandemic. Majority of funding was spent totreat severe spectrum of DR and concerned in urban area.

Outlook of Diabetic Retinopathy Management through Universal Health Care in Indonesia from 2015 – 2020

Abstract
 Introduction & Objectives : To identify the National Health Expenditure associated with diabetic retinopathy (DR) from the perspective of Jaminan Kesehatan Nasional [JKN].
 Methods : A dataset of 1% of all individuals registered in JKN database was used from 2015 to 2020. We retrieved primary diagnosis with type 2 diabetes mellitus (T2DM) (ICD-10 E11) and/or T2DM with ophthalmic complications (E11.3). Further diagnosis with DR (H36) was retrieved. Four groups of medical procedures related to DR management were developed according to Indonesian Case Base Groups (INA-CBGs): diagnostic, laser photocoagulation and cryotherapy, minor (intravitreal injection), and major surgical procedures (e.g., vitrectomy). We performed descriptive analyses for the annual costs incurred for procedures, premium classifications, and regions.
 Results : Overall DR costs were US $41.5 million from 156,752 individuals with DR in JKN database sample. The total cost and per unit procedures cost specifically increased annually from 2015 to 2019 but declined substantially in 2020. The largest amount was spent on intravitreal injection ($36.3 million [87.5%]), whereas vitrectomy was the least ($145.0 million [0.3%]). Region 1 (Java Island) with non- beneficiaries of government subsidies (PBPU and PPU) was the major number of claims ($12.5 million [30.1%] and ($7.3 million [17.7%]), while beneficiaries of government subsidies (PBI) outside Java Island, conversely, were under average.
 Conclusion : There was significant increase in health expenditure associated with DR in Indonesia from 2015 to 2019, but decreased in 2020 possibly due to COVID-19 pandemic. Majority of funding was spent to treat severe spectrum of DR and concerned in urban area.

Export stability and adolescent fertility rate

AbstractThis paper studies the effect of export stability on the adolescent fertility rate. The test results show that the improvement of export stability will decrease the adolescent fertility rate of exporting countries through four mechanisms: raising female labour income, increasing health expenditure, promoting urbanization and strengthening female education empowerment. Compared to developed or high‐income countries, the impact of export stability in developing or low‐income countries is more substantial. The increase in export scale will strengthen the impact of export stability on adolescent fertility rates. The findings of this article can help countries to govern the adolescent fertility rate further.

Association of maternal constipation and risk of atopic dermatitis in offspring.

Objectives: Atopic dermatitis (AD) is a chronic and relapsing dermatologic disease that can affect individuals of all ages, including children and adults. The prevalence of AD has increased dramatically over the past few decades. AD may affect children's daily activities, increase their parents' stress, and increase health expenditure. Constipation is a worldwide issue and may affect the gut microbiome. Some research has indicated that constipation might be associated with risk of atopic disease. The primary objective of this retrospective cohort study was to extend and to explore the link between maternal constipation and risk of atopic dermatitis in offspring. Methods: Using the Longitudinal Health Insurance Database, a subset of Taiwan's National Health Insurance Research Database, we identified 138,553 mothers with constipation and 138,553 matched controls between 2005 and 2016. Propensity score analysis was used matching birth year, child's sex, birth weight, gestational weeks, mode of delivery, maternal comorbidities, and antibiotics usage, with a ratio of 1:1. Multiple Cox regression and subgroup analyses were used to estimate the adjusted hazard ratio of child AD. Results: The incidence of childhood AD was 66.17 per 1,000 person-years in constipated mothers. By adjusting child's sex, birth weight, gestational weeks, mode of delivery, maternal comorbidities, and received antibiotics, it was found that in children whose mother had constipation, there was a 1.26-fold risk of AD compared to the children of mothers without constipation (adjusted hazard ratio [aHR]: 1.26; 95% CI, 1.25-1.28). According to subgroup analyses, children in the maternal constipation group had a higher likelihood of AD irrespective of child's sex, birth weight, gestational weeks, mode of delivery, and with or without comorbidities, as well as usage of antibiotics during pregnancy. Compared to the non-constipated mothers, the aHR for the constipated mothers with laxative prescriptions <12 and ≥12 times within one year before the index date were 1.26; 95% CI, 1.24 -1.28 and 1.40; 95% CI, 1.29-1.52, respectively. Conclusion: Maternal constipation was associated with an elevated risk of AD in offspring. Clinicians should be aware of the potential link to atopic dermatitis in the children of constipation in pregnant women and should treat gut patency issues during pregnancy. More study is needed to investigate the mechanisms of maternal constipation and atopic diseases in offspring.

Inhibiting or promoting: Population aging and economic development in China.

Population aging has become a social issue of concern to the whole world, and as the world's most populous country, how to cope with population aging will be a hot issue that all sectors of Chinese society must think about. This paper uses provincial panel data from 30 provinces in China from 2000 to 2021 to study the relationship between population aging and economic development based on the perspective of health expenditure. The DIFF-GMM model, the fixed effect model (FE), and fixed effect instrumental variable model (FE-IV) are used to test this study. The following two conclusions are drawn from the empirical study: (1) population aging has a significant inhibitory effect on economic development, while health expenditures have a significant promotional effect on economic development; and (2) increased health expenditures help to alleviate the negative impact of population aging on economic development. However, the deepening of population aging will likewise inhibit the positive effect of health expenditure on economic growth. Based on the conclusions of the study, it is recommended that the government and society should continue to increase spending in the field of health protection, encourage and guide residents to carry out self-care, and moderately increase personal health expenditure, to promote economic development with healthy bodies and realize the goal of "Healthy China".

Asymmetric Effects of Exchange Rate Shocks on Urban Household Health Expenditures in Iran

Background: The evidence of Iran's economy shows that many economic variables, including household health expenditures, can be affected by exchange rate shocks. According to previous studies, the increase in the exchange rate from two channels of the general increase in prices, as well as the increase in the price of medicines and imported medical supplies, increases health expenditures. This study investigated the asymmetric effects of the unofficial exchange rate on the health expenditures of urban households in Iran.&#x0D; Methods: The present applied study investigated the short-run and long-run effects of positive and negative shocks of the unofficial exchange rate, gross domestic product (GDP), and CO2 emissions on the health expenditures of urban households during 1971-2019 using time series data. The data were collected from the database of the Statistics Center and the Central Bank. To investigate the reliability of data, generalized Phillips-Prone and Dickey-Fuller tests and to check the stability of the coefficients, cumulative sum and cumulative sum squares were used. Also, to check the short-run dynamics and adjustment towards the long-run, the error correction model was estimated. The regression model was estimated using the Nonlinear Autoregressive Distributed Lag approach by Eviews (12.0) software. After estimation, diagnostic tests including Wald test, normality, heterogeneity of variance and autocorrelation were performed.&#x0D; Results: The results showed that the increase in exchange rate has a positive and significant effect on household health expenditures, its reduction has no significant effect Therefore, the effect of exchange rate shocks was asymmetric. Accordingly, 1% increase in the unofficial exchange rate led to a 0.237 % increase in household health expenditures in the short-run and 0.55 % increase in the long-run. In addition, 1% increase in GDP led to 0.49 % increase in household health expenditures in the short-run and 1.57% increase in the long-run. Finally, 1 % increase in CO2 emissions led to a 1.49 % increase in household health expenditures in the long-run.&#x0D; Conclusion: Based on the results, after the increasing exchange rate shocks and possible future declines, due to the persistence of the shocks effects for up to three years, it is suggested not to stop supportive policies for providing health expenditures, especially for low-income groups.

Spatial–temporal analysis and spatial drivers of hepatitis-related deaths in 183 countries, 2000–2019

Hepatitis is the seventh leading cause of mortality worldwide and is the only communicable disease where mortality is increasing, yet the long-term spatial–temporal variation at global scale and its possible causes, i.e., drivers, remain unknown. Firstly, this study employed the measure of spatial autocorrelation, Moran’s I, and the measure of local spatial cluster, Getis-Ord Gi*, to characterize the spatial variation of mortality due to hepatitis in 183 countries globally for years 2000, 2010, 2015 and 2019. Then, a novel spatial statistical method, named the Geographical Detector, was utilized to investigate eight possible influencing factors, i.e., risk factors, of the spatial–temporal variation of mortality due to hepatitis. The results showed significant disparities of hepatitis-related mortality rates among countries. Hot spots, representing locations with higher mortality rates, were consistently observed in Africa, East Asia, and Southeast Asia, while the cold spots, representing locations with lower mortality rates, were predominantly found in Europe and the Americas. Potential spatial drivers of hepatitis mortality, identified by geographical detector, include “health expenditure”, “universal health coverage”, and “per capita income”. However, “hepatitis B immunization” and “total population” were not identified as significant spatial drivers for hepatitis mortality The findings highlighted the critical role of socioeconomic factors in the variations in hepatitis mortality, and pointed out relative importance of increasing health expenditure, per capita income, and improve universal health coverage on alleviating global hepatitis-related mortality.

The impact of financial development, health expenditure, CO2 emissions, institutional quality, and energy Mix on life expectancy in Eastern Europe: CS-ARDL and quantile regression Approaches

In recent years, the interrelationships between the environment, energy, and health have received a growing amount of attention due to their substantial impact on the health of humans. By examining what influences Eastern Europeans' longevity between 1990 and 2021, this study hopes to contribute to this field of study. Energy consumption, health expenditure, pollution, institutional quality index (IQI), financial development, and other attributes profoundly impact human health. Because of the extensive network of commerce, tourism, education, religion, and treaties connecting East European countries, tests for cross-sectional dependence (CSD) and slope heterogeneity (SH) are utilized. After verifying the CSD and SH issues, the study uses the second generation's unit root and cointegration tests. As the previous test indicates, a new panel method, the cross-sectional autoregressive distributive lag (CS-ARDL) model, is required, as conventional estimations are inappropriate. The Quantile Regression (QR) method is also applied to check robustness. This study indicated that increased health expenditure, renewable energy consumption, and IQI improves health outcomes in Eastern European nations. There was a good connection between renewable energy consumption and health benefits, the study concluded. Though financial development positively impacts life expectancy, the impact is insignificant. On the other hand, the study also shows that CO2 emissions and fossil fuel consumption decrease life expectancy. These results are consistent with those obtained using the QR method. To enhance health outcomes, it is necessary to take measures to raise health spending, increase the use of renewable energy, and foster financial development over the long term. On the other hand, Eastern European nations need to shift their attention from fossil fuels to renewable energy.

THE RELATIONSHIP BETWEEN HUMAN DEVELOPMENT AND HEALTH EXPENDITURES: EVIDENCE FROM THE DRISCOLL-KRAAY ESTIMATOR

In this study employing panel data methods, it was aimed to econometrically test the relationship between human development and health expenditures in 25 OECD countries using data from the 2003-2019 period. For this purpose, in the econometric model established, the Human Development Index is included as the dependent variable to represent human development, while public health expenditures and household voluntary health expenditures are included as independent variables to represent health expenditures. The results of the empirical analyses indicate a positive and statistically significant relationship between health expenditures and human development. Accordingly, considering the overall panel based on the aforementioned period and group of countries, it is concluded that a 1 unit increase in public health expenditures increases the Human Development Index value by 0.11 units. Similarly, it was observed that a 1 unit increase in household voluntary health expenditures also increases the Human Development Index value by 0.03 units. Therefore, it is concluded that increases in investments in health, both by the public sector and at the household level, and thus the increase in health expenditures, will support human development in this group of countries.

The Relationship Between the Health Transformation Program and Health Expenditures: Evidence From an Autoregressive Distributed Lag Testing Approach

ObjectivesAs health expenditure increases every year, countries try to provide accessible health services to society and try to protect individuals from the expenses they cannot overcome by investigating the reason for this increase. Especially with the arrangements made in the health systems in developing countries such as Turkey, it has been tried to take the control of dramatic increases in health expenditure. Based on this issue, in this study, we aimed to evaluate the effect of income per capita, annual inflation, and health reform called as Health Transformation Program on the health expenditure per capita in Turkey. MethodsThis study reflected the effects of income, inflation, and the reform on the total health expenditure through the autoregressive distributed lag. This study covered the years between 1985 and 2016 for Turkey. ResultsAs a result of this study, there was a positive relationship between health expenditure and income and a negative relationship with the reform (P < .05). ConclusionAccording to the results of this study, it is suggested that health expenditures can be kept under control with improvements such as encouraging individuals to use more primary healthcare services than curative health services and increasing the quality of service without compromising the equity in financing.

Global burden of disease due to rifampicin-resistant tuberculosis: a mathematical modeling analysis

In 2020, almost half a million individuals developed rifampicin-resistant tuberculosis (RR-TB). We estimated the global burden of RR-TB over the lifetime of affected individuals. We synthesized data on incidence, case detection, and treatment outcomes in 192 countries (99.99% of global tuberculosis). Using a mathematical model, we projected disability-adjusted life years (DALYs) over the lifetime for individuals developing tuberculosis in 2020 stratified by country, age, sex, HIV, and rifampicin resistance. Here we show that incident RR-TB in 2020 was responsible for an estimated 6.9 (95% uncertainty interval: 5.5, 8.5) million DALYs, 44% (31, 54) of which accrued among TB survivors. We estimated an average of 17 (14, 21) DALYs per person developing RR-TB, 34% (12, 56) greater than for rifampicin-susceptible tuberculosis. RR-TB burden per 100,000 was highest in former Soviet Union countries and southern African countries. While RR-TB causes substantial short-term morbidity and mortality, nearly half of the overall disease burden of RR-TB accrues among tuberculosis survivors. The substantial long-term health impacts among those surviving RR-TB disease suggest the need for improved post-treatment care and further justify increased health expenditures to prevent RR-TB transmission.