Percentage Of Health Expenditure Research Articles

Social Inequalities in mental health service use and perceived helpfulness: A global analysis across 111 countries

Abstract Social inequalities in mental health are evident in the prevalence of mental health problems, but also the utilisation and patents’ perceived benefits of treatment. However, the extent of these disparities on a global scale and whether there are country-level differences in the predictors of mental health service use remain unknown. This study uses data from the Wellcome Global Monitor 2020, a nationally representative survey encompassing 111 countries and 117,088 individuals. We examine the association of socio-economic factors (such as household income and education), psycho-social factors (including stigma perception and trust in health professionals), and country-level variables (such as GDP, Gini coefficient, and health expenditure) with mental health service use and perceived effectiveness of treatment. Multi-level logistic regression models were employed for analysis. The utilisation of mental health professions of people with depression or anxiety symptomology is higher in HICs (predicted probability of 62% CI[0.60 - 0.65]) compared to LIMCs (predicted probability of 33% CI[0.31 - 0.34]). Higher country GDP (OR = 1.26 CI[1.08-1.47]) and health expenditure (OR = 1.11 CI[1.04-1.19] per percentage of health expenditure) are associated with higher treatment utilisation. On the individual level, those in the wealthiest quintile are more likely to engage with mental health professionals (OR = 1.25[1.14-1.36]) and perceive this treatment as highly beneficial (OR = 1.23[1.07-1.40]). Trust in healthcare practitioners and perceived stigma are also associated with mental healthcare use. This analysis shows strong patterns of mental healthcare use and perceived benefits depending on the wealth of the country, health expenditure and individual socio-economic status. Moreover, disparities in treatment utilization and effectiveness are also influenced by trust in healthcare professionals and perceived mental health stigma.

Investigating the Relationship between Health Expenditures and Human Development Index: A Cross Country Analysis

Background: In recent decades, the human development index has become one of the most practical indicators for measuring the level of development in countries. There are several factors that affect the human development index, including health expenditures that increase human development along with manpower and physical capital. The purpose of this study was to investigate the effect of health costs on human development index for the period 2005-18.
 Methods: The present study examined the effects of health on human development index in different countries. The study population includes 187 countries with 3 types of divisions (continental, oil and income distribution). The data used by the World Bank were collected and analyzed using data panel regression or composite data.
 Results: Findings from estimation of models indicated that health expenditures in continents of Europe, South America, Africa and Oceania had a positive and significant effect on human development index. But in Asia, the effect of health expenditure was negative and significant. The effect of per capita Gross Domestic Product (GDP) on the continents of Asia, North and South America, Africa and Oceania had been positive and significant, but it was positive and insignificant in continental Europe. In oil-rich countries, the effect of educational expenditures, GDP per capita on human development index was positive and significant, but the effect of health expenditures was positive and insignificant. Also, the effect of mortality index on human development index had been negative and significant. Similar results had been obtained for non-oil countries, albeit with different coefficients. The percentage of health expenditures, compared with GDP, had a direct and significant relationship with the human development index in countries with relatively equal and relatively unequal income distribution; considering the fact that this value for the group of countries with completely unequal income distribution suggested an insignificant value in the model. The percentage of educational expenditures showed a direct and significant relationship on human development in all income groups, and GDP per capita for all groups with different income distributions had a significant and direct effect on the human development index. Also, the under-5 mortality rate in all groups with different income distributions had an inverse and significant relationship with the human development index.
 Conclusion: Results showed a significant effect of health expenditures on improvement of the health status and development of the studied countries except oil countries, North America and countries with unequal income distribution. Furthermore, increasing the cost of health care is an important step in achieving countries' development goals. Therefore, it is necessary for managers and policy makers of the health system to consider the efficiency in allocating health expenditures to different sectors.

Socio-Economic Determinants of Infant Mortality Rate in Turkey

Turkey is one of the rare countries which have significantly reduced infant mortality in recent years while it still lacks behind when compared to some countries. Thus, in this study, it was aimed to determine the socio-economic causes of infant mortality in Turkey. In this context, the percentage of women with university degrees, the percentage of health expenditure in household expenditures, the GINI coefficient, the poverty rate, the fertility rate, and the urban population percentage were considered as independent variables that could possibly affect infant mortality. Data used in panel regression analyses covers the period of 2014-2018. In the results of the study, it was determined that education level had a statistically significant and negative effect, while the fertility rate had significant and positive effect (p

Performances in COVID-19 Management across Countries: Do Subnational Finances Matter?

The spread of the COVID-19 pandemic has emphasized the role of governments in a public health emergency not only in developing countries but in the developed world as well. This paper has a two-fold objective. First, we investigate the efficiency of COVID management using state-level data from three of the worst affected countries, the USA, India, and Mexico, in three time periods in the pre-vaccine phase. Next, we explore the extent to which state government financial, sociodemographic, and governance indicators can explain the difference in efficiency. We use a two-stage non-parametric method. The first stage comprises meta frontier analysis to derive efficiency scores for each state. We analyze state governments in these countries together (grand frontier) and separately (group frontier). Overall, grand efficiency continuously increased from August to November 2020. The grand efficiency scores of Mexico and the USA gradually increased on 3rd October and 29th November 2020. The results reflect that the USA was holding the leading position in terms of COVID-19 pandemic management at that time. In terms of group efficiency, American states performed consistently well with respect to their own country as well as other countries. However, if we compare the grand and group efficiency scores of all three countries, we find that states in India and Mexico performed well in their own countries but worse than USA states in terms of the global scenario. The states of India always performed better within their own country than the states of the other two countries. The second analytical stage uses an exploratory median analysis to investigate the impact of different indicators on efficiency. State finance variables are positively associated with the grand efficiency score for all three time periods, while the association is negative for the expenditures to own revenue ratio and expenditures to total revenue ratios, debt ratios with respect to different fiscal indicators, and percentage of health expenditure over total expenditures and GSDP. These patterns are less consistent among countries when we look at group efficiency over time. We find a positive association of per capita total revenue with group efficiency scores for all countries over all time periods.

HEALTH CARE EXPENDITURE AND ECONOMIC GROWTH IN NIGERIA: AN EMPIRICAL APPRAISAL OF THE NEXUS

A nation’s wealth is often described in terms of their physical stock of capital per time for the promotion of economic growth. One of such physical stock of capital is a healthy labour force. Therefore, this study investigated the relationship between health expenditure and economic growth in Nigeria from 1985 to 2019. To determine this, annual time series data was collected from various issues of the Central Bank of Nigeria (CBN) statistical bulletin and the World Development Indicator (WDI). Stationarity, long run relationship, equation estimation and causality were determined using the Augmented Dickey Fuller (ADF), Johansen-Cointegration, Parsimonious Error Correction Mechanism (ECM) and Pairwise Granger Causality test respectively. The result showed that a long run relationship exist among the variables while the ECM showed that in event of a disequilibrium, the system would restore itself to equilibrium at an adjustment speed of approximately 85.5percent. The result uncovered that current and past percentage of health expenditure in total expenditure (PHETE), government final consumption expenditure (GFCE), and labour force participation (LABF) all had direct impact on national growth (real GDP per capita) while current and past number of infant deaths (NUFD) had inverse relationship with national growth. Result further showed that there exists a unidirectional causality running from NUFD to RGDPPC; from GFCE to RGDPPC; from LABF to RGDPPC, from NUFD to PHETE, from LABF to PHETE, from NUFD to GFCE and from NUFD to LABF. It was recommended that the federal government through the Ministry of Health should endeavour to encourage private-public partnership in the building of quality health infrastructure such as hospitals with state of art facilities in localities where standard health care centres are not accessible to working citizens.

Indicators of the effectiveness of the health care financing system in the Western Balkan countries-critical analyze

Background/Aim. The main objective of the health system is to preserve and improve the general level of health of the population. Every country is making considerable efforts to ensure a sustainable healthcare financing system that would enable the qualitative realization of basic social security rights, rights to healthcare. The aim of the study was to determine the difference between the health system and the concepts of financing through the critical analysis of the system/model and indicators of financing health care in the Western Balkan countries. Methods. An overview of the current state of the health care system in the Western Balkan countries was based on data collected from sources such as the World Bank, World Health Organization, United Nations Development Programme (UNDP) reports, health ministries, finance ministries and statistical institutes of all countries in the analysis. Following the classification of the data, some categories were created to identify differences and similarities between the funding methods used in the Western Balkan countries. The analysis was performed by measuring the effect of healthcare funding on variables by measuring performance. Because it is impossible to measure the relationship between variables in a single regression analysis model, several regression functions were used for accurately determining the relationship results. Results. The two indicators: a total expenditure on health services and institutions as a percent of gross domestic product (GDP), and health expenditure per capita shows weak positive correlation (p = 0.3) indicating that a higher amount of GDP per capita does not have a positive impact on the percentage of health expenditure in the Western Balkan countries observed. Despite differences in expenditures, all countries had a relatively similar funding method with different regulation that has impact on effectiveness of health system and resources used. Conclusion. The health sector in the Western Balkans is characterized by a lack of adequate administrative resources, legislation and regulations, as well as significant constraints in securing the necessary budget. Considering the resources devoted to the health sector in the Balkan countries, it can be said that the authorities in these countries do not see the health system as an important pillar of the country''s development, as they do not devote sufficient financial resources to ensure the functioning of the health system.

Out-of-pocket health expenditures and antimicrobial resistance in low-income and middle-income countries: an economic analysis

BackgroundThe decreasing effectiveness of antimicrobial agents is a growing global public health concern. Low- and middle-income countries (LMIC) are vulnerable to the loss of antimicrobial efficacy given their high burden of infectious disease and the cost of treating resistant organisms.MethodsWe analyzed data from the World Health Organization’s Antibacterial Resistance Global Surveillance Report. We investigated the importance of out-of-pocket spending and copayment requirements for public sector medications on the level of bacterial resistance among LMIC, adjusting for environmental factors purported to be predictors of resistance, such as sanitation, animal husbandry and poverty as well as other structural components of the health sector.FindingsOut-of-pocket health expenditures were the only factor demonstrating a statistically significant relationship with antimicrobial resistance. A ten point increase in the percentage of health expenditures that were out-of-pocket was associated with a 3·2 percentage point increase in resistant isolates [95% CI, 1·17 to 5·15, p-value=0·002]. This relationship was driven by countries requiring copayments for medications in the public health sector. Among these countries, moving from the 20th to 80th percentile of out-of-pocket health expenditures was associated with an increase in resistant bacterial isolates from 17·76 [95%CI 12·54 to 22·97] to 36·27 percentage points [95% CI 31·16 to 41·38].InterpretationOut-of-pocket health expenditures were strongly correlated with antimicrobial resistance among LMIC. This relationship was driven by countries that require copayments on medications in the public sector.Our findings suggest cost-sharing of antimicrobials in the public sector may drive demand to the private sector where supply-side incentives to overprescribe are likely heightened and quality assurance less standardized.

Can health public expenditure reduce the tragic consequences of road traffic accidents? The EU-27 experience

This study uses data for the EU-27 countries in the period 1999-2009 to estimate determinants of road traffic fatality rates. Controlling for country attributes and road safety policy variables, we examine the influence of variables related with the national health systems; the number of hospital beds per square kilometer, and the percentage of health expenditures over gross domestic product. We find evidence that the density of hospital beds contributes to the fall in traffic-related fatalities. Furthermore, the quality of general medical facilities and technology associated with increases in health expenditure may be also a relevant factor in reducing road traffic fatalities.