Public Health Care Expenditure Research Articles

Do medical spending and income reduce the prevalence of human immunodeficiency virus and tuberculosis? A study on Sub-Saharan Africa

Several countries in sub-Saharan Africa (SSA) suffer from economic hardship and high unemployment rates; furthermore, this region has higher rates of human immunodeficiency virus (HIV) and tuberculosis (TB). This study examined the relationships between HIV and TB, income and total medical spending and its components private, and public healthcare expenditure, for 41 SSA countries. Random and fixed-effects models were utilized in this study to explore relationships by studying time series and cross-sectional panel data obtained from the World Bank. Results demonstrated that there is a positive relationship between HIV and unemployment and a negative relationship with income and medical spending. We also observed that, when private and public medical expenditures are compared, private medical expenditures alleviate the HIV epidemic. Considering the association with TB, income, total, and its components private and public medical expenditures are negatively related. Since prevention of such life-threatening diseases like HIV and TB become vital to find remedy for, there is a need for more government initiatives including, job creation, increased productivity and increased income levels can be seen as preconditions, in fighting and controlling HIV and TB.

Economic Impact of Health Expenditures: Panel Data Analysis for Selected Economies

It is estimated that healthcare services will increasingly strain public healthcare expenditures in the near future. Public health expenditures yield more effective outputs than household expenditures do. Due to its direct impact on human capital, public health displays a positive correlation with labor productivity, personal expenditures, and GDP indicators. In welfare economics theory, the examination of economic and social welfare focuses on the analysis of the distribution of economic resources among social actors. During the 2003-2016 timeframe in Turkey, Ukraine, Moldova, Poland, and South Korea, this research examined several health care expenditures. These included the proportion of the population spending more than 10 pct of their household consumption or income on out-of-pocket health care expenses, current health expenditure per capita, domestic general government health expenditure per capita, and domestic private health expenditure per capita. To conduct the panel data analysis, the "domestic private health expenditure per capita" data was utilized. Based on the research findings, an increase in domestic government health expenditures in certain countries results in an escalation of household health expenditures, while an increase in private sector health spending leads to a reduction in household health expenditures.

Contribution of high-technology procedures to public healthcare expenditures: the case of ischemic heart disease in Portugal, 2002-2015.

The magnitude of the impact of technological innovations on healthcare expenditure is unclear. This paper estimated the impact of high-technology procedures on public healthcare expenditure for patients with ischemic heart disease (IHD) in Portugal. The Blinder-Oaxaca decomposition method was applied to Portuguese NHS administrative data for IHD discharges during two periods, 2008-2015 vs. 2002-2007 (N = 434,870). We modelled per episode healthcare expenditures on the introduction of new technologies, adjusting for GDP, patient age, and comorbidities. The per episode healthcare expenditure was significantly higher in 2008-2015 compared to 2002-2007 for IHD discharges. The increase in the use of high-technology procedures contributed to 28.6% of this growth among all IHD patients, and to 18.4%, 6.8%, 11.1%, and 29.2% for acute myocardial infarction, unstable angina, stable angina, and other IHDs, respectively. Changes in the use of stents and embolic protection and/or coronary brachytherapy devices were the largest contributors to expenditure growth. High-technology procedures were confirmed as a key driver of public healthcare expenditure growth in Portugal, contributing to more than a quarter of this growth.

The Greek economic crisis and its impact on the national health system

Abstract The Greek economic crisis produced severe economic and social outcomes. A massive rescue package was conditional on implementing a Memorandum of Economic and Financial Policies agreed upon between the Greek government and the EU, European Central Bank, and the International Monetary Fund. The extremely austere fiscal consolidation and the structural reforms accompanying the Greek Economic Adjustment Programmes reduced the country’s GDP. Implementing the austerity policies on the Greek National Health System, which was already facing structural problems, reduced the quality and availability of public health care services. This paper investigates the impact of the GDP change on public healthcare expenditures (HCE) from 2000 to 2018. The empirical analysis reveals a statistically significant positive correlation between the GDP per capita and public healthcare expenditure (HCE) from 2000 to 2014 while the effect of GDP on HCE after the 2015 remains unchanged. This paper contributes to the field’s literature since it determines the impact of GDP on public HCE, specifically matched with empirical results to derive conclusive answers.

Private health insurance in the United States and Sweden: A comparative review.

The United States of America and Sweden both contain a public and private component to their healthcare systems. While both countries spend a similar amount per capita on public healthcare expenditures, the United States spends significantly more in the private healthcare sector. Sweden has a social democratic model of health care, and given its identity as a welfare state, private health insurance providers have a small and nuanced role. This paper was completed after searches were queried for "Sweden," "United States," and variants of the words "insurance," "public," "private," "Medicare," "Medicaid," "public," and "costs." A preliminary search in May 2022, yielded 78 articles, of which 45 were ultimately considered relevant for this review. Inclusion criteria consisted of English language articles, topic relevance, and verification of MEDLINE-indexed journals. These searches were performed in PubMed, Google Scholar, Embase, and Cochrane. Summary findings of these searches are compiled in this review. Sweden guarantees low-cost appropriate care to all citizens with equitable access; however, drawbacks of its system include high financial burden, lack of primary care infrastructure, as well as geographical and socioeconomic inequities. On the other hand, the United States' healthcare system is built around the private sector with public health insurance reserved only for the most vulnerable patient populations. Our goal is to provide an overview, compare the role of private health insurance in both countries, and highlight policies that have had beneficial effects in each nation. Possible solutions to the drawbacks of each nation's health insurance policies could be addressed by additional support to Sweden's vulnerable population by developing a program similar to the US' Medicare Advantage program. Conversely, the United States may benefit from increasing access to public health insurance, especially in instances where families face unemployment.

Pattern of Public Healthcare Expenditure and Preparedness for COVID-19 in India: An Interstate Analysis

The present study made an attempt to examine the changing pattern of public healthcare expenditure across Indian states for the period 1979–1980 to 2019–2020 and tried to relate this with the spread and mortality of COVID-19 infected cases. An attempt was also made to analyse the responsiveness of per capita public healthcare expenditure (PCPHE) with the change in per capita GSDP (PCGSDP) to a much-disaggregated level. The supply side composite index (SSCI), panel regression and panel generalised method of moments (GMM) was used for analytical purpose. The study found that the greater variation in PCPHE across Indian states start exhibiting since the early years of initiation of NRHM policy and continued till recent years. Unlike the PCPHE, the public healthcare expenditure to GSDP ratio declined for all states in the subsequent time periods. The value of SSCI for both revenue and capital expenditure was low in states having larger populations and geographical areas. The study argued that the average PCPHE across Indian states exhibited irregular pattern of association with the COVID-19 confirmed cases, positivity and death rate. The panel GMM estimate of PCPHE exhibited an inelastic relationship with PCGSDP implying public healthcare is a ‘necessity’ across the Indian states.

Analysis of Risk Factors for Carbapenem Resistant Klebsiella pneumoniae Infection and Construction of Nomogram Model: A Large Case-Control and Cohort Study from Shanxi, China.

Healthcare-associated infections caused by carbapenem-resistant Klebsiella pneumoniae (CRKP) are now a global public health problem, increasing the burden of disease and public healthcare expenditures in various countries. The aim of this study was to analyse the risk factors for CRKP infections and to develop nomogram models to help clinicians predict CRKP infections at an early stage to facilitate diagnosis and treatment. The clinical data of patients with Klebsiella pneumoniae (KP) infections in our hospital from January 2018 to January 2023 were collected. 174 patients with CRKP infections and 219 patients with CSKP infections were selected for case-control study. 27 predictors related to CRKP infections were determined. The least absolute shrinkage and selection operator (Lasso) regression was used to screen the characteristic variables, Multivariate logistic regression analysis was performed on the selected variables and a nomogram model was established. The discrimination and calibration of the nomogram model were evaluated by receiver operator curves (ROC) and calibration curves. Six predictive factors of ICU stay, fever time, central venous catheterization time, catheter indwelling time, carbapenem use and tetracycline use screened by lasso regression were included in the logistic regression model, and the nomogram was drawn to visualize the results. The area under ROC curve of training set and validation set was 0.894 (95% CI: 0.857, 0.931) and 0.872 (95% CI: 0.805, 0.939); The results of decision curve analysis also show that the model has good prediction accuracy. This study established a nomogram to predict CRKP infection based on lasso-logistic regression model, which has certain guiding significance for early diagnosis of CRKP infections.

Life Expectancy, Public Healthcare Expenditure and Economic Growth: The Nigerian experience

Life Expectancy, Public Healthcare Expenditure and Economic Growth: The Nigerian experience

Subsidy Entrepreneurship and Nigeria’s Economic Development

The research delved into the impact of subsidy entrepreneurship on the economic development within Nigeria throughout the span from 2012 to 2021, utilizing annual time series data. The evaluation of stationarity was conducted through the Augmented Dickey Fuller test, while the estimation of parameters was undertaken using the Autoregressive Distributed Lag (ARDL) methodology. The findings unveiled a persistent and long term relationship among the variables. The test outcomes reveal that all the variables exhibit stationarity upon initial differencing, surpassing the 5% level of significance. The results show an increase in fiscal deficit as a proxy for subsidy entrepreneurship leads to a decrease in economic development. The result also pointed out an increase in gross national income leads to increase in economic development. The results have obvious policy implications for Nigeria. Nigeria must do away with subsidy entrepreneurs which are corruptly enriched through fiscal deficit responsible for the infrastructural gap and fueling poor human development index in Nigeria. Keywords: Subsidy entrepreneurship; Economic Development; Human Development Indicator; Fiscal Deficit; Keywords: Life Expectancy; Public Healthcare Expenditure; Income Per Capita

The Impact of Public Healthcare Expenditure and Other Determinants on Life Expectancy in Nigeria

This study's core objective is to empirically investigate the impact of public healthcare expenditure and other determinants on life expectancy in Nigeria for the period 1981 to 2018, with the aim of proffering policies to improve life expectancy. Grossman's health model was used to analyze life expectancy as a function of gross domestic product (GDP), government health expenditure, inflation, secondary school enrolment, food production, and urban population. The autoregressive distributed lag (ARDL-bounds) technique, Granger causality test based on Toda Yamamoto approach, and Augmented Dickey Fuller test, was utilized to analyze the data. The results show a long-run causal relationship between life expectancy and the variables: per capita income, government health expenditure, inflation rate, secondary school enrolment, and urbanization in Nigeria. Thus, highlighting the significant long-run impact of public healthcare expenditure on life expectancy at birth in Nigeria. Based on the study's findings, key recommendations for Nigeria to improve the life expectancy of its citizenry were; to increase its public healthcare expenditure and GDP per capita expenditure, address issues of inadequate and insecure food production, develop new regional cities to cut down rural-urban drift, reduce inflation and ensure price stability.

Entwicklung der öffentlichen Gesundheitsausgaben

Abstract In light of demographic change, health expenditures of the German state should rise considerably in future. On the basis of the 15th population forecast of the German Federal Statistical Office, health expenditures of the German public health care system are projected until the year 2050. As the calculations show, public health care expenditures of the German federal state will almost triple by then.. In Germany, public health care expenditures are financed by social security contributions raised on gross wages. These wages, according to long-term economic projections of the OECD, will also rise considerably by the year of 2050. However, since public health care expenditures will increase more than gross wages due to demographic change, contribution rates or tax subsidies to the German statutory health insurance will have to be increased.

The Impact of Public Healthcare Expenditure and Other Determinants on Life Expectancy in Nigeria

This study’s core objective is to empirically investigate the impact of public healthcare expenditure and other determinants on life expectancy in Nigeria for the period 1981 to 2018, with the aim of proffering policies to improve life expectancy. Grossman’s health model was used to analyze life expectancy as a function of gross domestic product (GDP), government health expenditure, inflation, secondary school enrolment, food production, and urban population. The autoregressive distributed lag (ARDL-bounds) technique, Granger causality test based on Toda Yamamoto approach, and Augmented Dickey-Fuller test, was utilized to analyze the data. The results show a long-run causal relationship between life expectancy and the variables: per capita income, government health expenditure, inflation rate, secondary school enrolment, and urbanization in Nigeria. Thus, highlighting the significant long-run impact of public healthcare expenditure on life expectancy at birth in Nigeria. Based on the study’s findings, key recommendations for Nigeria to improve the life expectancy of its citizenry were; to increase its public healthcare expenditure and GDP per capita expenditure, address issues of inadequate and insecure food production, develop new regional cities to cut down rural-urban drift, reduce inflation and ensure price stability. Keywords: Life Expectancy; Public Healthcare Expenditure; Income Per Capita

The political and fiscal determinants of public health and curative care expenditures: evidence from the Canadian provinces, 1980-2018.

Public health systems have been centre stage during the COVID-19 pandemic, but governments invest relatively little in public health as compared to curative care. Previous research has shown that public health expenditures are under pressure during recessions and could be politically determined, but very few studies analyze quantitatively their determinants. This study investigates the political and fiscal determinants of public health and curative care expenditures. After constructing a dataset building on disaggregated health expenditures in the Canadian provinces from 1975 to 2018, we use error correction models to study the short-run and long-run influence of fiscal and political determinants on public health expenditures and on curative expenditures. Fiscal determinants include measures of public debt charges and federal transfers. Political determinants include government partisanship and election cycles. We also explore whether curative expenditures crowd out public health expenditures. We find no difference between left and right governments in curative care expenditures but show that left governments spend more on public health if we control for past spending decisions in favour of curative care. Fiscal austerity reduces both public health and curative expenditures, and provincial governments use additional intergovernmental transfers to increase their curative care budgets. A growth in the proportion of curative care relative to total health budgets is associated with a decline in public health expenditures. Even though they have low political salience, public health expenditures remain driven by partisanship and electoral concerns. Despite their widely acknowledged importance, public health programs develop in the shadow of curative care priorities.

DOES CARBON EMISSION, ENERGY CONSUMPTION AND INCOME MATTER? INVESTIGATING FACTORS AFFECTING HEALTHCARE EXPENDITURE AMONG 61 NATIONS

Empirical studies on the effects of carbon emissions on population health are still in their infancy and its true implications have not yet been fully understood. The purpose of this study is to conduct a comparative analysis on the relationship between carbon emissions, energy consumption, income and public healthcare expenditure in Organisation for Economic Co-operation and Development (OECD) and non-OECD countries. The empirical research employs the dynamic common correlated effects of mean group (DCCEMG) and two-stage least square estimators. The findings indicate that carbon emissions increase healthcare spending only in non-OECD countries. The relationship between energy consumption and health expenditure varies significantly between OECD and non-OECD countries. Income increases health expenditure; however, the correlation is more robust in the OECD than in non-OECD countries. As a result, the findings recommend that non-OECD governments implement strategic environmental management policies that prioritize clean and healthy air to reduce healthcare costs.

Impact of Coronavirus Disease COVID-19 on the Relationship between Healthcare Expenditures and Sustainable Economic Growth.

The coronavirus disease (COVID-19) pandemic led to a catastrophic burden on the healthcare system and increased expenditures for the supporting medical infrastructure. It also had dramatic socioeconomic consequences. The purpose of this study is to identify the empirical patterns of healthcare expenditures' influence on sustainable economic growth in the pandemic and pre-pandemic periods. Fulfilment of the research task involves the implementation of two empirical blocks: (1) development of a Sustainable Economic Growth Index based on public health, environmental, social, and economic indicators using principal component analysis, ranking, Fishburne approach, and additive convolution; (2) modelling the impact of different kinds of healthcare expenditures (current, capital, general government, private, out-of-pocket) on the index using panel data regression modelling (random-effects GLS regression). Regression results in the pre-pandemic period show that the growth of capital, government, and private healthcare expenditures positively influence sustainable economic growth. In 2020-2021, healthcare expenditures did not statistically significantly influence sustainable economic growth. Consequently, more stable conditions allowed capital healthcare expenditures to boost economic growth, while an excessive healthcare expenditure burden damaged economic stability during the COVID-19 pandemic. In the pre-pandemic period, public and private healthcare expenditures ensured sustainable economic growth; out-of-pocket healthcare expenditures dominantly contributed to the pandemic period.

POLÍTICA DE FINANCIAMENTO DO SISTEMA PÚBLICO DE SAÚDE NO BRASIL: DESAFIOS PARA O FUTURO PÓS-PANDEMIA

ABSTRACT Healthcare financing is attracting widespread interest due to the coronavirus pandemic. This study aims to assess federal public healthcare financing in Brazil in the light of a legal framework for minimum spending on health and the effects of economic cycles and crises. A literature review showed that public healthcare funding should increase during crises, which is contrary to what fiscal austerity policies postulate. Different formats of fiscal rules for minimum spending on health are analyzed based on the historical evolution of healthcare financing in Brazil. A simulation shows that linking this spending rule to GDP (and especially to current revenue) gives a pro-cyclical character to healthcare financing, which can make it difficult to guarantee health rights in times of crisis. Thus, a debate arises about the need to revise the rule set by the Constitutional Amendment 95/2016 (EC no. 95/2016) and to establish a parameter for growth in public healthcare expenditure that eliminates its pro-cyclical characteristic and enables the needs of the country to be met after the pandemic.

Breaking Barriers: Unlocking Opportunities to Optimize Public Health and Environmental Quality Benefits in Developing Economies

The surge in healthcare costs in recent years can be attributed to the harmful effects of pollution, rapid economic expansion, and social issues that negatively impact public health. The study utilizes the most advanced statistical techniques available to investigate the impact of carbon dioxide emissions and environmental indices on government and private healthcare expenditures in six emerging economies from 1994 to 2021. The findings reveal that carbon emissions and environmental index have a significant positive impact on public healthcare expenditure but a negative effect on private healthcare spending in developing nations. Sustainable economic growth supports healthcare spending, whereas foreign direct investment has mixed impacts, deleterious to public expenditure but salutary to private spending. Population aging is associated with increased healthcare costs, while secondary education is demonstrated to reduce personal healthcare spending in developing economies. Moreover, the study affirms the health-wealth nexus prevails in developing economies. These findings offer valuable insights for policymakers to pursue in optimizing public health and environmental quality benefits, which are inexorably linked to sustainable economic growth and progress in developing nations.

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.

The Effect of Public Healthcare Expenditure on the Reduction in Mortality Rates Caused by Unhealthy Habits among the Population.

The health systems of developed countries aim to reduce the mortality rates of their populations. To this end, they must fight against the unhealthy habits of citizens, such as smoking, excessive alcohol consumption, and sedentarism, since these result in a large number of deaths each year. Our research aims to analyze whether an increase in health resources influences the number of deaths caused by the unhealthy habits of the population. To achieve this objective, a sample containing key indicators of the Spanish health system was analyzed using the partial least squares structural equation modeling (PLS-SEM) method. The results show how increasing public health spending and, thus, the resources allocated to healthcare can curb the adverse effects of the population's unhealthy habits. These results have important implications for theory and practice, demonstrating the need for adequate investment in the healthcare system to reduce mortality among the population.

Corruption In Health Care Systems: Trends In Informal Payments Across Twenty-Eight EU Countries, 2013-19.

Corruption is a major challenge in health care systems across the European Union (EU), where it manifests most visibly as informal payments from patients to providers. A higher prevalence of informal payments has been associated with lower public health care expenditure. EU member states have experienced significant changes in public health care expenditure throughout the 2000s. Given the lack of research on the topic, we explored trends in informal payments using representative data from twenty-eight EU member states during the period 2013-19 and in relation to changes in public health care expenditure. Overall, we found that informal payments increased in 2019 compared with 2013, whereas the perception of corruption decreased. Although higher public health care expenditure was associated with less corruption, we found a smaller effect size between informal payments and this expenditure throughout the study period. Our results suggest that informal payments may be driven by other factors, although the directionality of this relationship requires further investigation. Moreover, additional public health care investments may be insufficient to confront corruption unless coupled with measures to limit wasteful spending and increase transparency. Policy makers should understand that factors external to health systems, including media coverage and cultural and political factors, should be explored to explain country-level differences in corruption.