Share Of Health Expenditure Research Articles

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.

OECD Ülkelerinin Sürdürülebilir Kalkınma Değişkenlerine Göre Kendi Kendine Öğrenen Haritalar Yaklaşımı ile Kümelenmesi

Sustainable Development concept (SD) aims to better life for future generations. However, the COVID-19 pandemic has caused tremendous effects on people’s life in several areas. Therefore, the study aimed to investigate the impact of COVID-19 on the selected part of SD indicators in the OECD countries using Self-Organizing Map (SOM). SOM is a kind of artificial neural network (ANN) method, which is an effective clustering method to find hinder non-linear relationships between indicators. The data contained 38 OECD member countries for 11 variables for each country, covering three years (2019-2021). Firstly, descriptive statistics and Spearman rank correlation analysis were used for bivariate analysis. The coefficient of variation was also used to measure the convergence of indicators. Then, it was a two-stage clustering method using SOM and hierarchical clustering methods—the optimal cluster found according to the Silhouette Index and Davies–Bouldin Index, and as three. The convergence of gross domestic product increased gradually to 40.33% in 2019, 42.01% in 2020, and 43.69% in 2021, meaning increasing relative variability of OECD countries. While the mean of the life span was decreased, the share of health expenditure, health expenditure per capita, out-of-pocket health expenditure, and government health expenditure were increased in the study period. According to clustering analysis, the countries had similar characteristics within three years, except Colombia. Also, the USA distinguished very different characteristics from other OECD countries. Although the mean of study indicators varies due to the effect of the pandemic, the change within each OECD country showed mostly similar characteristics within three years.

Healthcare system efficiency and drivers: Re-evaluation of OECD countries for COVID-19

The Covid-19 pandemic has raised concerns about the resilience of health systems. The aim of this study is twofold: i) to measure and compare the resilience of health system efficiency of OECD countries before and during Covid-19 and ii) to determine the healthcare efficiency drivers (e.g., socio-economic) of health system performance. Using a dataset of 31 OECD countries for 2018 and 2020, we first estimate bias-adjusted efficiency scores, followed by a double bootstrap truncated regression procedure to study the drivers associated with health system efficiency. We find that the health system efficiency overall score decreased among OECD countries during the Covid-19 pandemic compared to before Covid-19. Estonia and Japan retained their full efficiency scoreduring Covid-19. We find a negative association between health system efficiency and unemployment rate, share of health expenditure in GDP, and share of population over 65. Conversely, high vaccination rates contribute positively to health system efficiency during the Covid-19 period.

Whether occupational injuries of the industrial workers can be prevented: an analysis from the slums of West Bengal-India?

A lack of research exists concerning the heterogeneity of the occupational injuries of slum dwellers across industries which has a close link with health expenditure and hence livelihood. It necessitates analysing their occupational injuries and associated out-of-pocket health expenditures. Multi-stage random sampling is used to collect the primary data and the logit model is used for data analyses. Permanent non-fatal injuries in the civil-mechanical industries and temporary non-fatal injuries in textile industries are common. The share of health expenditure of the injured workers seeking medical consultations remains 59% of their average monthly income. Average monthly income, parental occupation, types of industry, job security, risk intensity, and salary basis are significant estimates of occupational injuries. The differences in the nature and extent of the occupational injuries of the workers across industries in the light of the socio-demographic and working environment context provide significant insight into the policy implications.

The Crowding-out Effect of Tobacco Expenditure on Health Expenditure: Evidence From a Lower-Middle-Income Country.

Poor people have remarkably lower health expenditures than rich people in Vietnam. According to the 2016 Vietnam Household Living Standard Survey (VHLSS), per capita health expenditure of the top quintile households is around 6 times higher than that of the bottom quintile households. We analyze economic inequalities in health expenditure using the concentration index approach and data from the VHLSS 2010-2016. Next, we use the instrumental-variable regression analysis to examine the crowding-out effect of tobacco expenditure on health expenditure. Finally, we use decomposition analysis to explore whether economic inequality in tobacco expenditure is associated with an economic inequality in health expenditure. We find a crowding-out effect of tobacco expenditure on health expenditure of households. The share of health expenditure of households with tobacco spending is 0.78% lower than that of households without tobacco spending. It is estimated that a one-VND increase in tobacco expenditure results in a 0.18 Vietnamese Dong (VND) (95% CI: -0.30 to -0.06) decrease in health expenditure. There is a negative association between economic inequality in tobacco expenditure and economic inequality in health expenditure. This means that if the poor consume less tobacco, their expenditure on health can be increased, resulting in a decrease in inequality in health expenditure. Findings from this study suggest that reducing tobacco expenditure could improve health care of the poor and reduce inequality in health care in Vietnam. Our study recommends that the government continuously increase the tobacco tax in order to effectively reduce tobacco consumption. Empirical studies show mixed results on the effect of tobacco expenditure on health expenditure. We find a crowding-out effect of tobacco expenditure on health expenditure of poor households in Vietnam. It implies that if the poor reduce their expenditure on tobacco, economic inequality in health expenditure can be reduced. Our findings suggest that reducing tobacco consumption in poor households can increase their health expenditure, therefore, decreasing inequality in health expenditure. Different policies to reduce tobacco consumption such as tobacco taxation, smoke-free areas, and tobacco advertisement bans should be strengthened.

Causality Analysis for Non-Communicable Diseases, Obesity, and Health Expenditure: Toda Yamamoto Approach

This study examines the causal relationship between non-communicable disease (NCD), obesity, and health expenditure in Turkey using econometric time series analysis. Data were obtained from the World Health Organization and Our World in Data for the years 1990-2019. We used a model structure capable of revealing robust causality between variables at consistent and successive time intervals to obtain reliable results. The Toda-Yamamoto econometric causality model was utilized in the E-Views 9.0 software for the analysis. The findings disclose three noteworthy results. Firstly, there exists causality from obesity to the burden of non-communicable diseases, meaning that obesity affects the proportion of non-communicable diseases in the population. Secondly, there is a causal relationship between obesity and health expenditure. Consequently, an increase in the obesity rate within society leads to a rise in the share of health expenditures in GDP. Lastly, the burden of non-communicable diseases in Disability-Adjusted Life Years (DALY) is also a determinant of health expenditures. By the obtained results from econometric causality, it is evident that NCDs, obesity, and health expenditure are interconnected as anticipated.

Health System Efficiency of OECD Countries with Data Envelopment Analysis

Purpose: This study is aimed at measuring the efficiency of 37 OECD countries for 2020 using the Data Envelopment Analysis (DEA) method. Besides, it is aimed at ranking the efficient decision making units by using the super-efficiency DEA model. Design/methodology/approach: In the study, analyses were carried out with input-oriented Charnes, Cooper and Rhodes (CCR), input-oriented Banker, Charnes and Cooper (BCC) models and super-efficiency models of these models by using 4 inputs and 3 outputs. Findings: As a result of the analysis, 14 countries in the CCR model and 20 countries in the BCC model were efficient. According to the results of the super-efficiency models, the efficient countries were ranked. Research limitations/implications: The limitations of the study are the analyses are based on input-oriented DEA models and the research was conducted in OECD countries. Originality/value: Performance evaluation of health systems has gained importance in recent years. Many countries are making efforts to improve their health systems. Due to epidemics such as COVID-19, OECD countries, like many countries around the world, have increased the share of health expenditures in GDP. Because of this situation, the evaluation of the performance of OECD countries in the field of health has emerged as a very important research topic.

Healthcare: Is it a Business or a Profession?

Thus, the question of medicine being a profession or a business arises. The share of health expenditure in the GDP of the Philippines is 5.6%; health spending of Filipino household has been increasing recently, mostly spent for drugs and other medical goods. Could this be one of the reasons why more businessmen engage in building and operating a hospital?  And some doctors turning to become health entrepreneurs too?

COVID-19 pandemisinin seyri ve sağlık giderleri açısından Türkiye ve Avrupa veri karşılaştırması

Introduction: The COVID-19 pandemic has affected the entire world and has been a challenge to the health prospects of the nations infected. The elderly population of the nations and parameters like the countries' health system and the allocation of budget to health are critical factors for explaining the epidemic's development with different mortality rates in various countries. The purpose of the study was to assess the characteristics of the Turkish population, COVID cases, the progression of diseases, and health expenditures compared to those in Europe.Methods: For this study, we used the following databases: the Worldometer digital database, the database of the Organization for Economic Cooperation and Development, and the Turkish National Databases on Economic and Finance references, such as the Turkish National Strategy and Budget Presidency and the database of the Turkish Statistical Institute. The data was for the date 15.12.2021 and the general annual for 2020.Results: By the investigation date as of 15/12/2021, the total number of COVID-19 cases was 9209740 in Turkey and 81556853 in the European Union countries. The incidence of the disease was 107.500 in Turkey and 135.525 in Europe. While the total change/ increase in last-week-new cases was -5% and 8% in Turkey and Europe, respectively, the real change/ increase in last-week-deaths was -1% to -8% in Turkey and Europe. The number of COVID screening tests per one million population was higher in Europe (1.343.256 to 8.790.27 in Turkey and Europe, respectively). The GDP and health expenditure per capita were distinctly higher in Europe.Conclusion: The fact that there is a higher percentage of elderly residents in European countries than in Turkey, that the number of new cases detected every week is higher, and that the death rate and the gradual decline in cases are linked to the large share of health expenditures distributed by nations for the fight against the disease.

Does microcredit for water and sanitation improve household welfare? Evidence from Indonesia

AbstractThe water supply and sanitation (WSS) sector requires large household investments and expenditure. Microfinance provides an alternative financing scheme to support in reaching universal access to WSS to improve public health and well-being. Using propensity score matching to Water.org's household survey data, combined with the Village Potential's village statistics, this study aims to evaluate the impact of microcredit devoted to improvements in water and sanitation facilities towards household welfare measured by the WSS Joint Monitoring Programme (JMP) ladder status, income, and the share of health expenditure. Due to data availability limitations, the results indicated an associative relationship, as opposed to a causality relationship, between WSS microcredit participation and the respective outcomes. Participation in WSS microcredit was significantly associated with a higher JMP ladder for sanitation access but not with a JMP ladder for water access. Moreover, borrowers’ participation in WSS microcredit was associated with a significantly higher monthly income and a significantly lower proportion of health expenditure. Future evaluation studies of WSS microcredit should focus on improving data collection or conducting randomized control trials. For ensuring better practices, microfinance institutions (MFIs) should conduct stringent monitoring on fund usage to assure households benefit from the expected outcomes of WSS improvements.

Exploring the possible sources of fiscal space for health in India: insights from political regimes

BackgroundRising healthcare costs and poor access to health services have become a significant concern for policy-makers; therefore, efforts must be made to generate fiscal space through alternative revenue measures in resource-poor economies. This study attempts to identify possible sources of fiscal space for health in India across political regimes.MethodsThe study followed a descriptive approach to examine the political commitment towards health sector development by estimating the trend of growth in fiscal space indicators over the political regimes from 1998–1999 to 2021–2022 using a dummy variable regression model.ResultsWe found four possible sources of fiscal space for health, which include (1) raising domestic revenue mobilization, (2) generating alternative revenue collection mechanisms, (3) prioritizing health through expenditure management and (4) effective utilization of central transfer. Fiscal space measures such as goods and services tax reform, collection of health-specific tax, higher excise duty on tobacco products, cooking gas subsidies to poor people, tax administration reform and direct beneficiary transfer of health services could be alternative revenue mobilization channels for fiscal space for health.ConclusionThe study reveals that the central government has a political commitment to generating revenue through various fiscal policy reforms. Health has been prioritized over the period, but there is less evidence of health-related political commitment for an increased share of health expenditure to total budgetary allocation. During the last 2 years, however, the health budget has been prioritized due to the COVID-19 pandemic crisis despite slower economic growth in India. This study will be a policy document for fiscal space analysis from a political-economic perspective, and the role of the ministry of finance can be assessed through administrative data and documents.

Measuring the level of energy and health expenditure among energy-poor and non-poor households in india: a disaggregated analysis

ABSTRACT Energy poverty is a complex multidimensional phenomenon perceived differently in developed and developing countries. It becomes necessary to identify the energy-poor households as energy poverty affects households in many ways, with negative consequences. This study is established upon an enhanced version of the multidimensional energy poverty index. Still, it differs from the earlier frameworks, as it incorporates two critical dimensions of 10% measurement and minimum energy required for necessities. Devising a multidimensional energy poverty index, this study analyzed the pattern and magnitude of household expenditure on energy and health among energy-poor and non-poor. This study is demonstrated in India using household-level data from the National Sample Survey 68th round. The results reveal that per capita energy and health expenditure; and the share of health expenditure in the total consumption expenditure among energy-poor households is high. Insights from this study can be a valuable input for policymakers to identify energy-poor households and frame relevant and effective policies to alleviate energy poverty.

Measuring the Magnitude of Health Expenditure Induced Removable Poverty in India

By using nationally representative consumer expenditure surveys of three quinquennial rounds conducted by NSSO, authors have measured the health expenditure induced removable poverty in the form of ‘hidden’ and ‘reinforced’ poverty in India. The analysis shows that both the incidence and depth of poverty are substantially understated because of overlooking out-of-pocket (OOP) health expenditure in the country's standard measure of poverty. It is the outpatient care that contributes most to the health expenditure impoverishment of the households in India. Muslims, among all religious groups, Scheduled Castes among social groups, and casual laborers among different household groups are more vulnerable to OOP health expenditure induced removable poverty in India. Poverty, in general, has dropped significantly, but the share of health expenditure induced poverty in general poverty has increased substantially, especially in rural India in the past 20 years. Health insurance coverage can make a significant change in the country's poverty level but focus on a particular group of the population may not solve this problem because health expenditure induced poverty is not any group-specific.

Generating Financial Resources for Health

The majority of developing countries in Asia have been making reforms to their health systems for decades but have still failed to achieve their targets for universal health coverage (UHC), that is, ensuring that all people obtain the health services they need without suffering financial hardship when paying for them, and the health- and poverty-related Sustainable Development Goals (SDGs). Countries in Asia rely on a mixture of healthcare financing sources, such as government general revenue, social health insurance (SHI), external funding, private health insurance and out-of-pocket (OOP) payments. Asian countries generally spend between 1% and 10% of their national GDP on health. There are variations in government investment in health as a proportion of total health expenditure across countries, from 23.4% in Japan to Myanmar’s 4.8%. Many governments in Asia have introduced various types of publicly financed health insurance schemes (SHI). The private sector, in providing healthcare, has expanded rapidly, because many national health systems are not able to cope with rising costs, especially for co-payment, and the increasing demand for services. The introduction of private health insurance has reduced OOP payments and, in the long run, could evolve a broader SHI system. As a result of the low levels of government spending, OOP payments by health consumers constitute a large share of health expenditures, amounting to more than US$0.5 trillion or US$80 per capita annually. Rapid increases in development assistance for health (DAH) since 2000 have resulted in major health gains in the poorest countries, yet DAH levels have stagnated in recent years. DAH must evolve to help accelerate progress toward UHC.

Role of the Health System in Combating Covid-19: Cross-Section Analysis and Artificial Neural Network Simulation for 124 Country Cases

ABSTRACT In the fight against Covid-19, developed countries and developing countries diverge in success. This drew attention to the discussion of how different health systems and different levels of health spending are effective in combating Covid-19. In this study, the role of the health system in the fight against Covid-19 is discussed. In this context, the number of hospital beds, the number of doctors, life expectancy at 60, universal health service and the share of health expenditures in GDP were used as health indicators. In the study, firstly 2020 data was estimated by using the Artificial Neural Networks simulation method and this year was used in the analysis. The model, with the data of 124 countries, was estimated using the cross-sectional OLS regression method. The estimation results show that the number of hospital beds, number of doctors and life expectancy at the age of 60 have statistically significant and positive effects on the ratio of Covid-19 recovered/cases. Universal health service and share of health expenditures in GDP are not significant statistically on the cases and recovered. Hospital bed capacity is the most effective variable on the recovered/case ratio.

Economic Evaluation of Health Tourism in Turkey

The purpose of this study is to make an economic evaluation of health tourism by utilizing the number of tourists coming to Turkey in order to receive health care, and by taking the expenditures of these tourists into consideration. In the study, the data were obtained from secondary sources, mainly those that have been provided by Turkish Statistical Institute. A descriptive analysis was performed in this study. Within the study, it was determined that the number of tourists coming for health purposes and the share of health expenditures of tourists in total tourism income have increased over the years. Besides, it was seen that the average spending of tourists visiting Turkey for healthcare is much more than the average expenditure of all tourists.

The share of health care spending in the structure of GDP as a criterion for the healthcare system effectiveness

Effective work of the healthcare system is becoming increasingly important in modern conditions, which actualizes the task of finding tools to increase the effectiveness of its functioning; this should ultimately lead to a decrease in morbidity and an increase in life expectancy. One of the main criteria for social development in modern conditions is the share of health care spending as a percentage of GDP; since this reflects the degree of attention and concern of the state about the health and life of citizens. The research hypothesis states that the share of health care costs does not affect the quality of the health care system, which is expressed in the average life expectancy of the population. To confirm the hypothesis, an analysis was made of the degree of influence of the share of expenditures on health care development on GDP on average life expectancy in the context of countries using a simple pair correlation and correlation between ranks; A cluster analysis of the countries was also carried out on the basis of their grouping according to the level of health spending as a percentage of GDP. It has been established that there is no connection between the share of health expenditures from GDP in countries and average life expectancy in them, which confirms the failure to use this indicator as a criterion for assessing the development of the health system. A cluster analysis of the countries under consideration showed that the effectiveness of the health care system is a complex category, depending not only on the level of state funding, but also on a number of other aspects.

Evaluating the performance of primary health care services in Turkey and the use of the Primary Care Assessment Tool (PCAT): lessons from Brazil in a national random household survey

Like Brazil, Turkey spends about $1,200 percapita on health. In demographic terms, othersimilarities can be observed: the populationover 65 years old is close to 9.0% in bothcountries, away from the demographic trendof aging in Europe, where the OECD averagefor a set of 36 countries is 17.4%.However, the share of healthexpenditure in relation to GDP is different: inthe first 9.2% and in the second only 4.2%,although, this percentage in the case of Turkeyconsiders that most of the spending comesfrom public sources (about 80%), while inBrazil only 43%

Overview of the pediatric healthcare system in Romania.

Until 1989, Romania was one of the countries of the communist bloc in Europe and its healthcare system was characterized by centralized planning and severe underfunding, with low performance and low quality healthcare. Since 1998, Romania replaced the Semashko model with a social health insurance system, highly centralized under the management of the Ministry of Health as the central administrative authority. After joining the European Union, quality of life increased in our country and there were efforts to improve the quality of healthcare, including pediatric and neonatal care. Still, Romania has the lowest share of health expenditure of gross domestic product among the European Union Member States and the lowest level of expenditure per inhabitant. The Romanian health system is organized on three levels of assistance: primary, secondary and tertiary assistance. This overview presents the organization and the characteristics of pediatric and neonatal healthcare in Romania at all levels, the infrastructure and the human resources, the educational system from medical school to pediatric residency, professional organizations, national health programs, and the child health status in Romania. Infant mortality, the most descriptive single indicator of the quality of a health system, decreased constantly for the last 30 years in Romania, but is still the highest in the European Union. Even though there were great improvements in the healthcare for children, more efforts should be made to assure a better quality of care for the future of our nation, both on the human resources (in great danger due to the brain-drain of medical professionals during the last 12 years), and on the infrastructure plan.

Russian healthcare in the context of achieving universal access to health services by 2030

The article presents the results of an analysis of data from global monitoring systems and international studies for the period 2000-2017, reflecting the trends in our country's movement towards universal health coverage (UHC) and a reduction in catastrophic medical expenses paid by patients from their own funds within the framework of the tasks for achieving the Sustainable Development Goals by 2030. It is emphasized that for our country it is of great interest to adapt the successful experience of developed and actively developing countries in using targeted integrated strategies for development of UHC programs aimed at giving priority to health in the system of public financing measures. This is confirmed by the data that for the period 2000-2017 against the background of an increase in the share of replacing the missing state funds with cash funds of citizens in the total health budget of our country from 30% to 40%, there was a parallel increase in the number of households, in the structure of the budgets of which the share of health expenditures exceeded 10% of their total financial resources. According to the analysis of monitoring data, the increase in the number of Russian families with this form of catastrophic costs of medical care reached in 2018 the number of 7,532,579 cases with a prevalence rate of 5.23%. These indicators are higher than the data levels for 1997 by more than 2.2 and 2.1 times, respectively. At the same time, the risk of financial catastrophe for families due to the need to seek surgical care in 2018 was noted in 21.3% of cases (WB, 2019). The study emphasizes the importance of scientific assessment of the consequences and prospects for the increased participation of private commercial institutions in implementation of the government program of the State guarantees of free medical assistance to citizens. The significance of such a study is due to the trends of increasing volume of the market for provision of disparate medical services and the need, therefore, to develop optimal intersectoral strategic approaches to development of both the public healthcare system and commercial medicine in the interests of ensuring health and well-being of the population.