Share Of Spending Research Articles

Resource dependence and the causes of local economic growth: An empirical investigation*

Previous research has found that regional resource dependence in Indonesia has been positively associated with income growth, contrary to a ‘resource curse’. We test five potential causal mechanisms for this positive effect: spillovers to manufacturing or to agriculture, higher education provision, improved institutional quality and share of public spending on capital. We follow 390 Indonesian districts from 2006 to 2015, using four alternative resource dependence measures, and instrumenting for their potential endogeneity. We first confirm a positive overall effect of resource dependence on real per capita Gross Regional Domestic Product (GRDP), then test whether district resource dependence positively affects manufacturing, agriculture, education, public capital investment and institutional quality. We finally test whether these factors contribute to GRDP while reducing the remaining effect of resource dependence. We find that resource dependence may aid income in part by raising district institutional quality, which in turn raises GRDP. We also find little support for a ‘contingent curse’ hypothesis that resource dependence only benefits districts that already have higher institutional quality.

UNRAVELING THE (INTRINSIC) LINKAGE BETWEEN SOCIAL SPENDING AND REGIONAL DEVELOPMENT: AN EMPIRICAL ANALYSIS FOR EUROPEAN UNION COUNTRIES

Theoretical approaches and place-specific solutions are required to face with the intrinsic linkage between social welfare and macroeconomic stability in advanced economies, especially in Europe. In this regard, the 2007 recession has influenced extensively the wide spectrum of social policies applicable in the European Community. New socioeconomic divides emerged and fiscal austerity urged Member States to resettle policy discourses, advancing social needs in a more effective way. In line with this evidence, our commentary discusses recent literature and it outlines policy implications of different political, institutional and socioeconomic settings. By analyzing cross-country variations in the shape and extent of welfare policies at the European level, our study evaluates apparent (and latent) performances of welfare systems in a comparative perspective, with a specific focus on Southern European countries. The existence of a latent relationship between social policy expenditures (SPE) and per-capita GDP was demonstrated. However, social expenditures may differ for a given level of income: for instance, Latvia had a lower level of social expenditures given its income level. Italy, Greece, Spain and Portugal were clustered together displaying a lower share of social spending in the total GDP in respect with the remaining European countries. This comparison suggests how Mediterranean countries are institutionally fragile and with a moderately higher level of corruption in respect with North-western countries. The results of this work contribute to bridge the semantic dichotomy between theoretical approaches and empirical findings in socioeconomic policy impact analysis.

The Quality of the Food Retail Environment When Consumers May Be Mobile

AbstractUsing USDA's National Household Food Acquisition and Purchase Survey (FoodAPS), we estimated block group‐level spending‐weighted mean distance to the retailers where consumers actually shop (3.9 miles overall; 7.0 miles in rural areas and 3.0 miles in urban areas). Holding constant retailer type, every 10% increase in travel distance was associated with a 3.5% decrease in the food‐at‐home spending share. If consumers travel farther to get food, it may signal that they lack satisfactory options at closer distances. Spending‐weighted mean travel distance could support measures of food retail gaps that are consistent both with consumers' revealed preferences and retailers' incentives.

Primary Care Physicians and Spending on Low-Value Care.

LettersJune 2021Primary Care Physicians and Spending on Low-Value CareAaron Baum, PhD, Andrew Bazemore, MD, MPH, Lars Peterson, MD, PhD, Sanjay Basu, MD, PhD, Keith Humphreys, PhD, and Robert L. Phillips, MD, MPHAaron Baum, PhDIcahn School of Medicine at Mount Sinai, New York, New YorkSearch for more papers by this author, Andrew Bazemore, MD, MPHAmerican Board of Family Medicine, Lexington, KentuckySearch for more papers by this author, Lars Peterson, MD, PhDAmerican Board of Family Medicine, Lexington, KentuckySearch for more papers by this author, Sanjay Basu, MD, PhDCollective Health, San Francisco, CaliforniaSearch for more papers by this author, Keith Humphreys, PhDCenter for Innovation to Implementation, Veterans Affairs and Stanford University Medical Centers, Palo Alto, CaliforniaSearch for more papers by this author, and Robert L. Phillips, MD, MPHCenter for Professionalism and Value in Health Care, Washington, DCSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/M20-6257 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Background: Low-value services account for $75 billion to $100 billion of U.S. health care spending (1). Primary care physicians (PCPs) have been conceptualized as potential gatekeepers for efforts to reduce low-value spending, but the share of low-value spending directly related to their services and referral decisions remains unclear (2, 3).Objective: To estimate the share of low-value spending on Medicare beneficiaries that is directly related to their attributed PCP's services or referrals.Methods and Findings: We analyzed Medicare Part B claims from a 20% random sample of beneficiaries enrolled between 2007 and 2014. The study population included beneficiaries who were ...

Sovereign Spreads and the Political Leaning of Nations

Using data from 56 nations over 45 years, we find that nations that are more likely to elect left wing governments face higher (and more volatile) sovereign spreads. To explain these facts, we build a sovereign default model in which two policymakers (left and right) alternate in power. The probability of an incumbent staying in power is increasing in the share of government spending. We parametrize the left policymaker as having a higher marginal political gain from increasing government spending than the right does, a feature found in our data. Model economies in which the left is more frequently in power face worse borrowing terms due to higher default risk, a greater reluctance for fiscal austerity in bad times, and a higher share of government spending on average. These features imply large welfare losses for households.

Фармакоэкономическая оценка эффективности службы клинической фармакологии в части амбулаторного лекарственного обеспечения в медицинской организации г. Нур-Султан (Казахстан)

Purpose of the study. Evaluate the clinical pharmacologist's contribution to the rational use of medications at the outpatient level.Methods. Clinical and economic analysis of budgetary expenditures on drugs purchased as part of the Guaranteed amount of free medical care and in the system of mandatory social health insurance (MSHI) for the period from 2019-2021. Assessment of the effectiveness of spending budgetary funds for drugs was conducted using data on the number and cost of drugs purchased to provide outpatient care in the medical organization of Nur-Sultan.Results. A three-year analysis showed a positive trend of a 7.1% decrease in the proportion of spending on unproven drugs (index N) by 2021 compared with the previous year 2020, which was 29.54% of spending on 13 drug items, despite the expansion of lists under insurance medicine. Before the introduction of mandatory social health insurance in 2019, this figure was 8.18% of all outpatient drug coverage costs in the Guaranteed amount of free medical care, indicating an average use of drugs not included in international clinical guidelines.Conclusions. The introduction of clinical pharmacology services into clinical practice has optimized the cost of drug therapy and promoted rational use of medications. The result is a 7.1% decrease in the share of spending on unproven drugs compared to the previous year 2020, which amounted to 29.54% of spending on 13 drugs (index N) not included in the Kazakhstan National Medical Formulary and the WHO Model List of Essential Medicines. However, due to the long-term training of clinical pharmacologists, including basic education in therapeutic medicine (6-7 years) and additional education at the level of residency or doctoral studies (2-3 years), there is decreased motivation of clinical pharmacologists to work in budget medical organizations due to the "low" level of wages. Abroad, in particular, this problem was solved by the introduction of clinical pharmacy, where training includes basic pharmaceutical education (4-5 years) with the possibility of additional training at the master's level (1-2 years) and doctoral studies (2-3 years).Keywords. ABC-VEN analysis, pharmacoeconomic analysis, clinical pharmacology, clinical pharmacy.

КАКАЯ МОДЕЛЬ ФИНАНСИРОВАНИЯ ЗДРАВООХРАНЕНИЯ ЛУЧШЕ: БЮДЖЕТНАЯ ИЛИ СОЦИАЛЬНОГО СТРАХОВАНИЯ? О ЧЕМ СВИДЕТЕЛЬСТВУЕТ МЕЖДУНАРОДНЫЙ ОПЫТ?

In Russia disputes on the need to abandon Compulsory Health Insurance (CHI) and return to the tax-based financing are yet to subside. At present, after the statement of the President of the Russian Federation V. Putin about the possibility to establish a state health care corporation, discussions on the issue have only escalated. Purpose. To conduct a comparative assessment of the public health financing model impact on the access and structural characteristics of health care delivery in the developed countries. Material and methods. Assessment of the potential impact of public funding models on the health system performance is carried out by analyzing variations in the main indicators of financial access, health care uptake and health status of the population, achieved in the developed countries with different health financing models. Results. Health care expenditures in countries with CHI are higher than in countries with the tax-based financing model. In countries with CHI the share of administrative expenses is slightly higher than in countries with the tax-based financing system. The share of spending on preventive care is slightly higher in countries with the tax-based financing system. There is a slightly lower level of outpatient and inpatient care uptake in countries with the tax-based financing system compared to countries with CHI. The premature mortality rate in countries with CHI is slightly lower than in countries with the tax-based system. Conclusion. The obtained data indicate that there are no significant differences in the access and structural characteristics of medical care in the health care system of the developed countries with different financing models. The main difference remains the level of health expenditures. In countries with CHI, the level of health expenditures is higher than in countries with the tax-based financing, which is largely due to the existence of a separate source of funding. The level of administrative costs in countries with CHI is also higher than in countries with the tax-based system.

Региональные проявления шоков спроса и предложения: экономика Хабаровского края в период пандемии

The article provides an overview of the short-term dynamics of macroeconomic indicators for the Khabarovsk Territory during the COVID-19 pandemic after the introduction of temporary restrictive measures in April and May 2020. The impact of these measures extended both to the elements of regional aggregate demand and aggregate supply. From the point of view of the theory of short-run economic fluctuations, aggregate supply and demand shocks, such as those that occurred in the initial period of the pandemic, lead to a reduction in aggregate output followed by an increase in actual and natural rate of unemployment. Expectations have an additional negative impact since the growth of uncertainty gives rise to an increase in savings and an additional reduction in consumer activity. In the case of Khabarovsk Territory it is shown that the most affected industries of the economy were retail trade and services. Both industries experienced a negative shock in April, but while the former began recovery as early as May, the latter returned to the growth trajectory only in June. Residents changed their income usage patterns due to the restrictions on the consumer market, as well as to increased uncertainty about their future income. The share of net savings and cash balances increased with a corresponding decrease in the share of spending on goods and services. A negative supply shock contributed to a sharp rise in unemployment up to 24.5 thousand unemployed in the third quarter of 2020. Starting from the fourth quarter unemployment began to decline rapidly, but it had not reached pre-pandemic level of less than 7 thousand unemployed by the second quarter of 2021. It is shown that the permanent population outmigration, which increased in 2020, is a specific feature of the regional labor market. It has slowed down the return of the regional aggregate supply to its pre-pandemic positions after the restrictions were cancelled

Financing Health in India: An Overview

Financing health care means ensuring adequate funds for health care to provide equitable access to all people and to reduce financial burden on the people. India’s healthcare system is neither sufficient nor updated. Quality of health care services is one serious issue in the country. Each year 122 person per 1 lakh die due to poor quality of care. There is linkage between poor quality of health service and low investment on health. For the last three decades Indian Government’s spending on health rangesbetween 1% to only 1.6% of GDP. The Indian government has been taking the major responsibility in health sector. It provides health care services to the people free of costs. But the public health systemis insufficient in comparison to the huge population size. Depriving quality health care services people are forced to move towards private health care providers. But in return of higher price the services provided by private players are not adequate. The objective of this paper is to have anoverview on the healthcare financing system of India and its consequences. It is found that government’s share of spending is decreasing while out of pocket expenditure is in an increasing trend in India.

Energy Poverty and Entrepreneurship

We use the 2012-2018 China Family Panel Studies data to examine the relationship between household energy poverty and an individual’s probability of becoming an entrepreneur. Consistent with the theory of underdog entrepreneurship that negative personal circumstances can foster self-reliance, resourcefulness and other skills and personality traits conducive to entrepreneurship, we find that spending a higher share of household income on energy consumption or being energy poor increases the probability of being an entrepreneur. The results are robust to various checks, including alternative measures of energy poverty, non-linear effects of the share of energy spending in household income, past entrepreneurial experience, alternative estimation methods and potential omitted variable bias. We also explore the channels through which energy poverty influences whether one chooses to become an entrepreneur. We find that cognitive functions, mental health and self-confidence negatively mediate, while self-belief, extroversion and openness positively mediate, the relationship between energy poverty and entrepreneurship.

Анализ текущей ситуации после внедрения системы обязательного социального медицинского страхования Республики Казахстан

The aim of the study: To assess the current state, the balance of functions and development trends of Social Health Insurance Fund NJSC. Methods. In order to study the level of awareness of the population about the implementation of the compulsory social health insurance system (CSHI), a mass survey was conducted twice during 2019 (in May and September) with a total sample of 2,150 respondents, including all regions of Kazakhstan. Also, within the framework of the study, such indicators of the activity of the Social Health Insurance Fund as the availability of funding for 2019-2020, the amount of funding by service providers, and coverage of the population were analyzed. Results. There is a positive trend in the compulsory health insurance system: awareness of the population is growing; the population positively assesses the changes in the provision of health services; there is a twofold increase in PHC visits; the share of private spending on health is twice the ceiling recommended by WHO; the level of coverage of the population with the compulsory health insurance system is quite high - 84%. However, about 3 million of the country's citizens remain uncovered. Conclusions. It is necessary to create a system for monitoring the effectiveness of the implementation of compulsory health insurance on the basis of information systems with the further adoption of managerial decisions both at the regional level and at the republican level. The introduction of mechanisms for proactive monitoring of the quality of medical care will protect the rights of patients, as well as improve feedback with them. Key words: Compulsory social health insurance, Medical services, Health care financing, Kazakhstan

Current trends in the structure of public expenditures in developed countries

All governments spend money. The classic “guns vs butter” debate illustrates the subject matter of this essay well: to what end do governments in developed nations spend their funds? Trends in public expenditure is a topic of particular interest in the aftermath of the year 2020, when many governments – especially developed ones – have spent tremendous amounts of money in Covid-19 stimulus packages. Research indicates that there is no immediate link between the extent of a country’s development and the share of government spending vis-à-vis its gross domestic product. In given research, we looked at the top-10 most developed countries as defined by UNDP’s Human Development Index, and at the trends in the government expenditure along three major lines – education, pensions, and health.

КЛАСТЕРНИЙ АНАЛІЗ СТРУКТУРИ ВИДАТКІВ БЮДЖЕТІВ ТЕРИТОРІАЛЬНИХ ГРОМАД УКРАЇНИ В УМОВАХ БЮДЖЕТНОГО ВИРІВНЮВАННЯ

The national fiscal equalization mechanism currently in force in Ukraine functions according to the tax capability criterion based on local budget revenues from personal income taxation. Potential conflicts of interest are inherent to this criterion due to differences in full revenue structures of territorial communities’ budgets, as well as their public service capacity and capital endowment, so that local authorities may not be motivated enough to use central government transfers to stimulate wider demand for productive labor in the community. Based on the relative budget expenditure indicators for 872 Ukrainian territorial communities, according to the 2020 totals, five categories of expenditure structure were identified using k-means cluster analysis: 1) the share of administrative spending in general fund expenditure is between 30% and 50%, the share of capital expenditures is at most 25% of total budget expenditure; 2) the capital expenditure share is at least 20%; 3) the share of wages is at most 75% in general fund expenditure; 4) the administrative spending share is higher than 50%; 5) the administrative spending share is lower than 30%, capital expenditure does not exceed 20% of the total. Parameters were estimated for log-linear dependency between general fund revenues per capita and ratios of direct/reverse transfers from central government budget, within the identified clusters and the full sample. The results allow noticing that the dependency between the revenue values and transfer ratios is statistically weaker and less elastic for clusters 2 and 3. Besides, the cluster groups show the statistically significant difference in average population of the respective communities, with lower population in clusters 1 and 4, moderate in 2 and 5, and higher in cluster 3. The differences in expenditure structure between donors and recipients of the fiscal equalization mechanism are most evident in modestly populated communities, i.e. with approximately 10,000 populations (clusters 2 and 5), where the analysis reveals subsidizing of higher administrative expenditure and capital investment shares at the expense of communities with more efficient administration. The potential conflict of interest is further amplified by lower differentiation in transfer ratios of communities with lower wage share, which predominantly act as donors through reverse budget transfers (cluster 3), as well as of communities with high capital expense shares, which are predominantly recipients (cluster 2). The identified interests and issues of the communities constituting the expenditure structure clusters allow suggesting two model priorities for inter-municipal cooperation. The first one is common projects in public services provision between the modestly populated communities with high wage shares and unequal endowment in investment resources. The second one is the shared commercial use of resources in least financially capable communities, funded by donor communities with comparatively low wage share which, in their turn, would require further optimization of administrative expenditures to be able to implement the projects of this kind.

EFFICIENCY OF GOVERNMENT EDUCATIONAL POLICY: IMPACT OF MIGRATION

Introduction. According to the document "Transforming our world: Agenda for sustainable development until 2030" adopted at the UN Summit on Sustainable Development, Ukraine has committed to 169 tasks under 17 goals by 2030. One of the goals of sustainable development is to provide equal experience in quality education, including lifelong learning. The aim of the study is determining the impact of migration processes on the level of higher education coverage in Ukraine. Research methods. To achieve the paper’s aim, the authors applied the following methods and tools: to assess stationarity - tests of Dickie Fuller (information criterion Akaike) and Phillips Perron (criterion Bartlett Kernel), to assess the integration of data - Johansen test, to identify factors influencing the study on the result - ECM-modeling. Results. The obtained results give grounds to conclude that a 5% level of statistical significance of the growth of public spending on education, GDP per capita and remittances from abroad lead to an increase in the level of higher education in Ukraine. Thus, the hypothesis of a statistically significant impact of migration processes and education expenditures on the level of higher education coverage is confirmed. In this case, the authors highlight that Ukrainian government should develop adjusting policies to improve the effectiveness of public policy on migration management and increase the share of education spending in the country. However, it should be noted that the population growth rate negatively affects the level of higher education coverage. Perspectives. Further research is needed to determine the strength of the impact of average wages, unemployment, environmental conditions, social progress and others factors on migration processes as determinants of improving the education in the country and achieving sustainable development goals.

Factor analysis of trends for national innovation-driven development

The global innovation trends involve ever new and more flexible systems for the development of industries, goods, and services. The consumer ability of society creates stable needs for new state-of-the-art goods, technologies, and products. Within this context, the need to develop innovations as a way to achieve market demands can hardly be overestimated. The article includes an overview of a number of important innovation-based factors, such as the share of domestic spending on research and development in GDP in the Russian Federation, domestic current spending on research and development in the Russian Federation, the overall level of innovative activity of industrial organizations, etc. Besides, following the study, it was found that the overall level of innovative activity of industrial organizations has a direct notable correlation dependence on domestic current spending on research and development.

The Untold Story of Cohabitation: Marital Choice and Education Investment

BACKGROUND Cohabitation is a common practice in eastern Indonesia due to high costs of marriage. There are few studies in the literature that investigate the impact of cohabitation in developing country context. However, there is a limited study on the impact of cohabitation on child development and the mechanism of the impact. OBJECTIVE This study analyzes the effect of cohabitation on households’ human capital investment on education, which is an important determinant of children’s future outcomes. METHODS We use an instrumental variable approach—with the gender of the child before marriage as the instrument—to identify the causal effect of cohabitation on household educational investment and child cognitive skills using a unique dataset provided by the 2012 Indonesian Family Life Survey East. RESULTS We find that cohabitation led to a lower child’s cognitive score by 0.288 standard deviations. One of the main explanations for this result is that cohabited couple spent a lower share of spending for education. In particular, cohabiting couples allocated a lower share of spending for education by 4.4 percentage points in comparison to married couples. CONCLUSIONS Cohabitation has a negative impact on child cognitive scores and it can be explained by, among others, relatively lower education spending. CONTRIBUTIONS Our study extends the literature that analyzes the effect of marital choice on children's outcome by explaining mechanisms on how marital choice affect child outcome.

Evidence for the Effectiveness of Health and Social Services Partnerships

Integration of health and social services is touted as a key method to address social needs and improve population health. We will share the latest evidence on how Area Agency on Aging (AAA) partnerships with health care entities and other organizations improve health outcomes for older adults, while reducing health care costs. AAAs are community leaders in cross-sectoral partnerships that effectively address social determinants of health for older adults, who account for a substantial share of overall health care spending. Results of a longitudinal study (2008 – 2016) which links data from four waves of the National Surveys of AAAs to data on county-level health outcomes show that AAA–health care partnerships and programs reduced health care utilization and costs. AAA partnerships with hospitals reduced Medicare spending by $136 per beneficiary. AAA involvement in evidence-based health promotion programs decreased potentially avoidable nursing home use by nearly one percentage point (representing a change of 6.5%). Finally, we will describe the prevalence and nature of contracting relationships between community-based organizations and health care entities, based on data from the 2020 CBOs and Health Care Contracting Request for Information, the third national RFI of AAAs, Centers for Independent Living, and other aging and disability community-based organizations.

Mandatory spending, political polarization, and macroeconomic volatility

This paper studies the impact of political polarization on macroeconomic volatility in a political economy model of optimal fiscal policy. I introduce the distinction between mandatory and discretionary public spending in a model where consumers disagree on the size of the public sector. In the presence of political turnover and political polarization, public policies that affect individual decision-making lead to macroeconomic volatility. I show that the legislative requirements behind the changes in mandatory public spending can reduce macroeconomic volatility caused by political polarization and political turnover. The numerical simulations of the model suggest that in the presence of a binding constraint on the changes in mandatory spending, an increase in the political polarization is associated with an increase in the share of mandatory spending and a decrease in the macroeconomic volatility, consistent with the U.S. data.

SIMULATING THE IMPACT OF DIGITAL TECHNOLOGIES ON THE EDUCATION QUALITY METRICS

Introduction. Digital technologies have become an integral part of the educational process in the modern world. The coronavirus pandemic accelerated their spread, allowed their new features to be tested, their advantages to be assessed and bottlenecks identified. It is thus relevant to develop regulatory measures to timely address the negative effects of global distance education and to take advantage of all its positive aspects. Methods. The study was conducted using regression analysis techniques. The monitoring data of the Programme for International Student Assessment (PISA) for 2009, 2012 and 2018 were used as a source of information (The PISA 2018 survey is currently the most recent one). These data were used to investigate the impact of the spread of digital technologies on the education quality metrics (reading literacy and numeracy) of students aged 15–16. To assess the spread of digital technologies, the following metrics were applied: the time spent by students on the Internet in an educational institution (2012 and 2018), the number of personal computers per student (2009 and 2012) and the share of students having a PC or a laptop at home (2009, 2012 and 2018). The share of spending per student in total public expenditure (2009 and 2012) and the share of teachers who have completed professional development courses in the last 3 months (2018) were also used for the analysis. Results and Discussion. The regression models constructed reflected the dual impact of digital technology on the quality of education. On the one hand, the use of PCs and laptops contributed to the higher levels of literacy and numeracy of students; on the other hand, the time spent on the Internet in school and at home during the school week had a negative impact on these indicators. In addition, a significant positive impact of the share of government spending per student in GDP per capita and teacher qualifications on testing results was established. Conclusion. Digital technologies and new devices have radically changed modern education. They help students develop technological skills, use their learning gains and share their knowledge. However, it is important to take into account that the quality of education may deteriorate due to the impact of digital technologies and to take timely governmental regulatory measures to prevent this.

Scientific and Technological Development of Egypt in the XXI Century

The author analyzes the scientific and technological development of modern Egypt, which the country’s leadership considers to be one of the main means for building a knowledge economy and ensuring national sovereignty. The current Constitution of Egypt contains a provision on the priority development of science and technology, as well as the obligation of the state to increase the share of spending for these purposes to 1% of GDP. Using mainly data from the Ministry of Higher Education and Scientific Research and the Ministry of Planning and Economic Development, as well as papers of Egyptian scientists, the author draws a detailed picture of the current state of science and technology in Egypt. He also provides data on their development plans until the 2021/22 financial year, according to which public investment for these purposes should be increased to 1.2% of GDP. This will not only strengthen the material base for the development of science and technology, significantly increase the number of researchers, their salaries and publication activity, but also create favorable conditions for improving the commercialization of scientific achievements. To this end, the country’s government is building science cities, encouraging the conclusion of scientific and technological alliances that combine the capabilities of science and business, and creating a favorable regulatory environment and incubators for the development of national startups, one of which has already turned into a unicorn. All this strengthens Egypt’s position as one of the leaders of scientific and technological progress in Africa.