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The objective of this study is to examine the sociodemographic factors that are associated with health care expenditure among households in Malaysia.

This study examines health care participation decision and amount of expenditure using the exponential Type 2 Tobit model. A dataset of a large sample (n = 14,838) that is nationally representative is used.

The results suggest that household size, location of residence as well as age, education and marital status of the household heads are significantly associated with household expenditure on health care. Health care expenditure increases with the age and educational attainment of household heads, whereas those who are being employed and residing in rural areas have lower health care expenditure. Although larger households are more likely to consume health care than smaller households, they spend less on health care. Furthermore, marital status does not affect the participation decision of health care expenditure, but the variable is associated with the decision on the amount of the expenditure.

The results provide insights into groups of population that can be targeted for healthcare intervention programmes and policy design.

This study is the first to our knowledge to use a microeconometric approach to analyse the health care participation as well as its level of expenditure among households in Malaysia.

In 2010 the Patient Protection and Affordable Care Act boosted the expansion of community health centers (CHCs) with $11 billion in mandatory funding from 2011 to 2015. This study used data from the Medical Expenditure Panel Survey (MEPS) and the North Carolina Behavioral Risk Factor Surveillance System (BRFSS) to assess the cost savings associated with the use of community health centers compared to other primary care providers. After controlling for various demographic, socioeconomic characteristics and health conditions, we found savings at an average of $3,437 in total expenditures and $1,211 in ambulatory care expenditures. These results suggest that continuing investment in health centers are important during times of budget cuts in order to improve access to care and to generate cost savings to the healthcare system.

The purpose of this paper is to explore the manner in which the degree of substitutability between public and private health expenditures contributes towards the distribution of wealth and political economy outcomes in the long run.

An overlapping generations model with heterogeneous agents where a person’s probability of survival into old age is determined by a variable elasticity of substitution (VES) health production function with public and private expenditures as inputs is developed. Public expenditure on health is determined through a political economy process.

Analytical and numerical results reveal that higher substitutability between private and public expenditures at the aggregate level and a higher share of public spending in the production of health lead to higher long run wealth levels and lower inequality. In the political equilibrium, higher aggregate substitutability between public and private health expenditures is associated with more tax revenue allocated towards public health. For most parameter combinations, the political economy and welfare maximising proportions of tax revenue allocated towards public health care converge in the long run.

The paper is a theoretical investigation of how substitutability between public and private health expenditures affect transitional and long run macroeconomic outcomes. These results are amenable to further empirical investigation.

The findings indicate that policies to improve institutional aspects that yield higher substitutability between public and private health expenditures and returns to public health spending could lead to better long run economic outcomes.

The results provide a political economy explanation for the low investments in public health care in developing countries, where aggregate substitutability between public and private health expenditures is likely to be lower. Furthermore, comparing the political economy and welfare maximising paradigms broadens the scope of the framework developed herein to provide potential explanations for cross-country differences in health outcomes.

This paper adopts an innovative approach to exploring this issue of substitutability in health expenditures by introducing a VES health production function. In an environment where agents have heterogeneous wealth endowments, this specification enables a distinction to be made between substitutability of these expenditures at the aggregate and individual levels, which introduces a rich set of dynamics that feeds into long run outcomes and political economy results.

This paper aims to evaluate the technical efficiency of the health-care systems in 21 selected middle-income countries during the period (2000–2017) and determine the source of inefficiency whether it is transient (short run) or persistent (long run).

The study uses the stochastic frontier analysis technique through employing the generalized true random effects model which overcomes the drawbacks of the previously introduced stochastic frontier models and allows for the separation between unobserved heterogeneity, persistent inefficiency and transient inefficiency.

Persistent efficiency is lower than the transient efficiency; hence, there are more efficiency gains that can be made by the selected countries by adopting long-term policies that aim at reforming the structure of the health-care system in the less efficient countries such as South Africa and Russia. The most efficient countries are Vietnam, Mexico and China which adopted a social health insurance that covers almost the whole population with the aim of increasing access to health-care services. Also, decentralization in health-care has assisted in adopting health-care policies that are suitable for both the rural and urban areas based on their specific conditions and health-care needs. A key success in the implementation of the adopted long-term policies by those countries is the continuous monitoring and evaluation of their outcomes and comparing them with the predefined targets and conducting any necessary modifications to ensure their movement in the right path to achieve their goals.

Although several studies have evaluated the technical efficiency both across and within countries using non-parametric (data envelopment analysis) and parametric (stochastic frontier analysis) approaches, to the best of the authors’ knowledge, this is the first attempt to evaluate the technical efficiency of selected middle-income countries during the period (2000–2017) using the generalized true random effects stochastic frontier analysis model.

The purpose of this paper is to examine the determinants of health expenditure at the household level in Nigeria with specific focus on the household and individual unique characteristics. It presents some stylised facts about the Nigerian health system and its financing options. It went further to show that household is the major financial organ of healthcare in Nigeria. The study aims to expand the domain of household health expenditure by analysing at national, urban and rural levels.

It adopted Engel curve approach, which was estimated using ordinary least squares technique. The model was structured to take care of life-cycle implications by examining effects of age in years and age groups (0-9, 10-19, 20-39, 40-59 and 60+) on healthcare spending. Data were drawn from the 2010 Harmonised Nigeria Living Standards Survey (HNLSS) conducted by the National Bureau of Statistics and analyses were conducted nationally, for urban and rural locations.

The result shows that individual characteristics like age, religion, education and household characteristics like income, size and headship commonly influence healthcare expenditure in Nigeria significantly. The household-level variables possess stronger significant effects among the rural households while marital status and employment had differential effects in both urban and rural locations. It also confirmed that Nigeria engages in intergenerational transfer of healthcare by the working population to the young and older generations.

HNLSS was only limited to those who were sick or injured in the last two weeks preceding the survey, leaving out those whose sickness preceded the two weeks before the survey. Also, the scope of health expenditure is limited to curative care spending that exclude expenses on preventive care, rehabilitative care as well as other cost-saving services.

This paper fulfils an identified need to examine the determinants of household health expenditure at the national, urban and rural locations.

This article describes structural developments of public expenditures in China in the past 30 years and demonstrates an increasing public's need for services in areas of education, health care, social security, and housing. Starting with a theory explaining the need to adjust the spending structure, the article specifies a proper proportion of public service expenditures in total governmental spending and discusses a possible path to this spending structure.

The economic shock posed by the current COVID-19 outbreak brought out a worldwide public health emergency with a close relationship between the industrial marketing practices, the health level of society and its economic development. The purpose of this study is to analyse the industrial dynamics in health care and their impact on economic growth and health status.

To empirically investigate the relationship between growth and health, the authors use a data set drawn from 29 selected Organisation for Economic Co-operation and Development (OECD) countries over the period 2000 and 2019. Using panel regressions, the authors investigate the impact of the health-care industry measured in terms of health status, health expenditure, sales on pharmaceutical products, the number of persons working in health care and the coverage by private health insurances. Fixed effect and random effect regressions are used to estimate this model.

Overall, the results are suggestive of a nexus between the industrial marketing dynamics of health-care context and economic growth – both interacting and improving each other. As the quality of the health-care market enhances, the economy grows richer and the health status of the population improves considerably.

To support health-care markets in OECD countries, health policymakers need to formulate a long-term industrial health policy that addresses all the social and individual determinants of health.

To the best of the knowledge, this is the first study to provide a better understanding of the relationship between health-care industrial dynamics and economic growth in OECD countries along different dimensions.

The purpose of this paper is to investigate the associations between obesogenic severity, the public health situation, environmental impacts, and health care expenditures in populations worldwide.

This ecological study is based on official data available for approximately 140 countries worldwide. This study defines four main variables: obesogenic severity, environmental impact, public health implications (PHI), and health expenditures, all measured through specific indicators. Data were obtained mainly from the WHO, World Bank, and IDF. The indicators were reduced to the main variables through factorial reduction and multiple regression analyses were used to test the main hypotheses.

Obesogenic severity strongly and positively affects environmental impacts (β=0.6578; p<0.001), PHI-1 (cardiovascular risk factor) (β=0.3137; p<0.001) and PHI-2 (blood glucose and diabetes diagnoses) (β=0.3170; p<0.001). Additionally, environmental impacts strongly and positively affect PHI-1 (β=0.4978; p<0.001) but not PHI-2. Thus, results suggest that environmental impact, PHI-1, and PHI-2 strongly affect health expenditures (β=0.3154; p<0.001, β=0.5745; p<0.001, and β=−0.4843; p<0.001, respectively), with PHI-2 negatively affecting the health expenditures.

This study presents evidence that can aid in decision making regarding public and private efforts to better align budgets and resources as well as predict the needs and expenditures of public health care systems.

This investigation finds that the main variables addressed are strongly associated at the worldwide level. Thus, these analytical procedures can be used to predict public health and health care cost scenarios at the global level.

Public hospitals in China usually rely on revenues from medical services and medications to compensate for major costs given their nonprofit nature. The lack of government subsidies and unreasonable prices of medical services have led to high medical costs and unbalanced reimbursement system for public hospitals. There is a critical need of research on improvement of reimbursement system that will create positive effect on China’s health-care system. This paper aims to focus on four dimensions of stakeholders (government, patients, medical insurance agencies and social organization) and six major expenditures to explore reimbursement scheme for public hospitals in China with the purpose of relieving unbalanced income and expenditure of hospitals, avoiding medication markups and reducing medical expenses from patients.

In this paper, the authors study reimbursement scheme for public hospitals from the perspective of four dimensions of stakeholders and how stakeholders reimburse six major expenditures of hospitals. A total of 128 effective samples were collected from financial data of 32 public hospitals through 2009-2012. This paper analyzes the econometric models of the selected revenue and expenditure. This paper analyzes the econometric models of the selected revenue and expenditure using linear regression. The linear relationship between each cost and different types of incomes (i.e. reimbursements from government, patients, insurance agencies and social organization) is analyzed before and after cancelling the medication markups.

Results from empirical research verify that government reimbursement is insufficient, and using medication markups to compensate for medical service costs has become a serious problem for China’s public hospitals. To avoid the medication markups and improve the reimbursement scheme, government should reimburse labor cost, fixed assets cost and research cost; patients and medical insurance agencies should reimburse the costs of medical service, medication and administration/operations; and social organization should supplement the fixed assets cost.

In this study, the authors defined and classified stakeholders of reimbursement scheme for public hospitals in China, which help understand the roles and effects that different stakeholders can play in compensation. Along with the proposed reimbursement scheme framework, this study will help make effective implementation of new health-care reform program in China.

Bangladesh is applauded for its achievement in various health and social outcomes though criticized for its failure in properly dealing with governance issues. The purpose of this paper is intends to see how the health outcomes (in case of life expectancy, under-five mortality and adolescent fertility) are impacted by health expenditure (both public and private), per capita income in presence of overall governance and female education. This paper assumes that rapid progress in female education reflects the Bangladeshis’ social responsiveness to change.

This paper uses autoregressive distributed lag technique to estimate the models with data ranges from 1990 to 2016 under two different scenarios.

This study has found that all the explanatory variables exert significant impact on health outcomes. Furthermore, public health expenditure is augmented with a composite governance issue, and this enhances robustness as well as statistical significance of the models. These suggest that the governance issues play a very crucial role to achieve the expected health outcomes. Female secondary enrolment ratio appears with improved coefficients in terms of sign and magnitude for all the health indicators.

This paper contributes to the existing literature showing econometric evidence that highlights the importance of governance and female education in improving health outcomes of Bangladesh apart from health expenditure and per capita gross domestic product.