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Article
Publication date: 21 September 2015

Ali Kazemi Karyani, Enayatollah Homaie Rad, Abolghasem Pourreza and Faramarz Shaahmadi

Health can be influenced by many factors. One of the factors is the political context of the country and democracy. The purpose of this paper is to examine the effects of…

Abstract

Purpose

Health can be influenced by many factors. One of the factors is the political context of the country and democracy. The purpose of this paper is to examine the effects of freedom in press and polity index in overall, public, private and out of pocket health expenditures.

Design/methodology/approach

A long-term panel data approach has been used to examine the relationship between democracy and health expenditures. The authors inserted polity and freedom into press indexes in the health expenditure model.

Findings

Increase in freedom of the press and democracy will increase the overall, public and private health expenditures while they decrease out of pocket health expenditures.

Originality/value

Polity and freedom index has a significant impact on all the health expenditure models.

Details

International Journal of Human Rights in Healthcare, vol. 8 no. 3
Type: Research Article
ISSN: 2056-4902

Keywords

Article
Publication date: 22 November 2022

Cleopatra Oluseye Ibukun and Wuraola Mahrufat Omisore

This paper examines the long-run and dynamic causal relationship among air pollution, health expenditure and economic growth in Mexico, Indonesia, Nigeria and Turkey (MINT…

Abstract

Purpose

This paper examines the long-run and dynamic causal relationship among air pollution, health expenditure and economic growth in Mexico, Indonesia, Nigeria and Turkey (MINT countries).

Design/methodology/approach

The bounds test approach to cointegration and causality test was employed on data covering 1995–2018.

Findings

The study shows evidence of a long-run relationship among the variables in MINT countries and the causality test confirms the existence of a bidirectional causal nexus between health expenditure and economic growth in the four countries. It also confirms that there is a bidirectional causal relationship between carbon dioxide (CO2) emission and economic growth, except in Nigeria where a unidirectional causal relationship was found running from CO2 emissions to economic growth. In addition, a bidirectional causal relationship was found between air pollution and health expenditure in Turkey, while no causal relationship was found among these variables in Nigeria.

Research limitations/implications

This study is limited by available data and it only focuses on four emerging economies. To address this, future studies can expand this scope to more emerging economies with severe air pollution and also extend the scope when more recent data becomes available.

Practical implications

This study suggests that pollution standards in MINT countries should be monitored and enforced with transparency so as to mitigate its health implications and ensure the sustainability of economic growth.

Social implications

The study confirms the importance of keeping air pollution as low as possible because of its negative effect on health and economic output.

Originality/value

The study accounts for the complexity of each MINT country instead of providing a general discussion on the relationship between air pollution, health expenditure and economic growth in MINT countries.

Details

Journal of Economic and Administrative Sciences, vol. ahead-of-print no. ahead-of-print
Type: Research Article
ISSN: 1026-4116

Keywords

Book part
Publication date: 30 May 2018

Albert A. Okunade, Xiaohui You and Kayhan Koleyni

The search for more effective policies, choice of optimal implementation strategies for achieving defined policy targets (e.g., cost-containment, improved access, and…

Abstract

The search for more effective policies, choice of optimal implementation strategies for achieving defined policy targets (e.g., cost-containment, improved access, and quality healthcare outcomes), and selection among the metrics relevant for assessing health system policy change performance simultaneously pose continuing healthcare sector challenges for many countries of the world. Meanwhile, research on the core drivers of healthcare costs across the health systems of the many countries continues to gain increased momentum as these countries learn among themselves. Consequently, cross-country comparison studies largely focus their interests on the relationship among health expenditures (HCE), GDP, aging demographics, and technology. Using more recent 1980–2014 annual data panel on 34 OECD countries and the panel ARDL (Autoregressive Distributed Lag) framework, this study investigates the long- and short-run relationships among aggregate healthcare expenditure, income (GDP per capita or per capita GDP_HCE), age dependency ratio, and “international co-operation patents” (for capturing the technology effects). Results from the panel ARDL approach and Granger causality tests suggest a long-run relationship among healthcare expenditure and the three major determinants. Findings from the Westerlund test with bootstrapping further corroborate the existence of a long-run relationship among healthcare expenditure and the three core determinants. Interestingly, GDP less health expenditure (GDP_HCE) is the only short-run driver of HCE. The income elasticity estimates, falling in the 1.16–1.46 range, suggest that the behavior of aggregate healthcare in the 34 OECD countries tends toward those for luxury goods. Finally, through cross-country technology spillover effects, these OECD countries benefit significantly from international investments through technology cooperations resulting in jointly owned patents.

Book part
Publication date: 22 March 2021

John Cullinan, Sheelah Connolly and Richard Whyte

This chapter provides an assessment of the sustainability of Ireland's health care system. It starts by describing the historical development of the Irish system and…

Abstract

This chapter provides an assessment of the sustainability of Ireland's health care system. It starts by describing the historical development of the Irish system and identifying key features of the current system that raise potential challenges for sustainability. It then provides an analysis of recently compiled and up-to-date data on trends in health care expenditures. A number of specific demand and supply side challenges to sustainability are then described and discussed. This is followed by an examination of recent and current reforms to the health care system, focussing on their likely impact on sustainability, as well as a discussion of how health economics has and can inform policy, practice and debate. We also discuss the potential implications of the COVID-19 pandemic for the Irish system.

Details

The Sustainability of Health Care Systems in Europe
Type: Book
ISBN: 978-1-83909-499-6

Keywords

Article
Publication date: 21 July 2022

Alhassan Bunyaminu, Ibrahim Mohammed, Ibrahim Nandom Yakubu, Bashiru Shani and Abdul-Lateef Abukari

This study investigates the impact of total health expenditure on life expectancy in a panel of 43 African countries from 2000 to 2018.

Abstract

Purpose

This study investigates the impact of total health expenditure on life expectancy in a panel of 43 African countries from 2000 to 2018.

Design/methodology/approach

The dynamic panel generalized method of moments (GMM) estimation method developed by Arellano and Bond (1991) is used in this study. This approach generates estimates that are heteroskedasticity and autocorrelation consistent, as well as controls for unobserved time-invariant country-specific effects and eliminates any endogeneity in the panel model.

Findings

The results reveal that health expenditure on its own has a positive significant influence on life expectancy. However, health expenditure via the moderating effect of government effectiveness reduces life expectancy. The authors also observe that school enrollment and the level of economic activity significantly drive life expectancy.

Research limitations/implications

The study is limited to 43 out of 54 African countries, and it covers a period of 18 years: 2000 to 2018.

Practical implications

The authors argue that larger health expenditure will aid in improving the life expectancy rate in Africa. However, in practice, this would be difficult given the needs of other priority sectors.

Social implications

Since most developing countries' health expenditures are small, a policy option is that healthcare services should be subsidized such that the poorest people can also access them.

Originality/value

The study differs from the previous attempts, and with this, the authors contribute significantly to the literature. First, to the best of the authors’ knowledge, the authors are unaware of any study considering the role of government effectiveness as a moderating factor in investigating the effect of health expenditure on life expectancy in the African context. Thus, the authors fill a yawning gap in the literature. Second, the authors employ a recent dataset with larger sample size. Finally, to address the problem of endogeneity and simultaneity bias, the authors use the system GMM technique.

Details

International Journal of Health Governance, vol. 27 no. 4
Type: Research Article
ISSN: 2059-4631

Keywords

Book part
Publication date: 30 May 2018

Zelalem Yilma, Owen O’Donnell, Anagaw Mebratie, Getnet Alemu and Arjun S. Bedi

Little is known about perceptions of medical expenditure risks despite their presumed relevance to the demand for health insurance. This is the first study to examine…

Abstract

Little is known about perceptions of medical expenditure risks despite their presumed relevance to the demand for health insurance. This is the first study to examine households’ beliefs about their future spending on health care. The study made a unique elicitation of subjective probabilities of medical expenditures from rural Ethiopians participating in a panel survey and offered the opportunity to enrol in a health insurance programme. The vast majority of respondents give logically consistent responses to the subjective probability questions. The data indicate that the cross-sectional variance of realized expenditures, which is often used to proxy risk exposure, greatly overestimate the risk faced by any single household. Consistent with the serial correlation observed in realized expenditures, expectations are positively correlated with past expenses. They are revised upward in response to an increase in realized expenditure and, to some extent, they predict expenditure incurred in the year ahead. Despite containing information on future medical expenditures, there is no evidence that expectations influence the decision to take out health insurance, although plans to insure are positively related to the perceived volatility of expenses.

These results suggest that adverse selection may not threaten the viability of voluntary health insurance. A caveat is that measurement error in the reported probabilities may weaken the test for adverse selection. Notwithstanding this limitation, measurement of household-specific distributions of future medical expenses is feasible and avoids relying on the cross-sectional variance, which provides an upwardly biased estimate of medical expenditure risk.

Article
Publication date: 18 January 2022

Idris Abdullahi Abdulqadir, Bello Malam Sa'idu, Ibrahim Muhammad Adam, Fatima Binta Haruna, Mustapha Adamu Zubairu and Maimunatu Aboki

This article investigates the dynamic implication of healthcare expenditure on economic growth in the selected ten Sub-Saharan African countries over the period 2000–2018.

Abstract

Purpose

This article investigates the dynamic implication of healthcare expenditure on economic growth in the selected ten Sub-Saharan African countries over the period 2000–2018.

Design/methodology/approach

The study methodology included dynamic heterogenous panel, using mean group and pooled mean group estimators. The investigation of the healthcare expenditure and economic growth nexus was achieved while controlling the effects of investment, savings, labor force and life expectancy via interaction terms.

Findings

The results from linear healthcare expenditure have a significant positive impact on economic growth, while the nonlinear estimates through the interaction terms between healthcare expenditure and investment have a negative statistically significant impact on growth. The marginal effect of healthcare expenditure evaluated at the minimum and maximum level of investment is positive, suggesting the impact of health expenditure on growth does not vary with the level of investments. This result responds to the primary objective of the article.

Research limitations/implications

In policy terms, the impact of investment on healthcare is essential to addressing future health crises. The impact of coronavirus disease 2019 (COVID-19) can never be separated from the shortages or low prioritization of health against other sectors of the economy. The article also provides an insight to policymakers on the demand for policy reform that will boost and make the health sector attractive to both domestic and foreign direct investment.

Originality/value

Given the vulnerability of SSA to the health crisis, there are limited studies to examine this phenomenon and first to address the needed investment priorities to the health sector infrastructure in SSA.

Details

Journal of Economic and Administrative Sciences, vol. ahead-of-print no. ahead-of-print
Type: Research Article
ISSN: 1026-4116

Keywords

Article
Publication date: 26 July 2021

Tahmina Sultana, Faroque Ahmed and Mohammad Tareque

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…

Abstract

Purpose

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.

Design/methodology/approach

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

Findings

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.

Originality/value

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.

Details

International Journal of Human Rights in Healthcare, vol. ahead-of-print no. ahead-of-print
Type: Research Article
ISSN: 2056-4902

Keywords

Article
Publication date: 27 January 2021

Cleopatra Oluseye Ibukun

Despite the global attempt at achieving goal 3 of the Sustainable Development Goals by improving health outcomes, some countries (West African countries inclusive) still…

Abstract

Purpose

Despite the global attempt at achieving goal 3 of the Sustainable Development Goals by improving health outcomes, some countries (West African countries inclusive) still do not spend a significant proportion of their income on health and they exhibit health outcomes that are still far below that of developed countries. Besides countries like Nigeria, Chad and Guinea-Bissau are experiencing worsening insecurity and political instability. This study, therefore, examines the effect of health expenditure on three health outcomes in the West African sub-region, while investigating the effect of the quality of governance in this nexus.

Design/methodology/approach

This study conducts an instrumental variable approach (two-stage least squares regression) on a panel of 15 West African countries over the period 2000–2018. This study uses three proxies to measure health outcomes and six measures of the quality of governance were also considered.

Findings

The result of this study shows that all forms of health expenditures significantly influenced health outcomes. That is, there is a negative relationship between health expenditure, infant mortality and under-five mortality, but a positive relationship between health expenditure and life expectancy at birth. Besides, the general effect of the same quantity of public health spending is subject to the quality of governance because countries with a higher quality of governance benefit better from their public health spending.

Originality/value

This study, to the authors' knowledge, is the first empirical attempt to examine the role of governance in the health expenditure-health outcomes nexus in 15 ECOWAS countries, using different measures of health outcomes and governance.

Details

International Journal of Social Economics, vol. 48 no. 4
Type: Research Article
ISSN: 0306-8293

Keywords

Article
Publication date: 4 December 2017

Subhalaxmi Mohapatra

The purpose of this paper is to employ a two-step approach to investigate the bi-directional causal linkage between: economic growth (measured by GDP) and public…

Abstract

Purpose

The purpose of this paper is to employ a two-step approach to investigate the bi-directional causal linkage between: economic growth (measured by GDP) and public expenditure on health; public expenditure on health and infant mortality rate (IMR); and economic growth and IMR in the Indian context.

Design/methodology/approach

The present study uses econometric analysis, namely, panel cointegration and Granger causality on 20-year panel data on 16 major Indian states to investigate the causality.

Findings

The results suggest GDP to Granger cause public expenditure on health both in the short run and in the long run, but public expenditure on health to Granger cause GDP only in the long run. Further, public expenditure on health and economic growth were found to Granger cause IMR in the long run. However, the reverse linkage from IMR to public expenditure on health and/or economic growth was not significant.

Research limitations/implications

The present study provides support to the existing literature on the effects of economic growth on health expenditure and health outcomes but also raises a question on the time required to realize the same.

Practical implications

The findings have implications for policy makers on the time frame and application of health expenditure to achieve better results.

Originality/value

The present study is one of the first to test the tripartite linkage between economic growth, public health expenditure and health outcomes at a state-level analysis.

Details

International Journal of Social Economics, vol. 44 no. 12
Type: Research Article
ISSN: 0306-8293

Keywords

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