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1 – 10 of 225
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 quality…

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.

Article
Publication date: 18 June 2021

Mehdi Barati and Hadiseh Fariditavana

The purpose of this study is to first assess how the US healthcare financing system is influenced by income variation. Then, it examines whether or not the impact of income

Abstract

Purpose

The purpose of this study is to first assess how the US healthcare financing system is influenced by income variation. Then, it examines whether or not the impact of income variation is asymmetric.

Design/methodology/approach

For the analyses of this paper, the autoregressive distributed lag (ARDL) model is implemented to a data set covering the period from 1960 to 2018.

Findings

The results provide evidence that major funding sources of aggregate healthcare expenditure (HCE) respond differently to changes in income. The results also imply that the effect of income is not always symmetric.

Originality/value

Many studies have attempted to identify the relationship between income and HCE. A common feature of past studies is that they have only focused on aggregate HCE, while one might be interested in knowing how major funders of aggregate HCE would be affected by changes in income. Another common feature of past studies is that they have assumed that the relationship between income and HCE is symmetric.

Details

Journal of Economic Studies, vol. 49 no. 5
Type: Research Article
ISSN: 0144-3585

Keywords

Article
Publication date: 4 December 2017

Noah Olasehinde and Olanrewaju Olaniyan

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…

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Abstract

Purpose

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.

Design/methodology/approach

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.

Findings

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.

Research limitations/implications

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.

Originality/value

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

Details

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

Keywords

Book part
Publication date: 29 January 2021

Eddie C. Cheung and Yiu C. Ma

This chapter attempts to study the long-term determinants of public and private healthcare expenditure in Hong Kong, by employing time series data over the period from 1990 to…

Abstract

This chapter attempts to study the long-term determinants of public and private healthcare expenditure in Hong Kong, by employing time series data over the period from 1990 to 2017. We find that income is not a determinant of either public or private spending per capita on healthcare services. Rather, a higher proportion of elderly will raise public expenditure on health and private spending even more. The share of children within the population will conversely decrease both public and private spending. Results also show that the rising density of doctors decreases both public and private per capita healthcare spending, showing that the supplier-induced demand problem is not an issue in Hong Kong.

Details

Modeling Economic Growth in Contemporary Hong Kong
Type: Book
ISBN: 978-1-83909-937-3

Keywords

Article
Publication date: 17 June 2020

Samuel Ampaw, Edward Nketiah-Amponsah, Frank Agyire-Tettey and Bernardin Senadza

Equity in access to and use of healthcare resources is a global development agenda. Policymakers’ knowledge of the sources of differences in household healthcare spending is…

Abstract

Purpose

Equity in access to and use of healthcare resources is a global development agenda. Policymakers’ knowledge of the sources of differences in household healthcare spending is crucial for effective policy. This paper aims to investigate the differences in the determinants of household healthcare expenditure across space and along selected quantiles of healthcare expenditure in Ghana. The determinants of rural-urban healthcare expenditure gap are also explored.

Design/methodology/approach

Data was obtained from the sixth round of the Ghana Living Standards Survey (GLSS 6) conducted in 2013. An unconditional quantile regression (UQR) and a decomposition technique based on UQR, adjusted for sample selection bias, were applied.

Findings

The results indicate that differences in the determinants of household healthcare expenditure across space and along quantiles are driven by individual-level variables. Besides, the rural-urban health expenditure gap is greatest among households in the lower quantiles and this gap is largely driven by differences in household income per capita and percentage of household members enrolled on health insurance policies.

Originality/value

The findings show that there are differences in the determinants of household health expenditure along with the income distribution, as well as between rural and urban localities, which would call for targeted policies to address these inequalities.

Details

International Journal of Development Issues, vol. 19 no. 3
Type: Research Article
ISSN: 1446-8956

Keywords

Article
Publication date: 2 February 2015

De Zhou, Xiaohua Yu and Thomas Herzfeld

The purpose of this paper is to investigate dynamic food demand in urban China, with use of a complete dynamic demand system – dynamic linear expenditure system-linear approximate…

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Abstract

Purpose

The purpose of this paper is to investigate dynamic food demand in urban China, with use of a complete dynamic demand system – dynamic linear expenditure system-linear approximate dynamic almost ideal demand system (DLES-LA/DAIDS), which pushes forward the techniques of demand analysis.

Design/methodology/approach

The authors employ a transitionary demand process and develop a new approach of complete demand system with a two-stage dynamic budgeting: a strongly separable DLES in the first stage and a LA/DAIDS in the second stage. Employing provincial aggregate data (1995-2010) from the China urban household surveys, The authors estimated the demand elasticities for primary food products in urban China.

Findings

The results indicate that most primary food products are necessities and price inelastic for urban households in China. The authors also found that the dynamic model tends to yield relatively smaller expenditure elasticities in magnitude than the static models do due to the friction effect of dynamic adjusting costs, such as habit formation, switching costs, and learning process. However, the dynamic effects on own price elasticities are inconclusive due to the add-up restriction.

Practical implications

The research contributes to the demand analysis methodologically, and can be used for better projections in policy simulation models.

Originality/value

This paper methodologically relaxes the restrictive assumption of instant adjustment in static models and allows consumers to make a dynamic decision in food consumption. Empirically, the authors introduce a new complete dynamic demand model and carry out a case study with the use of urban household data in China.

Details

China Agricultural Economic Review, vol. 7 no. 1
Type: Research Article
ISSN: 1756-137X

Keywords

Article
Publication date: 17 August 2021

Mehmet Hilmi Özkaya, Naib Alakbarov and Murat Gündüz

When the factors affecting health expenditures are examined in the literature, it is seen that one of the most important factors is income. In this context, the purpose of this…

Abstract

Purpose

When the factors affecting health expenditures are examined in the literature, it is seen that one of the most important factors is income. In this context, the purpose of this study is to investigate the relationship between out-of-pocket health expenditures and disposable personal income and revealing the income elasticity of health expenditures.

Design/methodology/approach

Therefore, short/long-term coefficients were obtained by analyzing Westerlund (2007) co-integration analysis and pooled mean group (PMG) regression methods for 22 European Union (EU) member states during the period 2003–2017. In addition, a comparison of the long-term coefficients for each country was obtained with augmented mean group (AMG) estimator.

Findings

The results of the AMG and PMG tests show that the long-term coefficients between disposable personal income and health expenditures are 0.83 and 0.97, respectively. These results imply that there is a significant relationship between the variables, and that health care should be categorized in the group of normal goods. However, the fact that the long-term coefficient is very close to 1, despite being classified in the category of necessity goods, requires more care to be taken in evaluating whether health services are luxury goods or necessity goods.

Originality/value

The use of second generation econometric tests on both cross-sectional dependence and heterogeneity demonstrates the value of the study. On the other hand, obtaining similar results by investigating the relationship between variables using different appropriate econometric models reveals the importance of the methodology used in this study. It reveals important details in terms of the literature regarding the long-term and short-term results obtained in this study.

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: 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

Open Access
Article
Publication date: 16 December 2022

Banna Banik, Chandan Kumar Roy and Rabiul Hossain

This study aims to investigate the consequence of the quality of governance (QoG) in moderating the effect of healthcare spending on human development.

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Abstract

Purpose

This study aims to investigate the consequence of the quality of governance (QoG) in moderating the effect of healthcare spending on human development.

Design/methodology/approach

The authors employ a two-step Windmeijer finite sample-corrected system-generalized method of moments (sys-GMM) estimation technique on a panel dataset of 161 countries from 2005 to 2019. The authors use healthcare expenditure as the main explanatory variable and the Human Development Index (HDI) as the dependent variable and also consider voice and accountability (VnA), political stability and absence of terrorism (PSnAT), governance effectiveness (GoE), regulatory quality (ReQ), rules of law (RLaw) and control of corruption (CoC) dimensions of governance indicators as proxies of good governance. The authors develop a new measure of good governance from these six dimensions of governance using principal component analysis (PCA).

Findings

The authors empirically revealed that allocating more healthcare support alone is insufficient to improve human development. Individually, PSnAT has the highest net positive effect on health expenditure that helps to increase human welfare. Further, the corresponding interaction effect between expenditure and the Good Governance Index (GGI) is negative but insignificant for low-income countries (LICs); negative and statistically significant for sub-Saharan African (SSA) economies and positive but insignificant for South Asian nations.

Originality/value

This study is an in-depth analysis of how governance impacts the effectiveness of healthcare expenditure to ensure higher human development, particularly in a large panel of 161 countries. The authors have developed a new index of good governance and later extended the analysis by separating countries based on the income level and geographical location, which are utterly absent in existing literature.

Article
Publication date: 1 March 1997

Cynthia S. Sneed and John E. Sneed

The purpose of this research is to examine the association between the unfunded OPEB liability and current expenditures for state governments as a measure of intergenerational…

Abstract

The purpose of this research is to examine the association between the unfunded OPEB liability and current expenditures for state governments as a measure of intergenerational equity. The research hypothesizes that states use the money to provide a higher level of current services than would be possible if the retiree healthcare premiums were fully funded. The results indicate that the current generation is receiving services but deferring the burden of paying for a portion of the services to future generations. This study is among the first to investigate the OPEB liability as a source of financing for current-period services for state governments.

Details

Journal of Public Budgeting, Accounting & Financial Management, vol. 9 no. 2
Type: Research Article
ISSN: 1096-3367

1 – 10 of 225