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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.

Africa's population is the second largest and fastest growing in the world after Asia, and this puts African governments under great stress in terms of increased public expenditure and is faced with a low revenue generation. Hence, the need for this study. The purpose of this paper is to examine the socio-economic determinants of public expenditure in Africa by assessing the influence of population age structure using a sample of the top ten most populous countries in Africa covering period of 1989 to 2018.

The study employed panel fully modified ordinary least square (OLS) in estimating the relevant relationship between the variables in the model. The dynamic ordinary least square (DOLS) model was also used to check the robustness of the fully modified ordinary least square (FMOLS) results.

The findings revealed that the major population age structure that influences the growth of public expenditure in Africa are population ages (0–14) and population ages (15–64), but the former poses a stronger significant influence than the latter while population ages (65 and above) has a negative and insignificant influence. Also, in terms of other socio-economic factors, self-employment has a reducing and significant influence on public expenditure. GDP per capita has a negative and insignificant influence while foreign aid and unemployment rate has an increasing influence. Finally, inflation rate and control of corruption (CC) has a negative relationship with public expenditure.

The study argues that an increase in the young and working population will put enormous pressure on the government in the provision of more jobs and other public infrastructures such as health care and education. In the context of African economy with a low revenue generation, public expenditure will be low and the desperately poor masses will be denied of these public infrastructures.

Several studies (Jibir and Aluthge, 2019; Tayeh and Mustafa, 2011; Okafor and Eiya, 2011; Obeng and Sakyi, 2017; Ofori-Abebrese, 2012) have investigated the determinants of public expenditure using total population as a variable. However, this study is unique as it focused on the influence of population age structure on public expenditure in Africa. Also, the study incorporated other socio-economic determinants of public expenditure such as self-employment, standard of living, inflation rate, unemployment rate, foreign aid and corruption in its analytical model. To the best of our knowledge, some of these variables have not been employed in previous studies.

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.

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.

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.

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.

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

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.

This paper analyzes the impact of economic downturns on the revenue and expense sides of city financing for the period 2003 to 2009 using a convenience sample of the audited end of year financial reports for thirty midsized US cities. The analysis focuses on whether and how quickly and how extensively revenue and spending directions from past years are altered by recessions. A seven year series of Comprehensive Annual Financial Report (CAFR) data serves to explore whether citiesʼ revenues and spending, especially the traditional property tax and core functions such as public safety and infrastructure withstood the brief 2001 and the persistent 2007 recessions? The findings point to consumption (spending) over stability (revenue minus expense) for the recession of 2007, particularly in 2008 and 2009.

This paper aims to propose a tool to assess local public expenditure effectiveness based on a framework of alignment between outputs, outcomes and impacts – the Index of Municipal Expenditure Effectiveness (IMEE). This index is composed of a set of indicators associated with the typology of local expenditure.

The paper describes the methodological approach used in the development of the Index, considering the insights from the literature review and the opinion of a panel of experts. The indicators of outcomes and social impacts that are part of the Index are intentionally aligned with the UN Sustainable Development Goals (SDGs) as they provide an essential guide to assess public value creation in the current context. For simplicity purposes, three main components of municipal expenditure were considered, namely Education, Essential Public Services and Local Public Transportation. The Index is then illustrated through a pilot application, using data from five Portuguese municipalities.

This study argues that measuring the public expenditure effectiveness based on outcome and impact indicators can provide the data needed for local governments to better understand the effects of their activities over time, ultimately assessing their contribution to public value.

Assessing the impact of local spending is important to ensure the best use of public resources. Linking local public expenditures with the 2030 Agenda and the SDGs is a promising avenue to understand up to what extent the application of the public money is contributing to create public value by impacting on citizens’ lives.

The proposed IMEE contributes to addressing a gap identified in public organizations, including local governments, regarding the lack of consideration of expenditure and outcome/impact relationships, and the use of variables to measure long term impacts.

There is vast disparity in public expenditure on science, technology and environment (STE) across various Indian states. Public expenditure on STE is crucial in maintaining symmetric growth, social cohesion and sustainable development. Literature on this topic is scarce, which prompted the investigation of club convergence of STE public expenditure. In particular, the purpose of this paper to study the club convergence of STE public expenditure in the case of 20 Indian states during the period from 1987–1988 to 2019–2020.

This study applies the clustering algorithm to identify club convergence, advanced by the Phillips and Sul test, which enables identification of multiple steady states or club convergence, unlike beta and sigma convergences.

The findings of this paper show that all Indian states do not converge towards single steady states. This suggests a disparity in STE public expenditure across Indian states. Moreover, the findings favour three clubs that have their own unique transition paths. The results of this study are supported by the robustness check.

The findings suggest that the allocation of public expenditure on STE can be made based on club convergence to achieve social cohesion, sustainable development and millennium development goals across states.

Although several previous studies have investigated the convergence of public expenditure by considering either aggregate public expenditure or health/education expenditure, literature on the convergence hypothesis of STE public expenditure, particularly across Indian states, is scarce. Moreover, this paper is unique, as it examines multiple steady states or club convergence. Finally, this paper contributes to policymaking by suggesting which states should be given a push to achieve social cohesion and sustainable development.

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.

Budgetary reform in the UK since the International Monetary Fund (IMF) intervention under a Labour government in 1976 has been prompted by a new conventional wisdom that public expenditure was too high, and consequently, "crowded out" private sector investment. Although this belief became widespread in western democracies, in Britain it developed relatively early and was closely linked to the wider debate about Britain's relative economic decline. The first section of this article reviews the main reforms of the budgetary process which these concerns prompted.

In the second section we note that, despite the political concern with reducing public expenditure in the 1980s, success has been limited and priority is now the improvement of the underlying control and evaluation mechanisms in government spending. In practice, the main policy activity of the Thatcher administrations was on gaining "value for money" from existing expenditure. These developments are discussed and the likelihood of success considered. The nature of the present annual budgetary cycle is described as are the most recent developments designed to finally gain some form of effective expenditure control.

The chapter is devoted to the factors aimed at optimizing the partnership of public and private sectors in the sphere of public infrastructure development. In modern conditions of economic slowdown and budget consolidation in Russia, the infrastructure has become the most important driver of economic growth and public–private partnership (PPP) – the most perspective form of cooperation of public and private investors of infrastructure projects. PPP interpretation as a structural relationship of economic system allows the authors to model optimal combination of formal and informal institutions in order to stimulate long-term economic growth. It becomes promising to model replacement of budget funds by private investment to ensure positive impact on the Russian development despite the budget consolidation. It could only be achieved in the case of formal institutionalization of appropriate conditions for private investors as to low transactional costs and attractive financial parameters. There have been determined some PPP standards connected with public infrastructure projects in order to reduce capital expenditures of the budget funds and increase the inflow of private investment. The authors have managed to obtain model estimates and graphic interpretation of government expenditures’ efficiency increase that could help to structure the fiscal conditions to induce positive multiplier effect as a result of PPP forms improvement in the public infrastructure development.