Who Benefits from Government Health Spending and Why? A Global Assessment

This paper uses a common household survey instrument and a common set of imputation assumptions to estimate the pro-poorness of government health expenditure across 69 countries at all levels of income. On average, government health expenditure emerges as significantly pro-rich, but there is heterogeneity across countries: in the majority, government health expenditure is neither pro-rich nor pro-poor, while in a small minority it is pro-rich, and in an even smaller minority it is pro-poor. Government health expenditure on contracted private facilities emerges as significantly pro-rich for all types of care, and in almost all Asian countries government health expenditure overall is significantly pro-rich. The pro-poorness of government health expenditure at the country level is significantly and positively correlated with gross domestic product per capita and government health expenditure per capita, significantly and negatively correlated with the share of government facility revenues coming from user fees, and significantly and positively correlated with six measures of the quality of a country's governance; it is not, however, correlated with the size of the private sector nor with the degree to which the private sector delivers care disproportionately to the better-off. Because poorly-governed countries are underrepresented in the sample, government health expenditure is likely to be even more pro-rich in the world as a whole than it is in the countries in this study.

Bibliographic Details

Main Authors:	Bilger, Marcel, Wagstaff, Adam, Buisman, Leander R., Bredenkamp, Caryn
Language:	English en_US
Published:	World Bank Group, Washington, DC 2014-09
Subjects:	ABBREVIATIONS, AVERAGE COSTS, BUSINESS DEVELOPMENT, BUSINESS ENVIRONMENT, CAPITATION, CLASSIFICATION, CLINICS, CONSUMER PRICE INDEX, CRIME, DECISION TREE, DESCRIPTION, DEVELOPMENT POLICY, DISEASE CONTROL, DOCTORS, ELASTICITY, EXERCISES, FOREIGN TRADE, FUTURE RESEARCH, FUTURE STUDIES, GDP, GDP PER CAPITA, GOVERNMENT SERVICES, GROSS DOMESTIC PRODUCT, GROSS DOMESTIC PRODUCT PER CAPITA, HEALTH CARE, HEALTH CARE UTILIZATION, HEALTH EXPENDITURE, HEALTH FACILITIES, HEALTH FOR ALL, HEALTH INDICATORS, HEALTH INSURANCE, HEALTH MINISTRIES, HEALTH ORGANIZATION, HEALTH PLANS, HEALTH POLICY, HEALTH SECTOR, HEALTH SERVICE, HEALTH SERVICES, HEALTH STATUS, HEALTH SYSTEM, HOSPITAL ADMISSION, HOSPITALS, HUMAN DEVELOPMENT, IMPUTATION, IMPUTATION METHODS, INCIDENCE ANALYSIS, INCOME, INCOME DISTRIBUTION, INCOME TAXES, INDICES, INPATIENT CARE, IP, LIVING STANDARDS, NATIONAL INCOME, NUTRITION, OPEN ACCESS, OUTPATIENT CARE, PATIENTS, PER CAPITA INCOME, PER CAPITA INCOMES, PRICE CONTROLS, PRIMARY CARE, PRIVATE SECTOR, PRIVATE SECTORS, PUBLIC HEALTH, RESULT, RESULTS, SENSITIVITY ANALYSIS, SUPERVISION, USE VALUE, USER, USERS, USES, VOTERS,
Online Access:	http://documents.worldbank.org/curated/en/2014/09/20229062/benefits-government-health-spending-global-assessment https://hdl.handle.net/10986/20376
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