Why Do Some Countries Spend More for Health? An Assessment of Sociopolitical Determinants and International Aid for Government Health Expenditures
A consensus exists that rising income
levels and technological development are among the key
drivers of total health spending. However, determinants of
public sector health expenditure are less well understood.
This study examines a complex relationship across government
health expenditure (GHE), sociopolitical risks, and
international aid, while taking into account the impact of
national income and fiscal capacity on health spending. The
author apply a two-way fixed effects and two-stage least
squares regression method to a panel dataset comprising 120
countries for the years 1995 through 2010. Our results show
that democratic accountability has a diminishing positive
correlation with GHE, and that levels of spending are higher
when the government is more stable. Corruption is associated
with less spending in developing countries, but with more
spending in high-income countries. Furthermore, the author
find that development assistance for health (DAH)
substitutes for domestically financed government health
expenditure (DGHE). For an average country, a 1 percent
increase in total DAH or DAH to government is associated
with a 0.02 percent decrease in DGHE. Our work highlights
that policy reforms that aim to eliminate corruption are
fundamental to improving the capacity of developing
countries to scale up GHE, and to increasing the efficiency
of health care systems in developed countries in containing
health care costs. To minimize fungibility, donors may
impose stronger monitoring mechanisms for corruption.
Delivering aid through NGOs may be an option in countries
with high ethnic tensions; however, the ability to do so
depends on institutional arrangements and the capacity of
NGOs in individual countries.
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Bibliographic Details
Main Authors: |
Liang, Li-Lin,
Mirelman, Andrew J. |
Language: | English en_US |
Published: |
World Bank, Washington, DC
2014-01
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Subjects: | ACCOUNTABILITY,
AGGREGATE HEALTH EXPENDITURE,
AGGREGATE INCOME,
ANTICORRUPTION,
ANTICORRUPTION REFORMS,
BRIBES,
CABINET,
COALITION GOVERNMENT,
CORRUPT,
CORRUPTION,
CORRUPTION IN GOVERNMENT,
DEBT,
DELIVERY SYSTEM,
DEMOCRACIES,
DEMOCRACY,
DEMOCRATIC ACCOUNTABILITY,
DEMOCRATIC SYSTEMS,
DETERMINANTS OF HEALTH,
ECONOMETRIC ANALYSIS OF HEALTH CARE EXPENDITURE,
ECONOMIC REVIEW,
ELECTION,
EXTERNAL DEBT,
FINANCIAL RESOURCES,
FISCAL POLICY,
FRAUD,
HEALTH AFFAIRS,
HEALTH CARE,
HEALTH CARE COSTS,
HEALTH CARE EXPENDITURE,
HEALTH CARE FINANCE,
HEALTH CARE REFORM,
HEALTH CARE SPENDING,
HEALTH CARE SYSTEMS,
HEALTH COVERAGE,
HEALTH ECONOMICS,
HEALTH EXPENDITURE,
HEALTH EXPENDITURE GROWTH,
HEALTH EXPENDITURES,
HEALTH FINANCING,
HEALTH INSURANCE,
HEALTH INSURANCE COVERAGE,
HEALTH ORGANIZATION,
HEALTH OUTCOMES,
HEALTH POLICY,
HEALTH PROGRAMS,
HEALTH RESOURCES,
HEALTH SECTOR,
HEALTH SERVICES,
HEALTH SPENDING,
HEALTH SYSTEMS,
HOSPITAL SYSTEMS,
HUMAN DEVELOPMENT,
HUMAN RESOURCES,
INCENTIVE STRUCTURES,
INCOME COUNTRIES,
INCOME ELASTICITY,
INCOME ELASTICITY OF HEALTH CARE,
INCOME GROUPS,
INFORMAL SECTOR,
INSURANCE PREMIUMS,
INTERNATIONAL HEALTH CARE,
INVESTIGATION,
KICKBACKS,
LEADERSHIP,
LOW-INCOME COUNTRIES,
MEDICAL RESOURCES,
MEDICAL TECHNOLOGY,
MONITORING MECHANISMS,
NATIONAL HEALTH,
NEPOTISM,
NUTRITION,
OLDER PEOPLE,
PATRONAGE,
POCKET PAYMENT,
POLITICAL INTERESTS,
POLITICAL OPPONENTS,
POLITICAL PARTY,
POLITICAL SYSTEM,
POLITICAL SYSTEMS,
POLITICIANS,
PRIVATE HEALTH SERVICES,
PRIVATE SECTOR,
PROVISION OF HEALTH CARE,
PUBLIC HEALTH,
PUBLIC HEALTH CARE,
PUBLIC HEALTH SPENDING,
PUBLIC POLICY,
PUBLIC SECTOR,
PUBLIC SPENDING,
SOCIAL HEALTH INSURANCE,
SOCIAL WELFARE,
TRANSPARENCY,
TUBERCULOSIS, |
Online Access: | http://documents.worldbank.org/curated/en/2014/01/19543916/some-countries-spend-more-health-assessment-sociopolitical-determinants-international-aid-government-health-expenditures
https://hdl.handle.net/10986/19035
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