Does Urbanization Induce the Health Expenditures? A Dynamic Macro-Panel Analysis for Developing Countries

Year 2019, Issue: 61, 208 - 222, 23.07.2019

Mümin Atalay Çetin , İbrahim Bakırtaş

Abstract

Fast growing
urban population brings some opportunities while it can also causes significant
health costs, especially in developing countries. This study aims to
investigate the possible impact of urbanization on health expenditures in 89 developing
countries during the period 2006-2015 by using both static and dynamic panel
data techniques. Fixed Effects (FE) estimator results showed that the health
expenditures per capita has a positive relationship with income per capita, the
share of government expenditures, out-of-pocket payments per capita, the share
of population ages 65 and above. Furthermore, FE findings revealed that the
increased urbanization also induces the healthcare expenditures in developing
countries. In addition, dynamic panel estimation method is also applied in the
empirical analysis to avoid the possible endogeneity problem and to consider
the dynamic properties. Thus, Generalised Methods of Moments (GMM) findings
showed that the urbanization leads healthcare expenditures in developing
countries. Thereby, GMM results are coherence with the FE findings.
Consequently, the empirical results indicate the importance of urbanization as
a determinant of healthcare expenditures. Therefore, developing countries’
policy makers should re-consider their urban development policies to prevent
from the negative externalities of rapid urbanization.

Keywords

Urbanization, Health Expenditures, Fixed Effects, GMM, Developing Countries

Kentleşme Sağlık Harcamalarını Arttırır mı? Gelişmekte Olan Ülkeler İçin Bir Dinamik Makro-Panel Analiz

Abstract

Hızla artan
kentsel nüfus çeşitli fırsatları beraberinde getirdiği gibi, özellikle
gelişmekte olan ülkelerde, önemli sağlık maliyetlerine de neden olabilmektedir.
Bu çalışma, 89 gelişmekte olan ülke için 2006-2015 yılları arasında
kentleşmenin sağlık harcamaları üzerindeki olası etkisini statik ve dinamik
panel veri teknikleri ile incelemeyi amaçlamaktadır. Sabit Etkiler (FE)
tahminci sonuçları kişi başına düşen sağlık harcamalarının, kişi başına düşen
gelir, kamu harcamaları, sağlık harcamaları için gerçekleştirilen kişi başına
nakit ödemeler ve 65 yaş ve üstü nüfus ile doğru yönlü bir ilişki içinde
olduğunu göstermiştir. Ayrıca, FE bulguları gelişmekte olan ülkelerde
kentleşmede yaşanan artışın sağlık harcamalarını arttırdığını ortaya
çıkarmıştır. Buna ek olarak, bu çalışmada, olası içsellik sorunlarından
kaçınmak ve dinamik özellikleri göz önünde bulundurmak için dinamik panel
tahmin yöntemleri de uygulanmıştır. Bu bağlamda gerçekleştirilen Genelleştirilmiş
Momentler Yöntemi (GMM) bulguları kentleşme oranındaki artışın sağlık
harcamalarını arttırıcı bir etkisi olduğunu göstermiştir. Dolayısıyla, GMM
sonuçları FE bulguları ile uyumludur. Çalışmanın ampirik bulguları,
kentleşmenin, gelişmekte olan ülkelerde sağlık harcamalarının önemli bir
belirleyicisi olduğunu ortaya koymuştur. Bu nedenle, gelişmekte olan ülkelerin
politika yapıcıları, hızlı kentleşmenin negatif dışsallıklarını önlemek için
kentsel gelişim politikalarını yeniden gözden geçirmelidir.

Keywords

Kentleşme, Sağlık Harcamaları, Sabit Etkiler, GMM, Gelişmekte Olan Ülkeler

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