OECD Ülkelerinde Sağlık Sistemleri ve Sağlık Harcamaları İlişkisi: Ekonometrik bir Yaklaşım

Year 2023, Volume: 19 Issue: 1, 41 - 58, 27.06.2023

Nurbay Sey , Dündar Murat Demiröz

Abstract

Bu çalışmada OECD ülkelerinde sağlık harcamalarını belirleyen etkenler ve sağlık sistemlerinin bu etkenler üzerinde etkili olup olmadığı anlaşılmaya çalışılmıştır. Bu doğrultuda 27 OECD ülkesinin 1995-2020 yılları arasındaki yıllık verileri ile panel kointegrasyon ekonometrik modeli oluşturulmuştur. Bunun yanında bu çalışmada; sağlık sistemlerinin, sağlık harcamalarının belirleyicileri üzerindeki etkilerinin anlaşılması amaçlandığı için sağlık sistemleri ayrı ayrı modellenmiştir. Bu nedenle birinci modelde 27 OECD ülkesinin verileri incelenmiştir. İkinci modelde ise Beveridge sağlık sistemini benimseyen 14 ülkenin verileri, üçüncü modelde Bismarck sağlık sistemini benimseyen 13 ülkenin verileri modellenmiştir. Analizlerden doğru sonuçlar alabilmek için çalışmada kullanılan serilere ve kurulan modellere panel kointegrasyon analizinin gerektirdiği testler uygulanmıştır. Bu doğrultuda öncelikle serilere homojenlik ve yatay kesit bağımlılık testleri yapılmış ve bu testler sonucunda serilerin heterojen oldukları ve yatay kesit bağımlılığına sahip oldukları saptanmıştır. Buradan hareketlere serilere heterojenliği esas alan ikinci nesil panel birim kök testleri uygulanmıştır. Birim kök testleri sonucunda serilerin aynı derecede durağan olduklarının anlaşılması üzerine modeller oluşturulmuş ve bu sefer modellere yönelik homojenlik ve yatay kesit bağımlılık testleri yapılmış ve 3 modelin de heterojen olduğu ve yatay kesit bağımlılığına sahip oldukları ortaya konmuştur. Sonraki aşamada ise modellere kointegrasyon testleri yapılmıştır. Çalışmanın son aşamasında da CUP-FM kointegrasyon tahmincisinin sonuçları değerlendirilmiştir. Bu tahmin sonucunda ise sağlık sistemlerinin sağlık harcamalarını belirleyen etkenler üzerinde etkili olduğu ortaya konmuştur.

Keywords

Sağlık Harcamaları, Sağlık Sistemleri, Beveridge, Bismarck, OECD

The Relationship Between Health Systems and Health Expenditures In OECD Countries: An Econometric Approach

Abstract

This study aims to understand the determinants of health expenditures in OECD countries and whether health systems have an impact on these determinants. In this direction, it is constructed a panel cointegration econometric model with the annual data of 27 OECD countries between 1995-2020 years. In addition, since this study aims to understand the effects of health systems on the determinants of health expenditures, health systems are modeled separately. For this reason, in the first model it was examined the data of 27 OECD countries. In the second model, it is modeled the data of 14 countries that have adopted the Beveridge health and in the third model, it modeled the data of 13 countries that have adopted the Bismarck health system. In order to obtain accurate results from the analyses, it was conducted the tests to the that required by panel cointegration analysis. In this direction, first of all, homogeneity and cross-section dependence tests were performed to the series. According to result of these tests, it was determined that the series are heterogeneous and they have cross-section dependence. Therefore, second generation panel unit root tests based on heterogeneity were applied to the series. The unit root tests revealed that the series were stationary at the same degree. So afte that models were constructed. Then homogeneity and cross-section dependence tests were conducted for the models and it was revealed that all three models were heterogeneous and have cross-section dependence. In the next stage, the models were tested for cointegration. Finally in the last stage, it was evaluated the results of the CUP-FM cointegration estimator. As a result of this estimation, it is revealed that health systems have an impact on the determinants of health expenditures.

Keywords

Health Expenditures, Health Systems, Beveridge, Bismarck, OECD

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