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Sağlık Harcamalarının Belirleyicileri Üzerine Bir Uygulama: Çevre Kirliliği ve Yönetişimin Etkilerinin İncelenmesi

Year 2018, Volume: 7 Issue: 3, 1917 - 1939, 30.09.2018

Alper Karasoy , Gökhan Demirtaş

https://doi.org/10.15869/itobiad.449943
Cited By: 7

Abstract

Bu çalışmada seçilmiş 27
OECD ülkesine ait 2000-2015 dönemi verileri dikkate alınarak sağlık harcamalarının
belirleyicileri incelenmiştir. Bu süreçte bir bağımlı ve beş bağımsız değişken
içeren dört ekonometrik model oluşturulmuştur. Bu modelleri tahmin etmek için
panel veri analizi kullanılmıştır. Benzer çalışmalarda kullanılmış olan tipik
belirleyicilere (gelir, ortalama yaşam beklentisi, genç ve yaşlı nüfusun
çalışma çağındaki nüfusa oranı gibi) ek olarak modele iki değişken eklenmiştir:
Birincisi çevre kirliliğidir (Sülfür Oksitler-SOx, Karbon
Monoksit-CM, Nitrojen Oksitler-NOx ve Karbondioksit-CO2
olmak üzere dört farklı kirleticiyle yaklaşığı alınmıştır). İkincisiyse
Uluslararası Ülke Risk Rehberi’nden elde edilmiş olan yönetişim indeksidir.
Kullanılan dört kirleticiye göre oluşturulmuş olan dört modelin de sonuçlarına
göre: Gelir, ortalama yaşam beklentisi, yönetişim indeksindeki iyileşmeler ve
bağımlı nüfus oranı sağlık harcamalarını pozitif bir biçimde etkilemektedir. Ek
olarak, SOx ve CO2 değişkenlerinin katsayıları anlamlı ve
pozitifken; CM ve NOx değişkenlerinin katsayıları pozitif fakat anlamsızdır.
Bu sonuçlara bağlı olarak bazı politika önerileri de sunulmuştur. 

Keywords

Sağlık Harcamaları Panel Veri Analizi OECD Ülkeleri Çevre Kirliliği Yönetişim Yönetişim

References

  • Abdullah, H., Azam, M., & Zakariya, S. K. (2016). The Impact of Environmental Quality on Public Health Expenditure in Malaysia. Asia Pacific Journal of Advanced Business and Social Studies, 2(2), 365–379.
  • Amiri, A., & Ventelou, B. (2012). Granger causality between total expenditure on health and GDP in OECD: Evidence from the Toda–Yamamoto approach. Economics Letters, 116(3), 541–544. https://doi.org/10.1016/j.econlet.2012.04.040
  • Arellano, M. (2003). Panel Data Econometrics. Oxford: Oxford University Press.
  • Baltagi, B. H. (2005). Econometric Analysis of Panel Data (Third Ed.). West Sussex: John Wiley & Sons.
  • Baltagi, B. H., & Moscone, F. (2010). Health care expenditure and income in the OECD reconsidered: Evidence from panel data. Economic Modelling, 27(4), 804–811. https://doi.org/10.1016/j.econmod.2009.12.001
  • Chaabouni, S., & Abednnadher, C. (2014). The Determinants of Health Expenditures in Tunisia. International Journal of Information Systems in the Service Sector, 6(4), 60–72. https://doi.org/10.4018/ijisss.2014100104
  • Chaabouni, S., Zghidi, N., & Ben Mbarek, M. (2016). On the causal dynamics between CO 2 emissions, health expenditures and economic growth. Sustainable Cities and Society, 22, 184–191. https://doi.org/10.1016/j.scs.2016.02.001
  • Di Matteo, L. (2003). The income elasticity of health care spending: A comparison of parametric and nonparametric approaches. European Journal of Health Economics, 4(1), 20–29. https://doi.org/10.1007/s10198-002-0141-6
  • Ecevit, E., & Çetin, M. (2016). Ekonomik Büyüme ve Çevre Kirliliğinin Sağlık Üzerindeki Etkisi: Türkiye İle İlgili Ampirik Kanıt. Erciyes Üniversitesi İktisadi ve İdari Bilimler Fakültesi Dergisi, 0(48), 83–98. Tarihinde adresinden erişildi http://erciyes.dergipark.gov.tr/erciyesiibd/issue/28008/297412#article_cite
  • Erdil, E., & Yetkiner, I. H. (2009). The Granger-causality between health care expenditure and output: a panel data approach. Applied Economics, 41(4), 511–518. https://doi.org/10.1080/00036840601019083
  • Farag, M., Nandakumar, A. K., Wallack, S., Hodgkin, D., Gaumer, G., & Erbil, C. (2013). Health expenditures, health outcomes and the role of good governance. International Journal of Health Care Finance and Economics, 13(1), 33–52. https://doi.org/10.1007/s10754-012-9120-3
  • Fotourehchi, Z. (2016). Health effects of air pollution: An empirical analysis for developing countries. Atmospheric Pollution Research, 7(1), 201–206. https://doi.org/10.1016/j.apr.2015.08.011
  • Gerdtham, U.-G., & Jönsson, B. (2000). Chapter 1 International comparisons of health expenditure: Theory, data and econometric analysis (ss. 11–53). https://doi.org/10.1016/S1574-0064(00)80160-2
  • Greene, W. H. (1997). Econometric Analysis (Third Ed.). New Jersey: PrenticeHall International, Inc.
  • Gupta, S., Davoodi, H., & Tiongson, E. (2000). Corruption and the provision of health care and education services (IMF Working Paper No. WP/00/16).
  • Herwartz, H., & Theilen, B. (2003). The determinants of health care expenditure: testing pooling restrictions in small samples. Health Economics, 12(2), 113–124. https://doi.org/10.1002/hec.700
  • Hessami, Z. (2014). Political corruption, public procurement, and budget composition: Theory and evidence from OECD countries. European Journal of Political Economy, 34, 372–389. https://doi.org/10.1016/j.ejpoleco.2014.02.005
  • Hitiris, T. (1997). Health care expenditure and integration in the countries of the European Union. Applied Economics, 29(1), 1–6. https://doi.org/10.1080/000368497327335
  • Jerrett, M., Eyles, J., Dufournaud, C., & Birch, S. (2003). Environmental influences on healthcare expenditures: an exploratory analysis from Ontario, Canada. Journal of Epidemiology and Community Health, 57(5), 334–338. https://doi.org/10.1136/jech.57.5.334
  • Kennedy, P. (2006). Ekonometri Kılavuzu. (M. Sarımeşelive & Ş. Açıkgöz, Ed.) (Beşinci B.). Ankara/Turkey: Gazi Kitabevi.
  • Lago-Peñas, S., Cantarero-Prieto, D., & Blázquez-Fernández, C. (2013). On the relationship between GDP and health care expenditure: A new look. Economic Modelling, 32, 124–129. https://doi.org/10.1016/j.econmod.2013.01.021
  • Liang, L.-L., & Mirelman, A. J. (2014). Why do some countries spend more for health? An assessment of sociopolitical determinants and international aid for government health expenditures. Social Science & Medicine, 114, 161–168. https://doi.org/10.1016/j.socscimed.2014.05.044
  • Martín, J. J. M., del Amo González, M. P. L., & García, M. D. C. (2011). Review of the literature on the determinants of healthcare expenditure. Applied Economics, 43(1), 19–46. https://doi.org/10.1080/00036841003689754
  • Murthy, V. N. R., & Okunade, A. A. (2016). Determinants of U.S. health expenditure: Evidence from autoregressive distributed lag (ARDL) approach to cointegration. Economic Modelling, 59, 67–73. https://doi.org/10.1016/j.econmod.2016.07.001
  • Narayan, P. K., & Narayan, S. (2008). Does environmental quality influence health expenditures? Empirical evidence from a panel of selected OECD countries. Ecological Economics, 65(2), 367–374. https://doi.org/10.1016/j.ecolecon.2007.07.005
  • Newhouse, J. P. (1977). Medical-Care Expenditure: A Cross-National Survey. The Journal of Human Resources, 12(1), 115–125. https://doi.org/10.2307/145602
  • Nghiem, S. H., & Connelly, L. B. (2017). Convergence and determinants of health expenditures in OECD countries. Health Economics Review, 7(1), 29. https://doi.org/10.1186/s13561-017-0164-4
  • OECD. (y.y.). OECD Veritabanı. Tarihinde 08 Ağustos 2015, adresinden erişildi http://stats.oecd.org/
  • OECD. (2016). The Economic Consequences of Outdoor Air Pollution. Paris: OECD Publishing. https://doi.org/10.1787/9789264257474-en
  • Okunade, A. A., & Suraratdecha, C. (2000). Health care expenditure inertia in the OECD countries: A heterogeneous analysis. Health Care Management Science, 3(1), 31–42. https://doi.org/10.1023/A:1019020802989
  • Raeissi, P., Harati-Khalilabad, T., Rezapour, A., Hashemi, S. Y., Mousavi, A., & Khodabakhshzadeh, S. (2018). Effects of Air Pollution on Public and Private Health Expenditures in Iran: A Time Series Study (1972-2014). Journal of Preventive Medicine and Public Health, 51(3), 140–147. https://doi.org/10.3961/jpmph.17.153
  • Roberts, J. (2000). Spurious regression problems in the determinants of health care expenditure : a comment on Hitiris ( 1997 ). Applied Economics Letters, 7(September), 279–283. https://doi.org/10.1080/135048500351393
  • Sen, A. (2005). Is Health Care a Luxury? New Evidence from OECD Data. International Journal of Health Care Finance and Economics, 5(2), 147–164. https://doi.org/10.1007/s10754-005-1866-4
  • Smith, S., Newhouse, J. P., & Freeland, M. S. (2009). Income, Insurance, And Technology: Why Does Health Spending Outpace Economic Growth? Health Affairs, 28(5), 1276–1284. https://doi.org/10.1377/hlthaff.28.5.1276
  • The PRS Group. (y.y.). Politik Risk Grubu. Tarihinde 08 Ağustos 2016, adresinden erişildi http://epub.prsgroup.com/the-countrydata-gateway
  • Wooldridge, J. M. (2002). Econometric Analysis of Cross Section and Panel Data. Cambridge: MIT Press.
  • World Bank. (2017). World Development Indicators. Tarihinde 13 Ekim 2017, adresinden erişildi http://databank.worldbank.org/data/home.aspx
  • Yavuz, N. C., Yilanci, V., & Ozturk, Z. A. (2013). Is health care a luxury or a necessity or both? Evidence from Turkey. The European Journal of Health Economics, 14(1), 5–10. https://doi.org/10.1007/s10198-011-0339-6
  • Yazdi, S. K., & Khanalizadeh, B. (2017). Air pollution, economic growth and health care expenditure. Economic Research-Ekonomska Istrazivanja, 30(1), 1181–1190. https://doi.org/10.1080/1331677X.2017.1314823

An Application on the Determinants of Health Expenditures: Investigating the Impacts of Environmental Pollution and Governance

Year 2018, Volume: 7 Issue: 3, 1917 - 1939, 30.09.2018

Alper Karasoy , Gökhan Demirtaş

https://doi.org/10.15869/itobiad.449943
Cited By: 7

Abstract

This study investigates the determinants of
health expenditures for the selected 27 OECD countries considering the period 2000-2015.
Four econometric models, each of which includes one dependent and five
independent variables, are constructed. Panel data analysis tools are employed.
Besides using typical determinants of health expenditures (income, life
expectancy and age dependency ratio), two more variables are additionally
included: environmental pollution (which is separately proxied by four
pollutants, namely Sulphur Oxides-SOx, Carbon Monoxide-CM, Nitrogen
Oxides-NOx and Carbon Dioxides-CO2) and a governance
indicator that is the rankings by the International Country Risk Guide (ICGR). In
all four models, which correspond to each pollutant employed; income, life
expectancy, improvements in governance and dependency ratio significantly and
positively affect health expenditures. Moreover, while the coefficients of SOx
and CO2 are significant and positive, the coefficients of CM and NOx
are positive but insignificant. Some policy recommendations are put forward related
to these results.

Keywords

Health Expenditures Panel Data Analysis OECD Countries Environmental Pollution Governance

References

  • Abdullah, H., Azam, M., & Zakariya, S. K. (2016). The Impact of Environmental Quality on Public Health Expenditure in Malaysia. Asia Pacific Journal of Advanced Business and Social Studies, 2(2), 365–379.
  • Amiri, A., & Ventelou, B. (2012). Granger causality between total expenditure on health and GDP in OECD: Evidence from the Toda–Yamamoto approach. Economics Letters, 116(3), 541–544. https://doi.org/10.1016/j.econlet.2012.04.040
  • Arellano, M. (2003). Panel Data Econometrics. Oxford: Oxford University Press.
  • Baltagi, B. H. (2005). Econometric Analysis of Panel Data (Third Ed.). West Sussex: John Wiley & Sons.
  • Baltagi, B. H., & Moscone, F. (2010). Health care expenditure and income in the OECD reconsidered: Evidence from panel data. Economic Modelling, 27(4), 804–811. https://doi.org/10.1016/j.econmod.2009.12.001
  • Chaabouni, S., & Abednnadher, C. (2014). The Determinants of Health Expenditures in Tunisia. International Journal of Information Systems in the Service Sector, 6(4), 60–72. https://doi.org/10.4018/ijisss.2014100104
  • Chaabouni, S., Zghidi, N., & Ben Mbarek, M. (2016). On the causal dynamics between CO 2 emissions, health expenditures and economic growth. Sustainable Cities and Society, 22, 184–191. https://doi.org/10.1016/j.scs.2016.02.001
  • Di Matteo, L. (2003). The income elasticity of health care spending: A comparison of parametric and nonparametric approaches. European Journal of Health Economics, 4(1), 20–29. https://doi.org/10.1007/s10198-002-0141-6
  • Ecevit, E., & Çetin, M. (2016). Ekonomik Büyüme ve Çevre Kirliliğinin Sağlık Üzerindeki Etkisi: Türkiye İle İlgili Ampirik Kanıt. Erciyes Üniversitesi İktisadi ve İdari Bilimler Fakültesi Dergisi, 0(48), 83–98. Tarihinde adresinden erişildi http://erciyes.dergipark.gov.tr/erciyesiibd/issue/28008/297412#article_cite
  • Erdil, E., & Yetkiner, I. H. (2009). The Granger-causality between health care expenditure and output: a panel data approach. Applied Economics, 41(4), 511–518. https://doi.org/10.1080/00036840601019083
  • Farag, M., Nandakumar, A. K., Wallack, S., Hodgkin, D., Gaumer, G., & Erbil, C. (2013). Health expenditures, health outcomes and the role of good governance. International Journal of Health Care Finance and Economics, 13(1), 33–52. https://doi.org/10.1007/s10754-012-9120-3
  • Fotourehchi, Z. (2016). Health effects of air pollution: An empirical analysis for developing countries. Atmospheric Pollution Research, 7(1), 201–206. https://doi.org/10.1016/j.apr.2015.08.011
  • Gerdtham, U.-G., & Jönsson, B. (2000). Chapter 1 International comparisons of health expenditure: Theory, data and econometric analysis (ss. 11–53). https://doi.org/10.1016/S1574-0064(00)80160-2
  • Greene, W. H. (1997). Econometric Analysis (Third Ed.). New Jersey: PrenticeHall International, Inc.
  • Gupta, S., Davoodi, H., & Tiongson, E. (2000). Corruption and the provision of health care and education services (IMF Working Paper No. WP/00/16).
  • Herwartz, H., & Theilen, B. (2003). The determinants of health care expenditure: testing pooling restrictions in small samples. Health Economics, 12(2), 113–124. https://doi.org/10.1002/hec.700
  • Hessami, Z. (2014). Political corruption, public procurement, and budget composition: Theory and evidence from OECD countries. European Journal of Political Economy, 34, 372–389. https://doi.org/10.1016/j.ejpoleco.2014.02.005
  • Hitiris, T. (1997). Health care expenditure and integration in the countries of the European Union. Applied Economics, 29(1), 1–6. https://doi.org/10.1080/000368497327335
  • Jerrett, M., Eyles, J., Dufournaud, C., & Birch, S. (2003). Environmental influences on healthcare expenditures: an exploratory analysis from Ontario, Canada. Journal of Epidemiology and Community Health, 57(5), 334–338. https://doi.org/10.1136/jech.57.5.334
  • Kennedy, P. (2006). Ekonometri Kılavuzu. (M. Sarımeşelive & Ş. Açıkgöz, Ed.) (Beşinci B.). Ankara/Turkey: Gazi Kitabevi.
  • Lago-Peñas, S., Cantarero-Prieto, D., & Blázquez-Fernández, C. (2013). On the relationship between GDP and health care expenditure: A new look. Economic Modelling, 32, 124–129. https://doi.org/10.1016/j.econmod.2013.01.021
  • Liang, L.-L., & Mirelman, A. J. (2014). Why do some countries spend more for health? An assessment of sociopolitical determinants and international aid for government health expenditures. Social Science & Medicine, 114, 161–168. https://doi.org/10.1016/j.socscimed.2014.05.044
  • Martín, J. J. M., del Amo González, M. P. L., & García, M. D. C. (2011). Review of the literature on the determinants of healthcare expenditure. Applied Economics, 43(1), 19–46. https://doi.org/10.1080/00036841003689754
  • Murthy, V. N. R., & Okunade, A. A. (2016). Determinants of U.S. health expenditure: Evidence from autoregressive distributed lag (ARDL) approach to cointegration. Economic Modelling, 59, 67–73. https://doi.org/10.1016/j.econmod.2016.07.001
  • Narayan, P. K., & Narayan, S. (2008). Does environmental quality influence health expenditures? Empirical evidence from a panel of selected OECD countries. Ecological Economics, 65(2), 367–374. https://doi.org/10.1016/j.ecolecon.2007.07.005
  • Newhouse, J. P. (1977). Medical-Care Expenditure: A Cross-National Survey. The Journal of Human Resources, 12(1), 115–125. https://doi.org/10.2307/145602
  • Nghiem, S. H., & Connelly, L. B. (2017). Convergence and determinants of health expenditures in OECD countries. Health Economics Review, 7(1), 29. https://doi.org/10.1186/s13561-017-0164-4
  • OECD. (y.y.). OECD Veritabanı. Tarihinde 08 Ağustos 2015, adresinden erişildi http://stats.oecd.org/
  • OECD. (2016). The Economic Consequences of Outdoor Air Pollution. Paris: OECD Publishing. https://doi.org/10.1787/9789264257474-en
  • Okunade, A. A., & Suraratdecha, C. (2000). Health care expenditure inertia in the OECD countries: A heterogeneous analysis. Health Care Management Science, 3(1), 31–42. https://doi.org/10.1023/A:1019020802989
  • Raeissi, P., Harati-Khalilabad, T., Rezapour, A., Hashemi, S. Y., Mousavi, A., & Khodabakhshzadeh, S. (2018). Effects of Air Pollution on Public and Private Health Expenditures in Iran: A Time Series Study (1972-2014). Journal of Preventive Medicine and Public Health, 51(3), 140–147. https://doi.org/10.3961/jpmph.17.153
  • Roberts, J. (2000). Spurious regression problems in the determinants of health care expenditure : a comment on Hitiris ( 1997 ). Applied Economics Letters, 7(September), 279–283. https://doi.org/10.1080/135048500351393
  • Sen, A. (2005). Is Health Care a Luxury? New Evidence from OECD Data. International Journal of Health Care Finance and Economics, 5(2), 147–164. https://doi.org/10.1007/s10754-005-1866-4
  • Smith, S., Newhouse, J. P., & Freeland, M. S. (2009). Income, Insurance, And Technology: Why Does Health Spending Outpace Economic Growth? Health Affairs, 28(5), 1276–1284. https://doi.org/10.1377/hlthaff.28.5.1276
  • The PRS Group. (y.y.). Politik Risk Grubu. Tarihinde 08 Ağustos 2016, adresinden erişildi http://epub.prsgroup.com/the-countrydata-gateway
  • Wooldridge, J. M. (2002). Econometric Analysis of Cross Section and Panel Data. Cambridge: MIT Press.
  • World Bank. (2017). World Development Indicators. Tarihinde 13 Ekim 2017, adresinden erişildi http://databank.worldbank.org/data/home.aspx
  • Yavuz, N. C., Yilanci, V., & Ozturk, Z. A. (2013). Is health care a luxury or a necessity or both? Evidence from Turkey. The European Journal of Health Economics, 14(1), 5–10. https://doi.org/10.1007/s10198-011-0339-6
  • Yazdi, S. K., & Khanalizadeh, B. (2017). Air pollution, economic growth and health care expenditure. Economic Research-Ekonomska Istrazivanja, 30(1), 1181–1190. https://doi.org/10.1080/1331677X.2017.1314823
There are 39 citations in total.

Details

Primary Language Turkish
Journal Section Articles
Authors

Alper Karasoy 0000-0001-9447-3375

Gökhan Demirtaş 0000-0002-6757-5613

Publication Date September 30, 2018
Published in Issue Year 2018 Volume: 7 Issue: 3

Cite

APA Karasoy, A., & Demirtaş, G. (2018). Sağlık Harcamalarının Belirleyicileri Üzerine Bir Uygulama: Çevre Kirliliği ve Yönetişimin Etkilerinin İncelenmesi. İnsan Ve Toplum Bilimleri Araştırmaları Dergisi, 7(3), 1917-1939. https://doi.org/10.15869/itobiad.449943

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