MACRO DETERMINANTS OF HEALTH EXPENDITURES IN DEVELOPED AND DEVELOPING COUNTRIES: DYNAMIC PANEL DATA ANALYSIS

Öz

Besides the studies investigating the relationship between health expenditures and economic growth, the factors that affect the amount of expenditure is an important question for the researchers. In this context, the aim of this study is to determine the macro determinants of health expenditures and the differences of these factors for countries in different income groups. In this study, annual data from 139 countries were used for the 2000-2015 period obtained from the World Bank Development Indicators database. In addition to the general panel data set, four different data sets, high, upper middle, lower middle and low income, were used to investigate how the health expenditure determinants change according to the development level of the countries. In this study, per capita income, public expenditures, population over 65 and under 14 years of age, life expectancy, maternal mortality rates and the effect of urban population on health expenditures were investigated considering the studies in the literature. As a result of the study, a positive correlation was found between health expenditures and per capita income, public expenditures and population over 65 years, and a negative correlation between maternal mortality and under 14 years of age for the overall country set. Consistent results regarding life expectancy and urbanization could not be obtained. When the results were examined in terms of income groups, it was found that the relationship between health expenditures and the variables discussed differed according to these sub-groups.

Anahtar Kelimeler

• Health Expenditures,GMM,Panel Data Analysis,Public policies

GELİŞMİŞ VE GELİŞMEKTE OLAN ÜLKELERDE SAĞLIK HARCAMALARININ MAKRO BELİRLEYİCİLERİ: DİNAMİK PANEL VERİ ANALİZİ

Öz

Sağlık harcamaları alanında literatürde yapılmış birçok çalışma bulunmaktadır. Çoğunlukla, sağlık harcamalarının iktisadi büyümeyle olan ilişkisi, araştırmacıların dikkatini çekmiştir. Ancak, harcama miktarının hangi faktörlerden etkilendiği sorusunun cevabı, en az harcama-büyüme ilişkisi kadar önemlidir. Bu bağlamda, bu çalışmanın amacı; sağlık harcamalarının makro belirleyicilerinin tanımlanması ve farklı gelir grubunda yer alan ülkeler için bu etkenlerin farklılıklarının tespit edilmesidir. Çalışmada, Dünya Bankası Kalkınma Göstergeleri veri tabanından elde edilen 2000-2015 dönemi için 139 ülkeye ait yıllık veriler kullanılmıştır. Genel panel veri setinin yanında sağlık harcamaları belirleyicilerinin ülkelerin gelişmişlik düzeyine göre nasıl değiştiğinin de araştırılması amacıyla Dünya Bankası’nın 2019 yılına ait “gelir grubuna göre ülke sınıflandırmasından” yararlanılmış ve yüksek, üst orta, alt orta ve düşük gelir grubu olmak üzere dört farklı veri seti oluşturularak model yeniden test edilmiştir. Çalışmada, literatürde yer alan çalışmalar göz önünde bulundurularak; kişi başı gelirin, kamu harcamalarının, 65 yaş üstü ve 14 yaş altı nüfus oranlarının, yaşam beklentisinin, anne ölüm oranlarının ve kentsel nüfusun, sağlık harcamaları üzerindeki etkisi araştırılmıştır. Çalışma sonucunda, ele alınan genel ülke seti için sağlık harcamalarıyla, kişi başı gelir, kamu harcamaları ve 65 yaş üstü nüfus oranı değişkenleri arasında pozitif, 14 yaş altı nüfus oranı ve anne ölüm oranları arasında ise negatif bir ilişki tespit edilmiştir. Yaşam beklentisi ve kentleşmeyle ilgili tutarlı sonuçlar elde edilememiştir. Gelir grupları açısından sonuçlar incelendiğinde ise, sağlık harcamaları ve ele alınan değişkenler arasındaki ilişkinin bu alt gruplara göre farklılık gösterdiği tespit edilmiştir.

Anahtar Kelimeler

• Sağlık Harcamaları,GMM,Panel Veri Analizi,Kamu Politikaları

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