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

Öz

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.

Anahtar Kelimeler

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

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

Öz

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.

Anahtar Kelimeler

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

Kaynakça

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