Determinants of Health Expenditures on the Axis of the Misery Index and Economic Development in OECD Countries: A Non-Additive Fixed Effects Panel Quantile Regression Approach

Yıl 2022, Sayı: 82, 267 - 286, 30.06.2022

Tuğçe Acar , Derya Topdağ

https://doi.org/10.26650/jspc.2022.82.946640

Öz

Identifying the growth in health expenditures and the factors affecting expenditure is a global problem. Accordingly, based on the recent developments in the economic growth literature, the determinants of health expenditures in Organisation for Economic Co-operation and Development (OECD) countries with similar economic development levels were analyzed within the framework of misery index and economic development. This study considers the data set and accessibility of the variables in the analysis, conducted for 34 OECD countries covering 2001–2019. In addition to the real gross domestic product per capita, the economic development indicator of the countries, this study analyzed the misery index, which is the macroeconomic performance indicator, the effects of the urban population, life expectancy at birth, household expenditures, and political stability as a state-institutional factor on health expenditures with the non-additive fixed-effect panel quantile regression method. According to the findings, the effect of the misery index and gross domestic product per capita on health expenditures at each quantile level was positive. In line with the findings, for governments to suppress growth in health expenditures, revising the health system would potentially be more effective than improving macroeconomic conditions.

Anahtar Kelimeler

Health Expenditures, Misery Index, Panel Data Analysis

OECD Ülkelerinde Sefalet Endeksi ve Ekonomik Kalkınma Ekseninde Sağlık Harcamalarının Belirleyicileri: Toplamsal Olmayan Sabit Etkili Panel Kantil Regresyon Yaklaşımı

Öz

Sağlık harcamalarındaki büyüme ve harcamayı etkileyen faktörlerin neler olduğunun belirlenmesi küresel bir sorundur. Bu doğrultuda çalışmada ekonomik büyüme literatüründeki son gelişmelere dayanarak, benzer ekonomik gelişmişlik düzeyine sahip olan OECD ülkelerinde sağlık harcamalarının belirleyicileri sefalet endeksi ve ekonomik kalkınma çerçevesinde analiz edilmiştir. Analizde veri seti ve değişkenlere ulaşılabilirlik dikkate alınarak 2001-2019 dönemini kapsayan 34 OECD ülkesi için analiz gerçekleştirilmiştir. Analizde ülkelerin ekonomik kalkınma göstergesi olan reel kişi başına GSYİH (LPGDP), makroekonomik performans göstergesi olan sefalet endeksine ek olarak, kentsel nüfus, doğumda yaşam beklentisi, hane halkı harcamaları ve devlet-kurumsal faktör olarak siyasi istikrar değişkeninin sağlık harcamaları üzerindeki etkisi toplamsal olmayan sabit etkili panel kantil regresyon yöntemi ile analiz edilmiştir. Elde edilen bulgulara göre sefalet endeksinin ve kişi başına GSYİH’nın incelenen her kantil düzeyinde sağlık harcamaları üzerindeki etkisi pozitif olarak tespit edilmiş, ele alınan diğer değişkenlerle birlikte elde edilen bulgular değerlendirilmiştir. Elde edilen bulgular doğrultusunda hükümetlerin sağlık harcamalarındaki büyümeyi bastırması için sağlık sistemini revize etmenin makroekonomik koşulları iyileştirmekten daha etkili olacağı belirtilmiştir.

Anahtar Kelimeler

Sağlık Harcamaları, Sefalet Endeksi, Panel Veri Analizi

Kaynakça

• Allard, A., Takman, J., Uddin, G. S., Ahmed, A. (2018). The N-shaped environmental Kuznets curve: an empirical evaluation using a panel quantile regression approach. Environmental Science and Pollution Research, 25(6), 5848-5861.
• Atella, V., Marini, G. (2006). Is health care expenditure really a luxury good? Re-assessment and new evidence based on OECD data.
• 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.
• Bloom D, Canning D, Sevilla J. (2004). The effect of health on economic growth: a production function approach. World Development. 32(1). 1–13.
• Bloom DE, Canning D. (2003). The health and poverty of nations: from theory to practice. Journal of Human Development..4(1). 47–71.
• Bloom DE, Canning D.(2000). The health and wealth of nations. Science. 287(5456).1207–9.
• Cade, B. S., Noon, B. R. (2003). A gentle introduction to quantile regression for ecologists. Frontiers in Ecology and the Environment, 1(8), 412-420.
• Culyer, A.J., (1988). Health Care Expenditures in Canada: Myth and Reality. Past and Future. Tax Paper n. 82. Canadian Tax Foundation.
• Di Tella, R., MacCulloch, R. J., Oswald, A. (2001). Preferences over inflation and unemployment: Evidence from surveys of happiness. American Economic Review, 91(1), 335–341. Elmi Zahramira, Sadeghi, Somaye. (2012). Health care expenditures and economic growth in developing countries: Panel co-integration and causality. Middle East Journal of Scientific Research. 12(1):88-91
• Gerdtham, U. G., Sogaard, J., Andersson, F., ve Jonsson, B. (1992). An econometric analysis of health care expenditure: A cross-section study of the OECD countries. Journal of Health Economics, 11, 63-84.
• Ghobarah, H.A. Huth, Paul., Russett, Bruce. (2004). Comparative public health: The political economy of human misery and well-being, International Studies Quarterly, 48(1), 73–94.
• Golkhandan Abolghasem. (2019). Long-term impact of economic misery on the life expectancy in Iran. Health Research Journal. 4(2).104.111.
• Hartwig, J. (2006). What drives health care expenditure? Baumol’s model of ‘‘unbalanced growth’’ revisited. Zurich: Swiss Federal Institute of Technology.
• Hitiris, T., Posnett, J. (1992). The determinants and effects of health expenditure in developed countries. Journal of Health Economics, 11, 173-181.
• Hosoya, K. (2014). Determinants of health expenditures: Stylized facts and a new signal. Modern Economy, 5, 1171-1180.
• Hufbauer, G., Kim, J., Rosen, H. . (2008). The Augmented Misery Index . Peterson Institute for International Economics , 1-18.
• Kılıç Cüneyt, Kurt, Ünzile. (2020). Kentleşmenin Sağlık Harcamaları Üzerindeki Etkisi: Türkiye için ARDL Sınır Testi Yaklaşımı. Kafkas Üniversitesi İktisadi ve İdari Bilimler Fakültesi Dergisi. 11(21). 290-305.
• Koenker, R. (2004). Quantile regression for longitudinal data. Journal of Multivariate Analysis 91, 74-89.
• Koenker, R., & Bassett, G. (1978). Regression Quantiles. Econometrica, 46(1), 33-50. doi:10.2307/1913643
• Kraipornsak, Paitoon.(2017). Factors Determining Health Expenditure in the Asian and the OECD Countries. Economics World. 5(5). 407-417.
• Leu, R.R. (1986). Public and Private Health Services: Comptementarities and Conflicts, Chapter The Public–Private Mix and International Health Care Cost. Basil Blackwell
• Lovell, M. C. ve Tien, P. L. (2000). Economic Discomfort and Consumer Sentiment. Eastern Economic Journal 26(1), 1-8. Mankiw, N. G. (2010). Macroeconomics. New York, NY: Worth.
• Nessen, R. (2008, December 17). Arthur Okun Father of the misery index. Washington: The Brookings Institution.Oxford. Erişim adresi: https://www.brookings.edu/opinions/the-brookings-institutions-arthur-okun-father-of-the-misery-index/
• Newhouse, J. P. (1977). Medical care expenditure: A cross-national survey. Journal of Human Resources, 12, 115-125.
• Po-Chin Wu., Shiao-Yen Liu ve Sheng-Chieh Pan.(2014). Does misery index matter for the persistence of health spending? Evidence from OECD countries. Social Indicators Research: An International and Interdisciplinary Journal for Quality-of-Life Measurement.118(2). 893-910.
• Rezaei H, Alizadeh M, Nademi Y. (2017). Examining the Spatial Spillover Effects of Misery Index on Health Care Expenditure in Selected Developing Countries. Journal of Healthcare Management. 8(1).57-67.
• Rezapour, Aziz., Ghorbani, Selar., Eisavi, Mahmoud, Faradonbeh Saeed Bagheri (2020).The Impact of Okun Misery Index on Out-of-pocket-payments in the Iranian Healthcare System.
• Shahabadi A, Gho rbani Golparvar M.(2016). Impact of Misery Index on Health Spending in Iran. Economic Modeling. 10(33). 133-57.
• Shahbaz M, Loganathan N, Mujahid N, Ali A, Nawaz A. (2016). Determinants of life expectancy and its prospects under the role of economic misery: A case of Pakistan. Social Indicators Research.126(3).1299-316.
• Tejada CAO, Triaca LM, Liermann NH, Ewerling F, Costa JC. (2019) Economic crises, child mortality and the protective role of public health expenditure. Cien Saude Colet. 24,4395– 4404.
• Wu, P. C., Liu, S. Y., Pan, S. C. (2014). Does misery index matter for the persistence of health spending? Evidence from OECD countries. Social indicators research, 118(2), 893-910.