THE IMPACT OF ECONOMIC GROWTH, AGING POPULATION AND GLOBALIZATION ON HEALTH EXPENDITURES: AN ADVANCED PANEL DATA ESTIMATION

Öz

The increasing proportion of the elderly population and the increasing demand for medical and long-term care services have led to a global increase in healthcare expenditures. The increase in health expenditures has made it necessary for countries to take the necessary measures to ensure the sustainability of health systems. The study examines the impact of economic growth, aging population rate and globalization on health expenditures in BRICS-T countries with annual data for the period 2000-2020. As an econometric method, second generation advanced panel data methods that take cross-sectional dependence into account were used. Estimation findings reveal that economic growth and globalization have an increasing effect on the health expenditures of the elderly population, while globalization has a decreasing effect. The findings show that a comprehensive policy that takes into account economic, social and health factors is needed to improve the quality of the aging population and ensure sustainable economic growth and health systems in relevant countries.

Anahtar Kelimeler

• Health Expenditures
• Globalization
• Aging Population
• CCE Method

EKONOMİK BÜYÜME, YAŞLANAN NÜFUS VE KÜRESELLEŞMENİN SAĞLIK HARCAMALARI ÜZERİNDEKİ ETKİSİ: GELİŞMİŞ BİR PANEL VERİ TAHMİNİ

Öz

Yaşlı nüfusun artan oranı, tıbbi ve uzun vadeli bakım hizmetlerine olan talebin artması gibi nedenler sağlık harcamalarında küresel bir artışa yol açmıştır. Sağlık harcamalarındaki artış ülkelerde, sağlık sistemlerinin sürdürülebilirliğinin sağlanması için gerekli önlemlerin alınmasını zorunlu hale getirmiştir. Çalışma, BRICS-T ülkelerinde ekonomik büyümenin, yaşlanan nüfus oranının ve küreselleşmenin sağlık harcamaları üzerindeki etkisini 2000-2020 dönemine ait yıllık verilerle incelemektedir. Ekonometrik yöntem olarak yatay kesit bağımlılığını dikkate alan ikinci nesil gelişmiş panel veri yöntemleri kullanılmıştır. Tahmin bulguları, ekonomik büyümenin ve yaşlı nüfusun sağlık harcamaları üzerinde artırıcı küreselleşmenin ise azaltıcı bir etkiye sahip olduğunu ortaya koymaktadır. Bulgular, ilgili ülkelerde yaşlı nüfus kalitesinin iyileştirilmesi, sürdürülebilir ekonomik büyümenin ve sağlık sistemlerinin sağlanması için ekonomik, sosyal ve sağlık faktörlerini dikkate alan kapsamlı bir politikaya ihtiyaç olduğunu göstermektedir.

Anahtar Kelimeler

• Sağlık Harcamaları
• Küreselleşme
• Yaşlanan Nüfus
• CCE Yöntemi

Kaynakça

1. Aghion, P., Howitt, P., ve Murtin, F. (2010). The Relationship Between Health and Growth: When Lucas Meets Nelson-Phelps (No. w15813). National Bureau of Economic Research,1-24.
2. Ağır, H. ve Türkmen, S. (2020). Ekonomik Büyümeye Etkisi Bakımından Doğal Kaynaklar: Dinamik Panel Veri Analizi. Gaziantep University Journal of Social Sciences, 19(3), 840-852.
3. Albouy, V., Davezies, L., ve Debrand, T. (2010). Health Expenditure Models: A Comparison using Panel Data. Economic Modelling, 27(4), 791-803.
4. Baldacci, E., Clements, B., Gupta, S., ve Cui, Q. (2008). Social Spending, Human Capital, and Growth in Developing Countries. World Dev, 36,1317–1341.
5. Barkat, K., Sbia, R., ve Maouchi, Y. (2019). Empirical Evidence on the Long and Short Run Determinants of Health Expenditure in the Arab World. The Quarterly Review of Economics and Finance, 73, 78-87.
6. Bergman, H., Karunananthan, S., Robledo, L. M., Brodsky, J., Chan, P., Cheung, M., ve Bovet, P. (2013). Understanding and Meeting the Needs of the Older Population: A Global Challenge. Canadian Geriatrics Journal, 16(2), 61.
7. Breusch T.S. ve Pagan, A.R. (1980). A Lagrange Multiplier Test and its Applications to Model Specification in Econometrics. Review of Economic Studies, 47(1), 239- 253.
8. Cengiz, O. ve Manga, M. (2022). Türki Cumhuriyetlerde Küreselleşmenin Sağlık Harcamaları Üzerindeki Rolü. Gaziantep University Journal of Social Sciences, 21(2), 583-598.

9. Cervantes, M. P. A., Lopez,L. N., ve Rambaud, S. C. (2020). The Relative Importance of Globalization and Public Expenditure on Life Expectancy in Europe: An Approach Based on MARS Methodology. International Journal of Environmental Research and Public Health, 17(22), 8614.
10. De Meijer, C., Wouterse, B., Polder, J., ve Koopmanschap, M. (2013). The Effect of Population Aging on Health Expenditure Growth: A Critical Review. European Journal of Ageing, 10, 353-361.
11. Ecevit, E. ve Çetin, M. (2016). Ekonomik Büyüme Ve Çevre Kirliliğinin Sağlık Üzerindeki Etkisi: Türkiye ile İlgili Ampirik Kanıt. Erciyes Üniversitesi İktisadi ve İdari Bilimler Fakültesi Dergisi, 48, 83-98.
12. Ecevit, E., Çetin, M., Koçak, E., Doğan, R., ve Yıldız, O. (2023). Greenhouse Gas Emissions, Economic Globalization, and Health Expenditures Nexus: Does Population Aging Matter in Emerging Market Economies?. Environmental Science and Pollution Research, 30(11), 29961-29975.
13. Farooq, F., Yusop, Z., ve Chaudhry, I. S. (2019). How do Trade Openness and Public Expenditures Affect Health Status in OIC Member Countries? An Empirical Analysis. Pakistan Journal of Commerce and Social Sciences (PJCSS), 13(4), 1041-1056.
14. Fervers, L., Oser, P., ve Picot, G. (2016). Globalization and Healthcare Policy: A Constraint on Growing Expenditures. Journal of European Public Policy, 23(2), 197-216.
15. González-González, C., Sánchez-García, S., Juárez-Cedillo, T., Rosas-Carrasco, O., Gutiérrez-Robledo, L. M., ve García-Peña, C. (2011). Health Care Utilization in the Elderly Mexican Population: Expenditures and Determinants. BMC Public Health, 11(1), 1-10.
16. Hayat, E. ve Ertekïn, Ş. (2020). OECD Ülkelerinde Cepten Yapilan Sağlık Harcamalarının Belirleyicileri: Dinamik Panel Veri Analizi. Third Sector Social Economic Review, 55(4), 2739-2757.
17. Huynen, M. M., Martens, P., ve Hilderink, H. B. (2005). The Health Impacts of Globalisation: A Conceptual Framework. Globalization and Health, 1, 1-12.
18. Jaba, E., Balan, C, B., ve Robu, I,B. (2014). The Relationship Between Life Expectancy at Birth and Health Expenditures is Estimated by a Cross-Country and Time-Series Analysis. Procedia Econ Financ, 15,108–114.
19. Jani, V. J., Joshi, N. A. ve Mehta, D. J. (2019). Globalization and Health: An Empirical Investigation. Global Social Policy, 19(3), 207-224.
20. Jawadi, F., El Gouddi, S., Ftiti, Z., ve Kacem, A. (2018). Assessing the Effect of Trade Openness on Health in the MENA Region: A Panel Data Analysis. Open Economies Review, 29, 469-479.
21. Kiross, G. T., Chojenta, C., Barker, D., ve Loxton, D. (2020). The Effects of Health Expenditure on Infant Mortality in Sub-Saharan Africa: Evidence from Panel Data Analysis. Health Economics Review, 10, 1-9.
22. KOF Swiss Economic Institute Database (2023). “KOF Globalisation Index” https://kof.ethz.ch/en/forecasts- andindicators/indicators/kof-globalisation-index.html (07.10.2023).
23. Lopreite, M. ve Mauro, M. (2017). The Effects of Population Ageing on Health Care Expenditure: A Bayesian VAR Analysis using Data from Italy. Health Policy, 121(6), 663-674.
24. Martens, P., Akin, S. M., Maud, H., ve Mohsin, R. (2010). Is Globalization Healthy: A Statistical Indicator Analysis of the Impacts of Globalization on Health. Globalization and Health, 6, 1-14.
25. McCoskey, S. ve Kao, C. (1998). A Residual-Based Test of the Null of Cointegration in Panel Data. Econometric Reviews, 17(1), 57-84.
26. Mohapatra, G., Arora, R., ve Giri, A. K. (2022). Establishing the Relationship Between Population Aging and Health Care Expenditure in India. Journal of Economic and Administrative Sciences, 1-18.
27. Newhouse, J. (1977). Medical Care Expenditure: A Cross National Survey. The Journal of Human Resources, 12(1), 115-125.
28. Orosz, E. ve Morgan, D. (2004). SHA-Based National Health Accounts in Thirteen OECD Countries: A Comparative Analysis. https://cdi.mecon.gob.ar/bases/doc/oecd/hwp/16.pdf adresinden erişildi.
29. Pesaran, M. H. (2004). General Diagnostic Tests for Cross Section Dependence in Panels. Cambridge: University of Cambridge, 1-47.
30. Pesaran, M. H. (2006). Estimation and Inference in Large Heterogeneous Panels with a Multifactor Error Structure. Econometrica, 74(4), 967–1012.
31. Pesaran, M. H. ve Yamagata, T. (2008). Testing Slope Homogeneity in Large Panels. Journal of Econometrics, 142(1), 50-93.
32. Pesaran, M. H., Ullah, A., ve Yamagata, T. (2008). A Bias-Adjusted LM test of Error Cross-Section Independence. Econometrics Journal, 11, 105-127.
33. Ray, D. ve Linden, M. (2020). Health Expenditures, Longevity, and Child Mortality: Dynamic Panel Data Approach with Global Data. International Journal of Health Economics and Management, 20, 99-119.
34. Reese, S. ve Westerlund, J. (2016). Panicca: Panic on Cross‐Section Averages. Journal of Applied Econometrics, 31(6), 961-981.
35. Reinhardt, UE. (2003). Does the Aging of the Population Really Drive the Demand for Health Care? Health Aff. 22(6):27–39.
36. Samadi, A. ve Rad, E. H. (2013). Determinants of Healthcare Expenditure in Economic Cooperation Organization (ECO) Countries: Evidence from Panel Cointegration Tests. International Journal Of Health Policy and Management, 1(1), 63.
37. Shahzad, K., Jianqiu, Z., Hashim, M., Nazam, M., ve Wang, L. (2020). Impact of using Information and Communication Technology and Renewable Energy on Health Expenditure: A Case Study from Pakistan. Energy, 204, 117956.
38. Shakoor, U., Rashid, M., Baloch, A. A., Husnain, M, I, U., ve Saboor, A. (2021). How Aging Population Affects Health Care Expenditures in Pakistan? A Bayesian VAR Analysis. Social Indicators Research, 153, 585-607.
39. Tausch, A. (2015). Is Globalization Really Good for Public Health?. The International Journal of Health Planning and Management, 31, 511-536.
40. Vandersteegen, T., Marneffe, W., Cleemput, I., ve Vereeck, L. (2015). The Impact of No-Fault Compensation on Health Care Expenditures: An Empirical Study of OECD Countries. Health Policy, 119(3), 367-374.
41. Weil, D, N. (2007). Accounting for the Efects of Health on Economic Growth. Quart J Econ 122, 1265–1306.
42. Westerlund, J. ve Edgerton, D. L. (2007). A Panel Bootstrap Cointegration Test. Economics Letters, 97, 185–190.
43. World Bank (2023). “World Development Indicators”, http://databank.worldbank.org/data/reports.aspx? source=world-development-indicators (11.10.2023).
44. Yang, B., Usman, M., ve Jahanger, A. (2021). Do Industrialization, Economic Growth and Globalization Processes Influence the Ecological Footprint and Healthcare Expenditures? Fresh Insights Based on the STIRPAT Model for Countries with the Highest Healthcare Expenditures. Sustainable Production and Consumption, 28, 893-910.
45. Yang, X. (2020). Health Expenditure, Human Capital, and Economic Growth: An Empirical Study of Developing Countries. International Journal of Health Economics and Management, 20(2), 163-176.
46. Yetim, B., İlgün, G., Çilhoroz, Y., Demirci, Ş., ve Konca, M. (2021). The Socioeconomic Determinants of Health Expenditure in OECD: An Examination on Panel Data. International Journal of Healthcare Management, 14(4), 1265-1269.