Türkiye’de Sağlık Harcamaları ile Yolsuzluk Arasındaki Dinamik İlişkinin ARDL Yaklaşımıyla İncelenmesi

Öz

Sağlık, insanlığın en önemli değerlerinden biridir. Aynı zamanda ekonomik kalkınma ve refah için bir ön koşuldur. Sağlık sektörü, karmaşık yapısı nedeniyle küresel düzeyde yolsuzluğun en yaygın olduğu alanlardan biridir. Araştırmalar yolsuzluğun sağlık harcamalarına ve hizmetlerine zarar verdiğini gösteriyor. Bu çalışmada, 1984'ten 2019'a kadar Dünya Bankası, PRS/ICRG ve IMF'den alınan verileri analiz etmek için otoregresif dağıtılmış gecikme (ARDL) ve dinamik hata düzeltme modeli (ECM) kullanılmıştır. Bulgular, yolsuzluğun Türkiye'de uzun ve kısa dönemde sağlık harcamalarını ve hizmetlerini olumsuz etkilediğini göstermektedir. Uzun dönemde reel GSYİH büyümesi ile sağlık harcamaları arasında negatif bir ilişki vardır. Ayrıca, kısa vadede CO2 emisyonları ile sağlık harcamaları arasında pozitif bir ilişki olduğu tespit edilmiştir. Çalışmamızda enflasyon ile sağlık harcamaları arasında kısa dönemde gecikmeli bir değerle negatif bir ilişki olduğu gözlemlenmektedir. Türkiye'de sağlık hizmetlerinin ve harcamalarının kalitesinin artırılması için etkin sağlık politikaları uygulanmalı ve yolsuzlukla mücadeleye önem verilmelidir.

Anahtar Kelimeler

• Yolsuzluk
• Sağlık Harcaması
• Reel Gayri Safi Yurt İçi Hasıla
• CO2 emisyonu
• Enflasyon

Investigation of The Dynamic Relationship Between Health Expenditures and Corruption in Turkey through The ARDL Approach

Öz

Health is one of the most crucial values of humanity. It is also a prerequisite for economic development and prosperity. Because of its complex structure, the healthcare sector is one area where corruption is most prevalent at the global level. Research shows that corruption harms healthcare expenditures and services. This study used autoregressive distributed delay (ARDL) and dynamic error correction model (ECM) to analyze data from the World Bank, PRS/ICRG, and IMF from 1984 to 2019. The findings show that corruption negatively affected health expenditures and services in Turkey in the long and short run. There is a negative relationship between real GDP growth and health expenditures in the long run. In addition, it was determined that there is a positive relationship between CO2 emissions and health expenditures in the short term. In our study, some observe that there is a negative relationship between inflation and health expenditures in the short run, with a lagged value. To increase the quality of health services and expenditures in Turkey, effective health policies should be implemented and the fight against corruption should be given importance.

Anahtar Kelimeler

• Corruption
• Health Expenditures
• Real GDP
• CO2 Emissions
• Inflation.

Kaynakça

1. Akbulut E.(2020). Sağlık harcamaları ve gelir dağılımı ilişkisi: Türkiye ve OECD ülkeleri karşılaştırmalı analizi, Maliye Araştırmaları Dergisi, 6(3),137-155.
2. Akhbari, R. ve Nejati, M. (2019). The effect of corruption on carbon emissions in developed and developing countries: empirical investigation of a claim. Heliyon, 5(9), e02516.
3. Apergis, N., Gupta, R., Lau, C.K.M. ve Mukherjee, Z. (2018). US state-level carbon dioxide emissions: does it affect health care expenditure? Renew Sust Energ Rev 91:521–530
4. Artan, S., Hayaloğlu, P. ve Demirel SK. (2017). BRICS ülkelerinde kamu sağlık harcamaları etkinliğinin belirleyicileri, SGD-Sosyal Güvenlik Dergisi 7 (1), 9-30.
5. Atay Polat, M. ve Ergun, S. (2018). Yapısal kırılma altında Türkiye’de ekonomik büyüme, CO2 emisyonu ve sağlık harcamaları ilişkisi. Business and Economics Research Journal, 9(3), 481-497.
6. Bağdigen, M. ve Dökmen, G. (2006). Yolsuzluğun kamu gelir ve giderleri üzerine etkisi (2006). ZKÜ Sosyal Bilimler Dergisi, 2(3), 53-69.
7. Brown, R.L., Durbin, J.ve Evans, J.M. (1975). “Techniques for testing the constancy of regression relationhips over time”, Journal of the Royal Statistical Society, B, 37(2).
8. Bukhari, N., Shahzadi K., ve Shakil Ahmad, M. (2014). Consequence of FDI on CO2 emissions in case of Pakistan. 20(9):1183–1189. Chaabouni, S. ve Saidi, K. (2017). The dynamic links between carbon dioxide (CO2) emissions, health spending and gdp growth: a case study for 51 countries. Environmental Research, 158, 137-144.

9. Chattopdhyay, S. (2016). Corruption in healthcare and medicine: Why should physicians and bioethicists care and what should they do? Indian Journal of Medical Ethics, 10 (3), 153. Retrieved from https://ijme.in/articles/corruption-in-healthcare-and-medicine-why-should-physicians-and-bioethicists-care-and-what-should-they-do/
10. Crémieux, P. Y., Ouellette, P. ve Pilon, C. (1999). Health care spending as determinants of health outcomes. Health economics, 8(7), 627–639.
11. Celentani, M. ve Ganuza, J. (2002). Corruption and competition in procurement. European Economic Review, 46(7).
12. Cohen, D. ve Petkov, M.(2016). Corruption in healthcare is rife worldwide, finds report. BMJ. Oct 12; 355: i5522. doi: 10.1136/bmj.i5522. PMID: 27733348.
13. Çiğdem, G. (2020). COVID-19 and net foreign exchange reserve relationship in Turkey: evidence from ARDL bounds testing approach. Journal of Business, Economics and Finance (JBEF), 9(2), p.80-96.
14. Demir, H. ve Kurt, M.E. (2017). Yolsuzluk ve katastrofik sağlık harcamaları. Dicle Üniversitesi İktisadi ve İdari Bilimler Fakültesi Dergisi 7 (14), 363-384.
15. Davies, A. R., Homolova, L., Grey, C. ve Bellis, M. A. (2019). Health and mass unemployment events-developing a framework for preparedness and response. Journal of public health (Oxford, England), 41(4), 665–673.
16. Dumrul, Y. (2019). Sağlık harcamaları ve çevre kirliliği: Asean-5 ülkeleri üzerine bir panel veri analizi. IBAD Sosyal Bilimler Dergisi, Ekim 2019 Özel Sayısı, 396-407.
17. Erçelik, G. (2018). The relationship between health expenditure and economic growth in turkey from 1980 to 2015. Journal of Politics Economy and Management, 1 (1), 1-8.
18. Feliciano, M., Bezerra, A. ve Santo, A. (2017). Economic growth and inflation rate: implications for municipal revenue and health expenditure of the municipalities of Pernambuco, Brazil. Crescimento econômico e taxa de inflação: implicações na receita municipal e na despesa com saúde dos municípios de Pernambuco, Brasil. Ciencia & saude coletiva, 22(6), 1979–1990.
19. Fischer, C. (2014). Corruption in healthcare: a problem in Germany, too. Indian J Med Ethics. Apr 1;11(2):110-7.
20. Fotaki, M. (2020). Why we must talk about ınstitutional corruption to understand wrongdoing in the health sector comment on "we need to talk about corruption in health systems". International journal of health policy and management, 9(5), 206–208.
21. Gupta, S., Davoodi H. ve Tiongson E. (2000). Corruption and the provision of health care and education services, USA, IMF (WP/00/116.2000).
22. Gupta, S., Verhoeven, M. and Tiongson, E. R. (2003). Public spending on health care and the poor. Health economics, 12(8), 685–696.
23. Habibov, N. (2016) “Effect of corruption on healthcare satisfaction in post-soviet nations: a cross-country ınstrumental variable analysis of twelve countries”, Soc. Sci. Med, 152, s. 119-124.
24. Habibov, N. (2009). What determines healthcare utilization and related out-of-pocket expenditures in Tajikistan? Lessons from a national survey. Int J Public Health. 2009;54(4):260-6.
25. Howell, L.D. (2012). International Country Risk Guide Methodology, PRS Group, East Syracuse, NY.
26. Hanf, M., Van-Melle, A., Fraisse, F., Roger, A., Carme, B. ve Nacher, M. (2011). Corruption kills: estimating the global impact of corruption on children deaths. PloS one, 6(11), e26990.
27. Heijink, R, Koolman, X. ve Westert, GP. (2013). Spending more money, saving more lives? The relationship between avoidable mortality and healthcare spending in 14 countries. Eur J Health Econ. 2013 Jun;14(3):527-38. doi: 10.1007/s10198-012-0398-3. Epub 2012 Jun 8. PMID: 22678656.
28. Hone, T., Mirelman, A. J., Rasella, D., Paes-Sousa, R., Barreto, M. L., Rocha, R. ve Millett, C. (2019). Effect of economic recession and impact of health and social protection expenditures on adult mortality: a longitudinal analysis of 5565 Brazilian municipalities. The Lancet. Global health, 7(11), e1575–e1583.
29. Johnson S, Kaufmann D. ve Zoido-Lobaton, P. (1998). "Regulatory discretion and the unofficial economy," American Economic Review, American Economic Association, 88(2), 387-392.
30. Kar, M. ve Taban, S. (2003). Kamu harcama çeşitlerinin ekonomik büyüme üzerine etkisi. Ankara Üniversitesi SBF Dergisi, 58(3), 145-169.
31. Kohler, J.C. (2011). Fighting corruption in the health sector methods, tools and good practices. New York: United Nations Development Programme.
32. Kohler, J.C. ve Dimancesco, D. (2020). The risk of corruption in public pharmaceutical procurement: how anti-corruption, transparency and accountability measures may reduce this risk. Global health action, 13(sup1), 1694745.
33. Konuk, T. ve Eryer A. (2021). Ekonomik büyüme ve CO2 emisyonunun sağlık harcamaları üzerine etkisi: Türkiye örneği. Internatıonal Journal Of Dıscıplınes In Economıcs- Admınıstratıve Scıences Studıes(Ideastudıes), 7(30), 402-410.
34. Lu, H. S., Ho, B. X. ve Miranda, J. J. (2020). Corruption in health systems: the conversation has started, now time to continue it comment on "we need to talk about corruption in health systems". ınternational journal of health policy and management, 9(3), 128–132.
35. Mackey, T. K., Kohler, J. C., Savedoff, W. D., Vogl, F., Lewis, M., Sale, J., Michaud, J. ve Vian, T. (2016). The disease of corruption: views on how to fight corruption to advance 21st century global health goals. BMC medicine, 14(1), 149.
36. Mackey, T. K. (2019). Opening the policy window to mobilize action against corruption in the health sector comment on "we need to talk about in health systems". International journal of health policy and management, 8(11), 668–671.
37. Maruthappu, M., Da Zhou, C., Williams, C., Zeltner, T. ve Atun, R. (2015). Unemployment, public-sector health care expenditure and HIV mortality: An analysis of 74 countries, 1981-2009. Journal of global health, 5(1), 010403.
38. Ndaguba, E. A., Hlotywa, A. ve Christian, N. (Reviewing editor) (2021). Public health expenditure and economic development: The case of South Africa between 1996 and 2016.
39. OECD. Health spending statistics, https://data.oecd.org/healthres/health-spending.htm
40. Ostro, B. D. (1980). Air pollution, public health, and inflation. Environmental health perspectives, 34, 185–188.
41. Rezapour, A., Mousavi, A,, Lotfi, F., Soleimani Movahed, M. ve Alipour, S. (2019). The effects of health expenditure on health outcomes based on the classification of public health expenditure: a panel data Approach, Shiraz.
42. Saida Z. ve Kais S (2018) Environmental pollution, health expenditure and economic growth and in the sub-Saharan Africa countries: panel ARDL approach. Sustainable Cities Soc.
43. Sancar, C. ve Atay Polat, M. (2021). CO2 emisyonları, ekonomik büyüme ve sağlık harcamaları ilişkisi: türkiye ve seçilmiş ülke örnekleri için ampirik bir uygulama. MANAS Sosyal Araştırmalar Dergisi, 10(1).
44. Steigüber, S. (2020). Coronavirus ve yolsuzluk salgını: Küresel yolsuzlukla mücadele blogu; 2020. https://globalanticorruptionblog.com/2020/03/31/guest-post-coronavirus-and-the-corruption-outbreak/.
45. TI (2021). Health and Corruption. https://www.transparency.org/en/our-priorities/health-and-corruption
46. TI (2021). Corruption Perception Index, https://www.transparency.org/en/cpi/2020
47. Tanzi, V. ve Davoodi H. (2002) Corruption, Public Investment, and Growth, in: George T. Abed and Sanjeev Gupta (Ed.): Governance, Corruption, and Economic Performance, International Monetary Fund, Publication Services, Washington, D.C.; 280-299.
48. Turgut, M., Ağırbaş, İ. ve Uğurluoğlu Aldoğan, E. (2017). Türkiye’de sağlık harcamaları ve enflasyon arasındaki ilişki. Asos Journal.
49. TÜİK (2022). Sağlık ve sosyal koruma istatistikleri, https://data.tuik.gov.tr/Kategori/GetKategori?p=Saglik-ve-Sosyal-Koruma-101
50. Tüylüoğlu, Ş. ve Tekin, M. (2009.). Gelir düzeyi ve sağlık harcamalarının beklenen yaşam süresi ve bebek ölüm oranı üzerindeki etkileri. Çukurova Üniversitesi İktisadi ve İdari Bilimler Fakültesi Dergisi, 13 (1), 1-31.
51. Wang, D. ve Tomek, W. G. (2007). Commodity prices and unit root tests. American Journal of Agricultural Economics, Vol. 89, November, No. 4, 873-889.
52. Wang, Z., Asghar, M. M., Zaidi, S. ve Wang, B. (2019). Dynamic linkages among CO2 emissions, health expenditures, and economic growth: empirical evidence from Pakistan. Environmental science and pollution research international, 26(15), 15285–15299.
53. Wang, C. M., Hsueh, H. P., Li, F. ve Wu, C. F. (2019). Bootstrap ARDL on health expenditure, CO2 emissions, and GDP growth relationship for 18 OECD countries. Frontiers in public health, 7, 324.
54. Vavken, P., Pagenstert, G., Grimm, C. ve Dorotka, R. (2012). Does increased health care spending afford better health care outcomes? Evidence from Austrian health care expenditure since the implementation of DRGs. Swiss Med Wkly. 2012 Jun 6;142: w13589. doi: 10.4414/smw.2012.13589. PMID: 22674229.
55. Vian T. (2008). Review of corruption in the health sector: theory, methods and interventions. Health policy and planning, 23(2), 83–94.
56. Vian T. (2020). Anti-corruption, transparency and accountability in health: concepts, frameworks, and approaches. Global health action, 13(sup1), 1694744.
57. Yalçın, A. ve Çakmak, F. (2016). Türkiye’de kamu sağlık harcamalarının insani gelişim üzerindeki etkisi. Atatürk Üniversitesi İktisadi ve İdari Bilimler Dergisi, 30 (4), 0-0.
58. Yorulmaz, Ö. (2017). Sosyo-ekonomik kalkınma, yolsuzluk ve sağlık göstergeleri arasındaki ilişki: kısmi en küçük kareler yapısal eşitlik modeli uygulaması. Alphanumeric Journal, 5(2), 191-206.