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This paper examines the determinants of healthcare expenditure for low-, middle- and high-income countries, and it quantifies their influences in order to assess policies for achieving universal health coverage. We elaborate two models, a fixed-effect model and the dynamic panel model, to estimate the factors associated with the total health expenditure growth as well as its major components for 167 countries over the period of 1993-2013. The panel data on total health expenditure per capita and its components were taken from the World Development Indicators. Overall, our results showed that total health expenditure per capita is rising in all countries over time as a result of rising incomes. However, our estimates showed that the income elasticity of health expenditure ranged from 0.75 to 0.96 in the fixed-effect static panel model, while in the dynamic panel model, it was smaller and ranged from 0.16 to 0.47. Our empirical findings indicate that development assistance for health reduced government domestic spending on health but increased total government health spending. Our results also indicate that the trend in health expenditure growth is significantly depending with the country's economic development. In addition, out-of-pocket expenditure is powerfully influenced by a country's capacity to increase general government revenues and social insurance contributions. Knowledge of factors associated to health expenditure might help policy makers to make wise judgments, plan health reforms and allocate resources efficiently.
In the United States, some populations suffer from far greater disparities in health than others. Those disparities are caused not only by fundamental differences in health status across segments of the population, but also because of inequities in factors that impact health status, so-called determinants of health. Only part of an individual's health status depends on his or her behavior and choice; community-wide problems like poverty, unemployment, poor education, inadequate housing, poor public transportation, interpersonal violence, and decaying neighborhoods also contribute to health inequities, as well as the historic and ongoing interplay of structures, policies, and norms that shape lives. When these factors are not optimal in a community, it does not mean they are intractable: such inequities can be mitigated by social policies that can shape health in powerful ways. Communities in Action: Pathways to Health Equity seeks to delineate the causes of and the solutions to health inequities in the United States. This report focuses on what communities can do to promote health equity, what actions are needed by the many and varied stakeholders that are part of communities or support them, as well as the root causes and structural barriers that need to be overcome.
In this book the authors explore the state of the art on efficiency measurement in health systems and international experts offer insights into the pitfalls and potential associated with various measurement techniques. The authors show that: - The core idea of efficiency is easy to understand in principle - maximizing valued outputs relative to inputs, but is often difficult to make operational in real-life situations - There have been numerous advances in data collection and availability, as well as innovative methodological approaches that give valuable insights into how efficiently health care is delivered - Our simple analytical framework can facilitate the development and interpretation of efficiency indicators.
Rationale: Health care expenditures in industrial countries have been growing rapidly over the past forty years. This rapid growth jeopardizes the sustainability of public budgets. A particular concern for the next decades is the effect of aging of the population on health care expenditures. Objectives: The first purpose of this research project is to provide an up to date overview of the literature on international comparisons of health care expenditures. This gives an insight in the most important variables to be used in estimating and projecting health care expenditures. Furthermore, this project aims to contribute to the existing literature by investigating the determinants of health care expenditures making use of panel data analysis. Herewith, the main focus is on the relative price of health care. The relative price of health care tends to increase over time because of the Baumol effect. Omitting the relative price in the set of explanatory variables may lead to biased coefficients for the other variables. Methodology: The literature overview serves as a starting point for determining the explanatory variables. In addition to the standard variables, we include the relative price as a possible determinant of health care expenditure. The main data source is the OECD Health Data set 2005, from which available data of the EU-15 countries are used for the period 1970-2003. Series for relative prices of health care for all countries were constructed out of series of wages and a consumer price index. We estimated several fixed effects models and performed unit root and cointegration tests. Results and Conclusions: We find that income and the share of the population aged 65-74 are important drivers of health care expenditures, which is consistent with the main findings of the recent literature. In addition, the share of the population aged above 75 and the time trend turn out to be insignificant. With respect to the relative price of health care, the results indicate that it has a negative but insignificant effect on the volume of health care when considering the period 1970-2003. In the period 1980-2003, however, the relative price of health care has a significant negative effect on the volume of health care. The estimated price elasticity of approximately -0.75 implies that a higher relative price is associated with a decrease in volume but still an increase in real health care expenditures. The significant effect of the relative price on volume over the period 1980-2003 seems to be consistent with the strong cost containment policy in many countries during this period.
The anthrax incidents following the 9/11 terrorist attacks put the spotlight on the nation's public health agencies, placing it under an unprecedented scrutiny that added new dimensions to the complex issues considered in this report. The Future of the Public's Health in the 21st Century reaffirms the vision of Healthy People 2010, and outlines a systems approach to assuring the nation's health in practice, research, and policy. This approach focuses on joining the unique resources and perspectives of diverse sectors and entities and challenges these groups to work in a concerted, strategic way to promote and protect the public's health. Focusing on diverse partnerships as the framework for public health, the book discusses: The need for a shift from an individual to a population-based approach in practice, research, policy, and community engagement. The status of the governmental public health infrastructure and what needs to be improved, including its interface with the health care delivery system. The roles nongovernment actors, such as academia, business, local communities and the media can play in creating a healthy nation. Providing an accessible analysis, this book will be important to public health policy-makers and practitioners, business and community leaders, health advocates, educators and journalists.
Economic shocks pose a threat to health and health system performance by increasing people's need for health care and making access to care more difficult - a situation compounded by cuts in public spending on health and other social services. But these negative effects can be avoided by timely public policy action. While important public policy levers lie outside the health sector, in the hands of those responsible for fiscal policy and social protection, the health system response is critical. This book looks at how health systems in Europe reacted to pressure created by the financial and economic crisis that began in 2008. Drawing on the experience of over 45 countries, the authors:' analyse health system responses to the crisis in three policy areas: public funding for the health system; health coverage; and health service planning, purchasing and delivery 'assess the impact of these responses on health systems and population health' identify policies most likely to sustain the performance of health systems facing financial pressure' explore the political economy of implementing reforms in a crisisThe book is essential reading for anyone who wants to understand the choices available to policy-makers - and the implications of failing to protect health and health-system performance - in the face of economic and other forms of shock.--
Health, The Medical Profession, and Regulation presents new evidence concerning health and the environment, inequality of health in many countries, and the compatibility of different quality of life measurements, along with new solutions to problems of health policy. The book is grouped into three sections. Section I, comprising six papers, looks into the determinants of people's health. Section II consists of three papers and deals with the supply side of the market for health care services. Finally, Section III contains three contributions devoted to health regulation. The intended market for this volume includes, but is not limited to, health economists, policy makers, insurers, and governmental advisors who need to stay abreast of the latest developments in health services research worldwide.
How do communities protect and improve the health of their populations? Health care is part of the answer but so are environmental protections, social and educational services, adequate nutrition, and a host of other activities. With concern over funding constraints, making sure such activities are efficient and effective is becoming a high priority. Improving Health in the Community explains how population-based performance monitoring programs can help communities point their efforts in the right direction. Within a broad definition of community health, the committee addresses factors surrounding the implementation of performance monitoring and explores the "why" and "how to" of establishing mechanisms to monitor the performance of those who can influence community health. The book offers a policy framework, applies a multidimensional model of the determinants of health, and provides sets of prototype performance indicators for specific health issues. Improving Health in the Community presents an attainable vision of a process that can achieve community-wide health benefits.