Suchergebnisse

The United States spent an estimated $287 billion for health care in 1981 (Figure 1), an amount equal to 9.8 percent of the Gross National Product (GNP). Highlights of the figures that underly this estimate include the following: Health care expenditures continued to grow at a rapid rate in 1981, at a time when the economy as a whole exhibited sluggish growth. The 9.8 percent share of the GNP was a dramatic increase from the 8.9 percent share seen just two years earlier.Health care expenditures amounted to $1,225 per person in 1981 (Table 1). Of that amount, $524, or 42.7 percent, came from public funds.Hospital care accounted for 41.2 percent of total health care spending in 1981 (Table 2). These expenditures increased 17.5 percent from 1980, to a level of $118 billion.Spending for the services of physicians increased 16.9 percent to $55 billion—19.1 percent of all health care spending.Public sources provided 42.7 percent of the money spent on health in 1981, including Federal payments of $84 billion and $39 billion in State and local government funds (Table 3).All third parties combined—private health insurers, governments, private charities, and Industry—financed 67.9 percent of the $255 billion in personal health care in 1981 (Table 4), covering 89.2 percent of hospital care services, 62.1 percent of physicians' services, and 41.3 percent of the remainder (Table 5).Direct patient payments for health care reached $82 billion in 1981, accounting for 32.1 percent of all personal health care expenses (Table 6). Consumers and their employers paid another $73 billion in premiums to private health insurers, $67 billion of which was returned in the form of benefits.Outlays for health care benefits by the Medicare and Medicaid programs totaled $73 billion, including $42 billion for hospital care. The two programs combined paid for 28.6 percent of all personal health care in the nation (Table 7).

Background: Out-of-pocket health expenditures leave households exposed to the risk of financial catastrophe and poverty whenever they entail significant dissaving or the sale of key household assets. Even relatively small expenditures on health can be financially disastrous for poor households and similarly, large health care expenditures can lead to financial catastrophe and bankruptcy for rich households. Objective: There is increasing evidence that out-of-pocket expenditures act as a financial barrier to accessing health care, and are a source of catastrophic expenditures and impoverishment. This paper estimates the burden of out-of-pocket payments in Kenya; the incidence and intensity of catastrophic health care expenditure and impoverishment in Kenya. Methods: Using Kenya Household Health Expenditures and Utilization Survey data of 2007, the study uses both descriptive and econometric analysis to investigate the incidence and intensity of catastrophic health expenditures and impoverishment as well as the determinants of catastrophic health expenditures. To estimate the incidence and intensity of catastrophic expenditures and impoverishment, the study used both Wagstaff and van Doorslaer, (2002) and Xu et al. (2005) and applied various thresholds to demonstrate the sensitivity of catastrophic measures. For determinants of catastrophic health expenditures, a logit model was employed. Findings: Among those who utilized health care, 11.7 percent experienced catastrophic expenditures and 4 percent were impoverished by health care payments. In addition, approximately 2.5 million individuals were pushed into poverty as a result of paying for health care. The poor experienced the highest incidence of catastrophic expenditures. Conclusion: The paper recommends that the government should establish avenues for reducing the burden of out-of-pocket expenditures borne by households. This could be through a legal requirement for everyone to belong to a health insurance and targeting the poor, the elderly and chronically ill through the devolved system of the government and devolved funds.

The current study investigates the association of various economic, non-economic, governance, and environmental indicators on human health for seven emerging economies. Covering the period from 2000Q1 to 2018Q1, this study uses various panel data approaches for empirical estimations. The data is found first-order stationary. Besides, the panel slope is heterogeneous and cross-sectional dependence is present. Further, the cointegration association is found valid among the variables. Therefore, panel quantile regression is used to determine the long-run impact of each explanatory variable on human health at four quantiles (Q(25), Q(50), Q(75), and Q(90)). The estimated results asserted that economic growth, government health expenditure, and human capital significantly reduce human health disasters like malaria incidences and cases. At the same time, greenhouse gas emissions and regulatory quality are significantly and positively correlated to human health issues in emerging economies. Moreover, mixed (unidirectional and bidirectional) causal associations exist between the variables. This study also provides relevant policy implications based on the empirical results, providing a path for regulating various economic, environmental, and governance sectors. Effective policy implementation and preventive measures can reduce the spread of diseases and mortality rates due to Malaria.

This report includes estimates of how much was spent on health between 2003–04 and 2013–14. This information contributes to understanding the performance and efficiency of Australia's health system and how changes arise over time. Summary Continued slow growth Health expenditure growth in 2013–14 was relatively slow according to most measures. Total expenditure on health was estimated at $154.6 billion in 2013–14, up by 3.1% on 2012–13 in real terms (after adjusting for inflation). This growth was higher than the 1.1% growth experienced in 2012–13 but 1.9 percentage points lower than the average annual growth over the past decade (5.0%). Growth was also relatively slow in expenditure per person. An estimated $6,639 was spent per person on health in 2013–14, which was $94 more in real terms than in the previous year. This growth of 1.4% was less than half the average annual growth over the decade (3.3%). Despite this relatively slow growth in health spending, the proportion of the economy that health represented increased from 9.7% of gross domestic product (GDP) in 2012–13 to 9.8% in 2013–14. This was a result of relatively low growth in GDP. When compared to taxation revenue, government health spending represented the same proportion of taxation revenue (24.7%) as the previous year.

Rapid growth in the share of the nation's gross national product devoted to health expenditure has heightened concern over the survival of government entitlement programs and has led to debate of the desirability of current methods of financing health care. In this article, the authors present the data at the heart of the issue, quantifying spending for various types of health care in 1982 and discussing the sources of funds for that spending.

The last two decades have witnessed a decrease in public health expenditure relative to total health spending. One may ask whether this decreasing role of Government expenditure in the financing of health care is due to mature options on the desired health care system or is more the result of Governments complying with more binding budget constraints. In this paper, we provide a first answer to this question, based on evidence for a set of OECD countries. The main point of the paper can be easily stated: the observed smaller role of public financing of health expenditures in total public expenditure is the result, to a significant extent, of exogenous political pressures for lower Government budget deficits. Given an overall budget ceiling, there is no evidence supporting a general time change in health spending priority in the budget bargaining process. However, we do find that Government budget constraints lead to lower priority of health care in the Government's budget allocation process. This conclusion seems to hold whether health public spending is determined by a bargaining process within the Government or by population needs. At least, the empirical evidence provided suggests that more research on the political process governing health care expenditures is desirable. ; N/A

This report focuses on expenditures for personal health care, since these goods and services constitute most spending on health-related activities.

International audience ; The study aims to determine the effect of health expenditures on economic growth while taking into account the quality of health institutions, keeping in view the fact that it's not just the level, rather quality of expenditures or institutions that matters. Our hypothesis was where institutions are better health investment in health brings more economic growth as compared to those with low quality institutions. To attain that objective the standard neo-classical Solow Growth Model at steady-state level was taken as theoretical framework and made a production function adding institutional quality proxied by government effectiveness along with other variables like health expenditure, primary education completion rate, population growth etc. For estimation purposes, data for the sample of 20 South, East Asian and Pacific developing countries was used for the period 1995-2017. It was found that if health expenditures adjusted for the quality of government expenditures increase by 100%, then the economic growth will increase by 5%.

International audience ; The study aims to determine the effect of health expenditures on economic growth while taking into account the quality of health institutions, keeping in view the fact that it's not just the level, rather quality of expenditures or institutions that matters. Our hypothesis was where institutions are better health investment in health brings more economic growth as compared to those with low quality institutions. To attain that objective the standard neo-classical Solow Growth Model at steady-state level was taken as theoretical framework and made a production function adding institutional quality proxied by government effectiveness along with other variables like health expenditure, primary education completion rate, population growth etc. For estimation purposes, data for the sample of 20 South, East Asian and Pacific developing countries was used for the period 1995-2017. It was found that if health expenditures adjusted for the quality of government expenditures increase by 100%, then the economic growth will increase by 5%.

International audience ; The study aims to determine the effect of health expenditures on economic growth while taking into account the quality of health institutions, keeping in view the fact that it's not just the level, rather quality of expenditures or institutions that matters. Our hypothesis was where institutions are better health investment in health brings more economic growth as compared to those with low quality institutions. To attain that objective the standard neo-classical Solow Growth Model at steady-state level was taken as theoretical framework and made a production function adding institutional quality proxied by government effectiveness along with other variables like health expenditure, primary education completion rate, population growth etc. For estimation purposes, data for the sample of 20 South, East Asian and Pacific developing countries was used for the period 1995-2017. It was found that if health expenditures adjusted for the quality of government expenditures increase by 100%, then the economic growth will increase by 5%.

In this paper we propose a simple model of bailing out that closely describes the intergovernmental relationships between the Central government and the regional governments in the Italian public health care sector. The theoretical model suggests that bail out expectations by regions can be thought as the missing variable emphasised by Culyer (1988) in empirical models explaining health expenditure. We test this prediction by using data on regional health expenditure during the years 1990-1999. We show that financing by regions is influenced by political variables that capture changes in bail out expectations. This "expected" funding has a positive relationship with expenditure, even when Central government decreased financing to regions. Moreover, the "alignment effect" shows that "friendly" regional governments receive more money and support Central government by reducing expenditure.

Following decentralization in Indonesia there is evidence of a mismatch between spending responsibilities at the local level and local government's ability to effectively manage resources. This research investigates the relationship between institutional arrangements for public expenditure management (PEM) and inequalities in health outcomes in selected districts of Bengkulu Province, Indonesia. The primary aims of this study are to identify factors contributing to health outcome attainment differences and efficiency determinants. The role of the central government and the own-source capacity of district-level governments in financing health resources are also explained. This research differs from previous works by focusing on the inefficiency of the district-level health sector that is associated with weak PEM systems in order to explain the significant disparity in health outcome attainment within a country, using the new institutional economics (NIE) perspective as a guideline. Mixed methods procedures were adopted: quantitative and qualitative data were collected concurrently. The quantitative study utilized secondary data from data sets of government institutions. A correlational analysis, using the software package SPSS, was applied to assess the relationship between public health expenditure and other determinants with health outcomes at the provincial level. The qualitative study used primary data from in-depth face-to-face interviews with 20 key actors involved in the budget process for the health sector in four district governments of Bengkulu Province. Qualitative data were analysed using the QSR NVivo software program. This study reveals that changes in public health expenditure as a percentage of GRDP and real public health expenditure per capita and other determinants can be important factors behind observed declines in infant and child mortality and increases in life expectancy in Bengkulu Province. Other determinants of health outcomes comprise real GRDP per capita, the percentage of population participation in managed care, the percentage of delivering mothers assisted by health personnel, the ratio of midwives per 100,000 population, and the female literacy rate. The role of central government in financing health resources in the districts studied is also very prominent. These districts rely heavily on the central government and have limited financial capacity. Consequently, district governments have difficulty in performing their functions in the health sector properly because of frequently insufficient and reduced public health spending that originates from the central budget. This study also finds that the inability of institutional arrangements to adopt PEM principles has undermined the efficiency of government intervention in the health sector at district level. Weak institutional arrangements in PEM have had harmful effects on the size, allocation and use of public health expenditure, which contributes to inequalities in health outcome attainment in Bengkulu Province. Such weaknesses include the absence of constructive political engagement, lack of policy clarity, consistency and affordability, the presence of poor predictability, lack of transparency, the presence of poor comprehensiveness and integration and a lack of accountability. District governments also face severe inefficiencies in PEM that are created by delays in the budget approval processes. The introduction of market-based practices in PEM of the district governments studied has been unable to prevent potential opportunistic political behaviour. This has led to failure in reducing or eliminating the costs of negotiating and enforcing political agreements in allocating public resources by policy makers, since the budget can be viewed as a contract. These findings reinforce the criticism that the applicability of the PEM technique is country-specific. Proper institutional arrangements that address an Indonesia-specific context are required for the success of PEM. Using the NIE perspective, the findings support the view that hierarchies as an alternative mode of governance are more appropriate than markets, which cannot reduce transaction costs. Results-oriented cultures of the PEM approach cause difficulty in implementing this approach due to serious measurement problems in the health service.