Health Expenditure and All-Cause Mortality in the ‘Galaxy’ of Italian Regional Healthcare Systems: A 15-Year Panel Data Analysis

Golinelli, Davide; Toscano, F; Bucci, Andrea; Lenzi, Jacopo; Fantini, Maria Pia; Nante, Nicola; Messina, Gabriele

doi:10.1007/s40258-017-0342-x

Cited by 34 publications

(30 citation statements)

References 32 publications

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“…The panel data analysis described the association between health spending and mortality and showed that DPS is the only spending item significantly related with mortality in all models considered. This result is consistent with our prior findings [ 39 ]. Our models confirm that DPS is the financial driving force of the publicly funded Italian health system, and a potential determinant of the Italian population health status.…”

Section: Discussionsupporting

confidence: 94%

Real and predicted mortality under health spending constraints in Italy: a time trend analysis through artificial neural networks

Golinelli

Bucci

Toscano³

et al. 2018

BMC Health Serv Res

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BackgroundAfter 2008 global economic crisis, Italian governments progressively reduced public healthcare financing. Describing the time trend of health outcomes and health expenditure may be helpful for policy makers during the resources’ allocation decision making process. The aim of this paper is to analyze the trend of mortality and health spending in Italy and to investigate their correlation in consideration of the funding constraints experienced by the Italian national health system (SSN).MethodsWe conducted a 20-year time-series study. Secondary data has been extracted from a national, institution based and publicly accessible retrospective database periodically released by the Italian Institute of Statistics. Age standardized all-cause mortality rate (MR) and health spending (Directly Provided Services - DPS, Agreed-Upon Services - TAUS, and private expenditure) were reviewed. Time trend analysis (1995–2014) through OLS and Multilayer Feed-forward Neural Networks (MFNN) models to forecast mortality and spending trend was performed. The association between healthcare expenditure and MR was analyzed through a fixed effect regression model. We then repeated MFNN time trend forecasting analyses on mortality by adding the spending item resulted significantly related with MR in the fixed effect analyses.ResultsDPS and TAUS decreased since 2011. There was a mismatch in mortality rates between real and predicted values. DPS resulted significantly associated to mortality (p < 0.05). In repeated mortality forecasting analysis, predicted MR was found to be lower when considering the pre-constraints health spending trend.ConclusionsBetween 2011 and 2014, Italian public health spending items showed a reduction when compared to prior years. Spending on services directly provided free of charge appears to be the financial driving force of the Italian public health system. The overall mortality was found to be higher than the predicted trend and this scenario may be partially attributable to the healthcare funding constraints experienced by the SSN.Electronic supplementary materialThe online version of this article (10.1186/s12913-018-3473-3) contains supplementary material, which is available to authorized users.

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Section: Discussionsupporting

confidence: 94%

Real and predicted mortality under health spending constraints in Italy: a time trend analysis through artificial neural networks

Golinelli

Bucci

Toscano³

et al. 2018

BMC Health Serv Res

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“…by AEs, general and specialized hospital wards, and so on. In our previous work [2], we identified DPS as the major driving force of the INHS, the one most closely related to overall mortality rate, one of the most important outcome measures for evaluating a health system's performance. However, this spending item adjusted by inflation saw a constant reduction in recent years together with an even stronger reduction in the spending for primary care (Fig.…”

Section: To the Editormentioning

confidence: 99%

Comment on: “The Italian NHS: What Lessons to Draw from COVID-19?”

Golinelli

Bucci

Adja

et al. 2020

Appl Health Econ Health Policy

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“…On the other hand, Nkemgha et al (2020) identified the positive and statistically significant influence of private health expenditure but no significant impact of public health expenditure on life expectancy in Cameroon during 1980-2014. Similarly, van den Heuvel and Olaroiu (2017) declared that public health expenditure is not a key determinant of life expectancy while conducting a study in 31 European countries for the data period of 2014-2014. Many other researchers pointed out the positive role of both public and private health care expenditure on health status.…”

Section: Health Status -Health Expenditure Nexusmentioning

confidence: 99%

“…The major contributions of this study are: (i) this is the first study in the literature, to the best of our understanding, that investigates the effects of public and private health expenditures, energy consumption, carbon emissions, economic growth, and sanitation facilities on health status in the context of SAARC-BIMSTEC regions; (ii) this work employs the latest available and inclusive data covering the period of 16 years (2002)(2003)(2004)(2005)(2006)(2007)(2008)(2009)(2010)(2011)(2012)(2013)(2014)(2015)(2016)(2017); (iii) the results are attained by employing various erudite econometric tools e.g.…”

Section: Introductionmentioning

confidence: 99%

The Nexus Between Health Status and Health Expenditure, Energy Consumption and Environmental Pollution: Empirical Evidence from SAARC-BIMSTEC Regions

Rahman

Alam

2020

Preprint

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Background: The prevailing COVID-19 pandemic made us deep concern for considering the betterment of health status along with health expenditure, energy, and environmental issues all over the world. This paper examines the nexus between health status and health expenditures (both public and private), energy consumption and environmental pollution in the SAARC-BIMSTEC region.Methodology: We have utilized the panel autoregressive distributed lag (ARDL) model, heterogeneous panel causality test, cross sectional dependence test, cointegration test and Pesaran cross sectional dependent (CADF) unit root test for obtaining estimated results from the data of 16 years (2002-2017). Results: The acquired results authorize the cointegration among the variables used, where energy consumption, public and private health expenditure and economic growth have positive and statistically significant effects and environmental pollution has both negative and significant effects on the health status of these regions in the long-run, but no panel wise significant impact is found in the short-run. Two-way causal relationships between health status and environmental pollution, public and private health expenditure, economic growth and sanitation facilities, and a one-way causality running from energy consumption to health status are revealed.Conclusions: The improved health status in the SAARC-BIMSTEC region required to be protected by articulating the effective policies on both public and private health expenditures, environmental pollution, energy consumption, and economic growth. The attained results are theoretically and empirically consistent, and have important policy implications in the health sector.JEL codes: I10, I15, I18, C23

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Health Expenditure and All-Cause Mortality in the ‘Galaxy’ of Italian Regional Healthcare Systems: A 15-Year Panel Data Analysis

Cited by 34 publications

References 32 publications

Real and predicted mortality under health spending constraints in Italy: a time trend analysis through artificial neural networks

Real and predicted mortality under health spending constraints in Italy: a time trend analysis through artificial neural networks

Comment on: “The Italian NHS: What Lessons to Draw from COVID-19?”

The Nexus Between Health Status and Health Expenditure, Energy Consumption and Environmental Pollution: Empirical Evidence from SAARC-BIMSTEC Regions

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