Investigating the Determinants of Healthcare Expenditures in Different Healthcare Systems

Abstract

Background:The rapid growth of health expenditures is a great concern for governments at present. Objectives: The present study aimed to determine the main factors affecting health care expenditures in countries with different types of the healthcare system. Methods: We studied 25 countries with different types of healthcare systems, including national health insurance, traditional sickness insurance, national health services, and mixed systems. Health expenditure per capita was estimated as a function of health care price, out-of-pocket health expenditure, income, and other exogenous factors. A random-effects model was selected instead of a fixed-effects model based on the Hausman test to assess the effect of different factors on health expenditures. Results: Income and health care price had the greatest impacts on health expenditures in countries with national health insurance and countries with mixed health care systems, respectively. Among the variables, mortality and life expectancy had the greatest impacts on health expenditure in all types of the healthcare system. The out-of-pocket health expenditure had the most and least impacts on health expenditures in countries with mixed health care systems and countries with national health insurance systems, respectively. Conclusions:The study showed that health condition and out-of-pocket health expenditure are the most important determinants of health expenditures in all health care systems, especially the mixed health care system.

Drivers of healthcare expenditure growth in West Africa: A panel data investigation

“…have increased demand for medical care, thereby raising healthcare expenditure across economies, including the sub-Saharan Africa. 39,40,44,46,60,[62][63][64][65][66][67] This notwithstanding, marked decline in health expenditure in Japan as COVID-19 virus spread with strained medical resources has been reported. 64 The decrease in healthcare expenditure was due largely to considerable changes in people's behaviour regarding willingness to visit medical institutions for treating COVID-19 or any other illness.…”

“…65,66 Furthermore, studies found that rising income across countries and regions has engendered significant surge in healthcare expenditure. 8,14,39,40,45,46,55,63,67 When income increases, demand for health tends to escalate as a result of rising marginal utility from healthcare. 55,68 The level of income, which is categorised under socioeconomic factor can influence individual's "ability to transform the need for health services into affordable health services, which in turn affects the health expenditure growth."…”

“…and services, such as organ transplants, which have contributed to the growth of healthcare expenditure. 70 Other factors reported to have contributed to increasing healthcare expenditure across various economies include: prices of health services 40,44,58,67,70,81 ; unemployment 70 ; average life expectancy at birth 66,67 ; geographical location such as the percentage of people who live in urban regions relative to the total population 39,63,82 ; crude birth rate per 1000 people 70 ; number of physicians 22,39 ; and number of hospital beds. 82 Conversely, carbon-di-oxide emission, 70 domestic product per capita, 70 trade openness 70 and proportion of population below 15 years 10,39 have contributed significantly to decline in health expenditure.…”

“…On health status of individual or population, morbidity, outbreak of diseases such as COVID‐19, malaria and tuberculosis etc. have increased demand for medical care, thereby raising healthcare expenditure across economies, including the sub‐Saharan Africa 39,40,44,46,60,62–67 . This notwithstanding, marked decline in health expenditure in Japan as COVID‐19 virus spread with strained medical resources has been reported 64 .…”

“…Furthermore, studies found that rising income across countries and regions has engendered significant surge in healthcare expenditure 8,14,39,40,45,46,55,63,67 . When income increases, demand for health tends to escalate as a result of rising marginal utility from healthcare 55,68 .…”