What is the role of institutional quality in health outcomes? A panel data analysis on 158 countries from 2001-2020

Hadipour, Alireza; Delavari, Sajad; Bayati, Mohsen

doi:10.1016/j.heliyon.2023.e20251

Cited by 7 publications

(8 citation statements)

References 43 publications

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“…This highlights that overall political governance and cross-sector favors in coordinative policy formulation and implementation perform relatively poorly in advancing their institutional output to improve health outcomes. However, our results are consistent with prior studies by Hadipour et al 169 , Azimi et al 90 , Rahman and Alam 170 , Jafari et al 171 , Bousmah et al 172 , Brinkerhoff and Bossert 173 , Kaini 174 , and Kirigia and Kirigia 175 in the general context; our findings are unique and specify key policy areas where clear interventions are sought.…”

Section: Resultssupporting

confidence: 92%

Unveiling the health consequences of air pollution in the world’s most polluted nations

Azimi,

Rahman

2024

Sci Rep

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Air pollution poses a persuasive threat to global health, demonstrating widespread detrimental effects on populations worldwide. Exposure to pollutants, notably particulate matter with a diameter of 2.5 µm (PM2.5), has been unequivocally linked to a spectrum of adverse health outcomes. A nuanced understanding of the relationship between them is crucial for implementing effective policies. This study employs a comprehensive investigation, utilizing the extended health production function framework alongside the system generalized method of moments (SGMM) technique, to scrutinize the interplay between air pollution and health outcomes. Focusing on a panel of the top twenty polluted nations from 2000 to 2021, the findings yield substantial insights. Notably, PM2.5 concentration emerges as a significant factor, correlating with a reduction in life expectancy by 3.69 years and an increase in infant mortality rates by 0.294%. Urbanization is found to increase life expectancy by 0.083 years while concurrently decreasing infant mortality rates by 0.00022%. An increase in real per capita gross domestic product corresponds with an improvement in life expectancy by 0.21 years and a decrease in infant mortality rates by 0.00065%. Similarly, an elevated school enrollment rate is associated with a rise in life expectancy by 0.17 years and a decline in infant mortality rates by 0.00032%. However, a higher population growth rate is found to modestly decrease life expectancy by 0.019 years and slightly elevate infant mortality rates by 0.000016%. The analysis reveals that per capita greenhouse gas emissions exert a negative impact, diminishing life expectancy by 0.486 years and elevating infant mortality rates by 0.00061%, while per capita energy consumption marginally reduces life expectancy by 0.026 years and increases infant mortality rates by 0.00004%. Additionally, economic volatility shock presents a notable decrement in life expectancy by 0.041 years and an increase in infant mortality rates by 0.000045%, with inflationary shock further exacerbating adverse health outcomes by lowering life expectancy by 0.70 years and elevating infant mortality rates by 0.00025%. Moreover, the study scrutinizes the role of institutional quality, revealing a constructive impact on health outcomes. Specifically, the institutional quality index is associated with an increase in life expectancy by 0.66% and a decrease in infant mortality rates by 0.0006%. Extending the analysis to examine the nuanced dimensions of institutional quality, the findings discern that economic institutions wield a notably stronger positive influence on health outcomes compared to political and institutional governance indices. Finally, the results underscore the pivotal moderating role of institutional quality in mitigating the deleterious impact of PM2.5 concentration on health outcomes, counterbalancing the influence of external shocks, and improving the relationships between explanatory variables and health outcome indicators. These findings offer critical insights for guiding evidence-based policy implications, with a focus on fostering resilient, sustainable, and health-conscious societies.

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Section: Resultssupporting

confidence: 92%

Unveiling the health consequences of air pollution in the world’s most polluted nations

Azimi,

Rahman

2024

Sci Rep

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“…The negative effect of external health on the U5MR is attributable to the fact that external health expenditure can provide additional funding for healthcare infrastructure, services, and programs, improving child survival rates. The results align with findings by [ 23 , 24 , 28 , 39 , 40 , 81 ].…”

Section: Resultssupporting

confidence: 90%

“…The values of each of the six components range from −2.5 weak to 2.5 strong [ 48 ]. Thus, the PCA effectively merges the six institutional indices (see Appendix D ) into a single composite index as recommended by Karamizadeh et al (2013) [ 49 ], Dutta, Gupta and Sengupta (2019) [ 50 ], Ouedraogo, Dianda and Adeyele (2020) [ 45 ], Kouton, Bétila and Lawin (2021) [ 51 ], and Hadipour, Delavari and Bayati (2023) [ 40 ]. The PCA reduces the number of variables in a dataset while retaining the most essential information [ 52 ].…”

Section: Methodsmentioning

confidence: 99%

“…Numerous studies that assess the direct effect of health spending, particularly public health expenditure, support health expenditure as an U5MR-reducing factor. Using a set of 158 developing and developed countries, Hadipour, Delavari, and Bayati (2023) [ 40 ] found a negative effect of health expenditure on the U5MR. Dhrifi (2020) [ 41 ] found similar results when using the generalized methods of moments (GMM) to assess the impact of health expenditure in 93 developed and developing economies.…”

Section: Literature Review On Under-five Mortalitymentioning

confidence: 99%

“…Nevertheless, studies that considered institutional quality as the mediating effect in the said relationship only focused on public health expenditure. Thus, studies in Malaysia [ 35 ], WAEMU [ 47 ], developing and developed countries [ 41 ], high and low-income countries [ 40 ], and in SSA [ 23 , 26 ] are in consensus that the quality of governance enhances the public health expenditure to reduce the U5MR.…”

Section: Literature Review On Under-five Mortalitymentioning

confidence: 99%

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Health Expenditure, Institutional Quality, and Under-Five Mortality in Sub-Saharan African Countries

Sibanda,

Qoko,

Gonese

2024

IJERPH

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The aim of this study is to examine the relationship between health expenditure, institutional quality, and under-five mortality rates in sub-Saharan African countries. Specifically, the study seeks to explore the mediating role of institutional quality in this relationship, focusing on understanding how variations in healthcare spending and institutional frameworks impact child health outcomes. By examining these dynamics, the study aims to provide valuable insights that can inform evidence-based policy interventions to reduce under-five mortality and improve child health outcomes in the region. Utilizing data spanning the years 2000 to 2021 from 46 sub-Saharan African countries, this study employs a systems GMM model to explore the intricate relationship between health expenditure and under-five mortality rates (U5MRs), with a particular focus on the mediating role of institutional quality. The findings reveal that the quality of institutions significantly influences the impact of health expenditures on the U5MR. Strong institutional quality enhances the effectiveness of health expenditure in improving child health outcomes, particularly concerning the allocation of external health funds. Conversely, poor institutional quality amplifies the positive impact of domestic private and out-of-pocket health expenditures on the U5MR, as these serve as coping mechanisms in the absence of robust public healthcare systems. This research emphasizes the need for strategies that increase health expenditure and prioritize institutional strengthening to ensure efficient resource allocation and healthcare system management, thereby reducing under-five mortality rates. Furthermore, it underscores the importance of policies that minimize reliance on private and out-of-pocket health expenditures, which can lead to financial burdens and worsened health outcomes. Sub-Saharan African countries can make significant strides toward improving child survival and overall public health by addressing these issues.

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Do institutions matter for citizens’ health status? Empirical evidence from Italy

Antonelli,

Marini

2024

Eur J Health Econ

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This paper investigates the role of institutional quality in explaining cross-regional variation in population health status in Italy. We first introduce a composite Regional Health Status Indicator summarizing life expectancy, mortality and morbidity data. Then, we study the empirical relationship between this indicator and a set of socioeconomic, health system and institutional controls at the Italian regional level over the period of 2011–2019. We find that institutional quality is a driver of population health. Furthermore, well-functioning local institutions and regions compliant with national standards in terms of public healthcare services (Essential Levels of Care) make socioeconomic context no longer relevant for population health, potentially reducing inequalities.

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What is the role of institutional quality in health outcomes? A panel data analysis on 158 countries from 2001-2020

Cited by 7 publications

References 43 publications

Unveiling the health consequences of air pollution in the world’s most polluted nations

Unveiling the health consequences of air pollution in the world’s most polluted nations

Health Expenditure, Institutional Quality, and Under-Five Mortality in Sub-Saharan African Countries

Do institutions matter for citizens’ health status? Empirical evidence from Italy

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