The U.S. health care expenditure: evidence from 2001 to 2009

This study utilizes state-level data from 2001 to 2009 to estimate the impact of the 2007 financial crisis upon health care expenditures. Higher death rates are consistently found to have a positive and statistically significant impact on health expenditures. While mental health and COPD are not generally found to impact expenditures, increases in the percentage of the population diagnosed with cholesterol and obesity tend to increase health expenditures. Increases in health expenditures slowed considerably after the financial crisis. Even though recessions (high unemployment rates) are generally found to have a positive impact on health expenditures, the post-financial crisis time period is estimated to have much lower health expenditures than in other time periods. Our results can be used to give insight into the conditions under which the slower rate of increase in health expenditures can be expected to increase. More research will be needed to be able to more completely explore not only the reasons for these changes in health expenditures but also whether they are likely to continue into the future.     

Human development and decentralization: The importance of public health expenditure

In this article, we empirically analyze the impact of central and subnational government spending on human development in a sample of 57 developed and developing countries over the period 2000–18. Specifically, we focus on the effects of health and education public expenditure on the Human Development Index (HDI) and its dimensions (life expectancy, education, and income). Applying data panel analysis, our empirical evidence shows the importance of central and subnational government health expenditure positively impacting on HDI and each of its components, while in the case of the education expenditure, this positive effect is only confirmed on the educational dimension of HDI. Our study shows how governments can stimulate human development, improving the well-being of citizens, by allocating more resources to healthcare through the different administrative levels.     

The impact of expenditure rules on budgetary discipline over the cycle

We study the impact of expenditure rules on the propensity for governments to deviate from their expenditure plans in response to surprising cyclical developments. Theoretical considerations suggest that due to political fragmentation in the budgetary process expenditure policy might be prone to a procyclical bias. However, this tendency may be mitigated by strictly enforced expenditure rules. These hypotheses are tested against data from a panel of EU Member States. Our key findings are that (1) deviations between actual and planned government expenditure tend to be positively related to output gap surprises, and (2) expenditure rules reduce this procyclical bias. These results are particularly pronounced when the analysis is confined to spending items with a high degree of budgetary flexibility.     

Mother's autonomy: impact on the quality of children's healthcare in India

Given the poor condition of children's health in developing countries, this article seeks to examine two hypotheses concerning healthcare for children. First, does mother's autonomy influence the quality of child healthcare and, second, which is related to the first, whether mother's autonomy reduces the apparent gender bias in child healthcare. Using household survey data from Bihar and Uttar Pradesh in India the article finds that for the most part as the mother's autonomy (measured several different ways) increases, the quality of care for children improves. The results also indicate that gender bias exists in the provision of quality healthcare for children. Male children generally receive better quality care. However, for several measures of female autonomy, an increase in such autonomy reduces the bias. The results of this analysis have important policy implications and provide additional insight into the state of affairs of children's health in rural India.     

数量指标和质量指标理论与应用评析

在各类《统计学》教科书中,对数量指标和质量指标概念的解释不大一样,但基本的含义却是相同的。两者从概念上区别并不困难,也容易理解,但在对一些特殊问题的分析时,却不易把握,特别是在比较复杂的统计分析中,那就更不容易做出准确的判断了。怎样才能对数量指标和质量指标的应用做出科学的评价和分析。本文拟就这方面的问题做些初步探索。     

Impact of remittances on household health care expenditure: Evidence from the Nepal Living Standards Survey

This paper examines the effect of remittance inflows on health care expenditure in Nepal using the Nepal Living Standards Survey 2010–2011. Using the recursive three‐stage least square regression method, the propensity score matching method, and the Oaxaca–Blinder decomposition method, we find a positive and significant effect of remittances on health care expenditure. In particular, our analysis shows a 0.099% increase in health care expenditure for every 1% increase in overall remittances. This effect increases to 0.189% for earned remittances (remittances received from a household member). We also find that remittance‐receiving households with at least one migrant family member have different health care spending behavior than those with no migrant members.     

The influence analysis on public expenditure to the technique efficiency of China

In this paper, we use SFA to estimate the time-variant stochastic frontier model of 31 cities in China. The results tell us that raising the proportion of public expenditure in GDP can lower the technological efficiency, but raising some parts of public expenditure in GDP can promote the technological efficiency. Its realistic meaning is that it is excellent to turn the public expenditure structure to promote the technological efficiency. We computed the technological efficiency of 31 provinces/cities and the results show that the gap between the eastern region and western region is growing much. Finally, we decompose total factor productivity (TFP) and get the following result: from three regions, the biggest influence factor on technological efficiency is the scales economy. Technological progress and allocation efficiency have a smaller influence. From our results, we suggest that technological progress and allocation efficiency from public expenditure and income be raised to influence the TFP rate of change, and have a more efficient public expenditure. __________ Translated from Journal of Finance and Economics (财经研究), 2005, (12) (in Chinese)     

Robust determinants of health care expenditure growth

Our aim is to disclose robust explanatory variables for health care expenditure (HCE) growth by introducing to this field of research a method that is especially well suited for situations of ‘model uncertainty’: the Extreme Bounds Analysis (EBA). We analyse data for 33 OECD countries over the period 1970–2010 and include – as far as it is statistically feasible – all macroeconomic and institutional determinants of HCE growth in the EBA that have been suggested in the literature. Furthermore, we analyse to what extent outliers in the data influence the results. Our results confirm earlier findings that GDP growth and a variable representing Baumol’s ‘cost disease’ theory emerge as robust and statistically significant determinants of HCE growth. Depending on whether or not outliers are excluded, we find up to six additional robust drivers: the growth in expenditure on health administration, the change in the share of inpatient expenditure in total health expenditure, the (lagged) government share in GDP, the change in the insurance coverage ratio, the growth in land traffic fatalities and the growth in the population share undergoing renal dialysis.     

The effectiveness of government spending on education and health care in developing and transition economies

Recent studies show that corruption is associated with higher military spending [Eur. J. Polit. Econ. 17 (2001) 794] and lower government spending on education and health care [J. Publ. Econ. 69 (1998) 263]. This suggests that policies aimed at reducing corruption may lead to changes in the composition of government outlays toward more productive spending. However, little empirical evidence has been presented to support the claim that public spending improves education and health indicators in developing and transition countries. This paper uses cross-sectional data for 50 such countries to show that increased public expenditure on education and health care is associated with improvements in both access to and attainment in schools, and reduces mortality rates for infants and children. The education regressions are robust to different specifications, but the relationship between health care spending and mortality rates is weaker.     

The societal impact of pain in the European Union: health-related quality of life and healthcare resource utilization

Abstract

Objectives:

This paper reports on the results of a series of quantitative assessments of the association of severe and frequent pain with health-related quality of life and healthcare resource utilization in five European countries.

Methods:

The analysis contrasts the contribution of the increasing severity and frequency of pain reported against respondents reporting no pain in the previous month. The data are taken from the 2008 National Health and Wellness Survey. Single-equation generalized linear regression models are used to evaluate the association of pain with the physical and mental component scores of the SF-12 questionnaire as well as health utilities generated from the SF-6D. In addition, the role of pain is assessed in its association with healthcare provider visits, emergency room visits and hospitalizations.

Results:

The results indicate that the experience of pain, notably severe and frequent pain, is substantial and is significantly associated with the SF-12 physical component scores, health utilities and all aspects of healthcare resource utilization, which far outweighs the role of demographic and socioeconomic variables, health risk factors (in particular body mass index) and the presence of comorbidities. In the case of severe daily pain, the marginal contribution of the SF-12 physical component score is a deficit of ?17.86 compared to those reporting no pain (population average score 46.49), while persons who are morbidly obese report a deficit of only ?6.63 compared to those who are normal weight. The corresponding association with health utilities is equally dramatic with a severe daily pain deficit of ?0.19 compared to those reporting no pain (average population utility 0.71).

Conclusions:

For the five largest EU countries, the societal burden of pain is considerable. The experience of pain far outweighs the contribution of more traditional explanations of HRQoL deficits as well as being the primary factor associated with increased provider visits, emergency room visits and hospitalizations.     

我国的政府教育支出与经济增长——基于1980—2011年的数据分析

对于政府教育支出与经济增长的关系实证研究并没有确定的结论。本文利用我国1980-2011年的时间序列数据分析了政府教育支出对经济增长的影响。实证研究表明,无论是在长期还是短期内政府教育支出都对经济增长具有正的显著的影响,即我国的政府教育支出能够促进经济增长。 Granger因果检验表明,我国的政府教育支出与经济增长之间存在双向因果关系。另外,长期中政府教育支出对经济增长的影响效果大于短期。这说明政府教育支出对经济增长的影响是个长期的累积过程,因而教育投入不应该是一种短期行为。目前我国政府的教育支出仍处于相对较低的水平,具有较大的提升空间,从而具有推动经济增长的巨大潜力。因此,为保持经济的持续增长,在近期和长期内不断加大政府对教育的投入、优化教育资源的配置应是一项极其重要的教育政策。     

Policy induced increases in private healthcare financing provide short-term relief of total healthcare expenditure growth: Evidence from OECD countries

Healthcare reforms have long been advocated as a cure to the increasing healthcare expenditures in advanced economies. Nevertheless, it has not been established whether a market solution via private financing, rather than public financing, curb aggregate healthcare expenditures. To our knowledge, this paper is the first that quantifies the impact of reforms that significantly increases (decreases) the private (public) share of healthcare financing on total healthcare expenditures relative to income in 20 OECD countries. Our reform measure is based on structural break testing of the private share of total expenditures, and verification using evidence of policy reforms. To quantify the effect of these reforms we apply Propensity Score Matching and Inverse Probability Weighted regression analysis. Over a 5-year evaluation period the reforms lead to an accumulated cost saving 0.45 percentage points of GDP. The yearly effects of the reforms are largest in the first years in the post-reform period and decreases in size as a function of time since the reform. Our findings suggest that the investigated healthcare reforms have a relatively short-lived effect on aggregate health spending relative to GDP. The findings are robust to various sensitivity tests.     

卫生服务产出的质量调整问题初探

随着医疗技术的持续进步,对卫生服务的产出进行质量调整愈发重要。目前,卫生服务产出的质量调整仍旧处在中国的国民经济核算框架之外,中国还没有卫生服务产出质量调整的理想指标。因此,如何将质量调整指标引入中国的国民经济核算还需要进一步研究。     

Heterogeneous effect of coinsurance rate on healthcare expenditure: generalized finite mixtures and matching estimators

The article proposes a combination of finite mixture models and matching estimators to account for heterogeneous and nonlinear effects of the coinsurance rate on healthcare expenditure. The analysis with panel data for adult Japanese consumers in 2008–2010 and for female consumers in 2000–2010 demonstrates the presence of subpopulations with high, medium and low healthcare expenditure, and subpopulation membership is explained by lifestyle variables. Generalized finite mixtures provide adequate fit compared to loglinear model. Conditional average treatment effect estimations reveal the existence of nonlinear effects of the coinsurance rate in the subpopulation with high expenditure.     

The impact of education expansion on wage inequality

The findings on education expansion and income inequality have important implications for policymakers to implement effective policies to reduce income inequality. This study attempts to explain how education expansion affects income inequality by education distribution and the rate of return to education. We decompose the effect of education expansion on wage gaps into price effect and structure effect. We compare the income inequality from 2002 to 2013 using the Chinese Household Income Project (CHIP) 2002 and CHIP2013 survey data and employ FFL decomposition method. Our findings suggest that income inequality increased in 2013 and that income inequality among the high-income groups increased even more significantly. The structure effect of education expansion on income inequality is negative, when average education increases one year, the income gap between 80th and 20th will decrease 1.2%, in other words, education expansion decreases income inequality by allowing a wide range of individuals to attend college. However, this effect is offset by the price effect, which is positive and much more significant in magnitude. One extra year of average education will increase income gap by 29% which means that the demand for high-skilled labour is increasing faster than the supply and thus lead to the increasing premium for higher education return.     

中国财政支出结构与经济增长的Granger因果关系分析

财政支出与经济增长之间有联系,那么,财政支出结构的变化是否会对经济增长起到显著的作用,它们之间的关系如何,就值得研究。可运用单位根、协整及Granger因果关系检验等计量方法,分析中国财政支出结构与经济增长的关系。     

The Effect of Public Education Expenditure on Shadow Economy: A Cross-Country Analysis

This paper empirically examines whether devoting more resources to education can reduce the size of the shadow economy on a cross-section of countries. The findings show a negative relationship between public education expenditure and the size of the shadow economy, which is robust to the inclusion of different proxies for the control variables, a large set of policy variables, regional differences and endogeneity. The findings also emphasize the role of education, suggesting that public policies devoted to higher education level imply a decreasing effect on the shadow economy.     

The impact of foreign and domestic remittance types and senders on education outcomes

Migration and remittances are very important for Nepal, yet the country continues to be plagued by low financial development. Increases in human capital investments, such as enrollment of school‐aged children, are a possible gain from the country's labor movements, which can be leveraged further through an understanding of the microeconomic processes involved. This study examines how remittances from both household and nonhousehold members affect school enrollment rates for children in Nepalese families. We analyze the positive and negative impacts of migration and remittances separately and consider both the type and location of the remittance sender using the Nepal Living Standards Survey (NLSS‐III) of 9,335 school‐aged children. We find enrollment more associated with an exogenous process and use this to estimate marginal effects in which remittances significantly increase children's school enrollment by about 2% points in most cases. These results suggest policymakers should encourage domestic migration (which allows proximity between senders and recipients of remittances as well as less family disruption).     

Relevance of corruption on the effect of public health expenditure and taxation on economic growth

We investigate whether corruption distorts the positive effect of public health expenditure and taxation on growth through panel data analysis of 75 developing countries for the period from 1995 to 2014. The findings indicate that, although both public health expenditure and taxation can increase economic growth, in countries with more corrupt governments this effect is reduced.     

我国劳动力质量对数量的抑制效应——基于高校招生和人口出生率的省级空间面板分析

利用中国大陆31个省区2005—2019年空间面板数据,采用变异系数、探索性空间数据分析以及空间计量模型等方法分析高等教育招生和人口出生率的时空演进特征,以及劳动力质量对数量的抑制效应。研究发现:(1)高校招生的峰值省份和人口出生率的谷值省份高度重叠,两者的空间集聚特征和收敛性发展趋势明显。(2)高等教育扩招降低了人口出生率,即劳动力质量对数量存在抑制效应,且在高等教育资源富集的东部和中部地区作用最大。(3)家庭财富对生育率的影响呈现较大的区域差异,在我国整体层面和中西部地区以收入效应为主,在东部地区以替代效应为主。(4)公共教育经费支出有助于提高生育率,城镇化降低了中部和东部的生育率,一孩一孩半二孩等计划生育政策都对生育率产生抑制。