Health expenditure and economic growth - a review of the literature and an analysis between the economic community for central African states (CEMAC) and selected African countries

Evaluating the implementation of the National Primary Health Care Development Agency (NPHCDA) gateway for the Basic Healthcare Provision Fund (BHCPF) across six Northern states in Nigeria

BACKGROUND

This evaluation research utilized both qualitative and quantitative methods to assess the implementation of the National Primary Health Care Development Agency (NPHCDA) gateway of the Basic Health Care Provision Fund (BHCPF) across six states in Northern Nigeria: Bauchi, Borno, Kaduna, Kano, Sokoto, and Yobe.

METHODS

This was a mixed-method research that utilized longitudinal surveys and Key informant interviews to gather information about the implementation status of the BHCPF-NPHCDA gateway. Checklists were developed based on the BHCPF's national guidelines to gather quantitative data, while simple open-ended questionnaires were used to collect qualitative data from the state BHCPF Program Implementation Unit (PIU) focal persons as key informants.

RESULTS

The result revealed that the NPHCDA had accredited these six states to use one Primary Health Care (PHC) facility in each political ward to implement the BHCPF. Factors that contributed to the success achieved in some states included the early completion of contingent start-up activities, well-established coordination structures, strong support from partners, and the availability of established financial management systems. However, the delays in the submission of quarterly business plans by the BHCPF facilities affected timely approval and fund disbursement. Other challenges included staff capacity gaps, inadequate human resources, and poor management and supervision from the state health agency teams.

CONCLUSION

There was suboptimal implementation of the BHCPF in at least one thematic area across all states. Therefore, actions such as government commitment for improved coordination, continuous capacity building, effective monitoring and evaluation, and targeted supportive supervision using innovative approaches should be undertaken to improve the program's implementation. In a broader setting, the insights from BHCPF implementation are valuable for LMICs, offering guidance on overcoming implementation challenges associated with PHC financing. This research provides a resource for enhancing healthcare financing strategies in similar contexts.

The nexus between economic growth, health expenditure, environmental quality: a comparative study for E7 countries

The motivation of this study is to analyze the relationship between economic growth, health expenditures, environmental pollution, gross fixed capital formation and labor force by using annual data of E7 countries for the period 2000 to 2018. The co-integration coefficient of the variables was analyzed using the PMG technique, and the causality relationship between the variables was analyzed using the Emirmahmutoglu F, Kose N. Testing for granger causality in heterogeneous mixed panels. Econ Modell 2011;28:870-6 technique. In the empirical findings, the elasticity coefficient of health expenditures, environmental pollution, gross fixed capital formation and labor force variables is positive and significant. On the other hand, in the results of the causality relationship, it was concluded that economic growth and health expenditures are causal. It is concluded that economic growth is causal to CO2 emissions. In addition, CO2 emissions are the cause of health expenditures. As a result of the empirical findings obtained, the implementation of policies that will reduce environmental pollution in the perspective of sustainable growth will also affect health expenditures.

Analysis of the coupling coordination between traditional Chinese medicine medical services and economy and its influencing factors in China

Background

The coordinative relationship between medical treatment and the economy is an important part of promoting the sustainable and healthy development of a social economy, and it is conducive to promoting the coordinated development of the two systems.

Methods

Based on constructing a comprehensive evaluation index system for the relationship between traditional Chinese medicine medical services and economic development, the entropy method, coupling coordination model, and Tobit model are used to calculate the comprehensive development level, coupling coordination degree, and influencing factors of the two systems in 31 provinces of China from 2015 to 2021. Suggestions are proposed for the coordinated development of traditional Chinese medicine medical services, and economy.

Results

The results showed that the development level of traditional Chinese medicine was higher than that of social and economic development, the relative development gap between the two systems was gradually narrowed, and the coupling coordination degree increased steadily; however, the regional differences were large. The relative development level and coupling coordination degree of each region show a development pattern of eastern > central > western > northeast; the coupling coordination degree of the two systems in the spatial region was positively correlated and was enhanced year by year. From the perspective of influencing factors, the level of economic development is the decisive factor in the coupling and coordination between traditional Chinese medicine medical treatment and the social economy. Factors such as human capital and health level in traditional Chinese medicine have an inhibitory effect on the coordinated development of the two systems.

Conclusion

So, China should focus on optimizing the regional allocation of traditional Chinese medicine medical personnel, improving the quality of medical services, and enhancing the health level of medical personnel.

Estimating the indirect economic burden of cancer in Jordan: a retrospective observational study

OBJECTIVE

The aim of this study is to estimate the indirect economic burden of 22 cancer types in Jordan using both the human capital approach (HCA) and the value of a statistical life year (VSLY) approach. Additionally, this study aims to forecast the burden of these cancers for the next 5 years while employing time series analysis.

DESIGN

Retrospective observational study with a time series analysis.

PARTICIPANTS

Disability adjusted life years records from the IHME Global Burden Disease estimates 2019 data.

PRIMARY OUTCOME MEASURE

Indirect economic burden of cancer in Jordan.

RESULTS

The mean total economic burden for all cancers is estimated to be $1.82 billion using HCA and $3.13 billion using VSLY approach. The cancers contributing most to the total burden are 'tracheal, bronchus and lung cancer' ($359.5 million HCA, $618.3 million VSLY), followed by 'colon and rectum cancer' ($300.6 million HCA, $517.1 million VSLY) and 'breast cancer' ($292.4 million HCA, $502.9 million VSLY). The indirect economic burden ranged from 1.4% to 2.1% of the gross domestic product (GDP) using the HCA, and from 2.3% to 3.6% of the GDP using the VSLY approach. The indirect economic burden is expected to reach 2.3 and 3.5 billion Intl$ by the year 2025 using the HCA and VSLY approach, respectively.

CONCLUSION

The indirect economic burden of cancer in Jordan amounted to 1.4%-3.6% of total GDP, with tracheal, bronchus and lung cancer; colon and rectum cancer; and breast cancer contributing to over 50% of the total burden. This will help set national cancer spending priorities following Jordan's economic modernisation vision with regard to maximising health economic outcomes.

Examining the dynamic impact of carbon emissions, renewable energy and economic growth on healthcare expenditure in Asian countries

This study aims to examine the impact of renewable energy, carbon emissions, and economic growth on healthcare spending in 36 Asian countries during 2000-2019. Fully Modified Ordinary Least Square (FMOLS) and Dynamic Ordinary Least Square (DOLS) models have been applied to the panel data for 36 Asian countries. The study's findings show that CO2 emissions in Asia increased due to public and private health spending, with the commercial health sector having a larger negative influence on CO2 emissions than the public sector. According to FMOLS and DOLS findings, carbon emissions and GDP are positively related to health spending, indicating that high economic growth through energy-intensive production processes leads to increased carbon emissions, but on the contrary, renewable energy consumption has decreased healthcare expenditure. This study advocates new policies to reduce carbon emissions and hospitalisation without jeopardising national economic growth. In order to achieve sustainable health services and an environmentally friendly future in Asia, health administrators must raise state and private healthcare spending while implementing an effective cost-service and energy-efficient management plan.

Economic impact of government health expenditure: An application of the computable general equilibrium model to the Iran

BACKGROUND

Considering the increase in health expenses and the government's role in health financing, this study investigated the economic impact of increases in the share of the health sector in the government budget while taxes remain unchanged and government spending is fixed.

MATERIAL AND METHODS

The economic model used in this study was a macroeconomic Computable General Equilibrium (CGE) model. This model was calibrated using a 2011 Social Accounting Matrix (SAM) Of Iran. The CGE model was solved with non-linear programming using the General Algebraic Modeling System package, version 2.50. The effect of this simulation on the government budget deficit, the production of different sectors of the economy, and the employment rate was investigated.

RESULTS

Based on our fundings the elasticity of substitution in the agricultural and industrial sectors is higher than in the health and service sector. Also, the biggest decrease in production occurred in the industry, agriculture, and service sectors, respectively. With the doubling of the share of government spending in the health sector, the employment rate of this sector has increased by 40.9%, but the highest decrease in the ignition rate is related to the service sectors (-2.7%), agriculture (-0.23%), and industry (-0.14%).

CONCLUSION

Increasing the share of government spending in the health sector in comparison with other sectors of the economy, provided that government spending is maintained in general, leads to a decrease in production and economic welfare. It seems that the Iranian government should seek to increase the sources of health financing and the share of government expenditures in the health sector with other ways in order to improve the health level of the society and have a positive effect on other economic sectors.

Experiences, Lessons, and Challenges With Adapting REDCap for COVID-19 Laboratory Data Management in a Resource-Limited Country: Descriptive Study

BACKGROUND

The COVID-19 pandemic brought challenges requiring timely health data sharing to inform accurate decision-making at national levels. In Botswana, we adapted and integrated the Research Electronic Data Capture (REDCap) and the District Health Information System version 2 (DHIS2) platforms to support timely collection and reporting of COVID-19 cases. We focused on establishing an effective COVID-19 data flow at the national public health laboratory, being guided by the needs of health care professionals at the National Health Laboratory (NHL). This integration contributed to automated centralized reporting of COVID-19 results at the Ministry of Health (MOH).

OBJECTIVE

This paper reports the experiences, challenges, and lessons learned while designing, adapting, and implementing the REDCap and DHIS2 platforms to support COVID-19 data management at the NHL in Botswana.

METHODS

A participatory design approach was adopted to guide the design, customization, and implementation of the REDCap platform in support of COVID-19 data management at the NHL. Study participants included 29 NHL and 4 MOH personnel, and the study was conducted from March 2, 2020, to June 30, 2020. Participants' requirements for an ideal COVID-19 data management system were established. NVivo 11 software supported thematic analysis of the challenges and resolutions identified during this study. These were categorized according to the 4 themes of infrastructure, capacity development, platform constraints, and interoperability.

RESULTS

Overall, REDCap supported the majority of perceived technical and nontechnical requirements for an ideal COVID-19 data management system at the NHL. Although some implementation challenges were identified, each had mitigation strategies such as procurement of mobile Internet routers, engagement of senior management to resolve conflicting policies, continuous REDCap training, and the development of a third-party web application to enhance REDCap's capabilities. Lessons learned informed next steps and further refinement of the REDCap platform.

CONCLUSIONS

Implementation of REDCap at the NHL to streamline COVID-19 data collection and integration with the DHIS2 platform was feasible despite the urgency of implementation during the pandemic. By implementing the REDCap platform at the NHL, we demonstrated the possibility of achieving a centralized reporting system of COVID-19 cases, hence enabling timely and informed decision-making at a national level. Challenges faced presented lessons learned to inform sustainable implementation of digital health innovations in Botswana and similar resource-limited countries.

The relationship between health insurance and economic performance: an empirical study based on meta-analysis

Health insurance stands as a pivotal facet of social wellbeing, with profound implications for the overarching landscape of economic development. The existing research, however, lacks consensus on the relationship between health insurance and economic performance and provides no evidence about the magnitude of the correlation. This lack of information seriously impedes the high-quality development of the healthcare system. Therefore, to scientifically elucidate the relationship between the two, this study involved a meta-analysis, analyzing 479 effect values derived from 34 independent research samples. The results reveal a strongly positive correlation between health insurance and economic performance [r = 0.429, 95% CI = (0.381, 0.475)]. Findings show that health insurance in developed countries more effectively fosters economic performance than in developing countries. Moreover, public health insurance exerts a stronger promoting effect on economic performance than commercial health insurance. The relationship between health insurance and economic performance is moderated by data type, research method, country of sample origin, literature type, journal impact factor, publication year, type of health insurance, and the research populations. Based on meta-analysis, this study not only scientifically responds to the controversy of the relationship between health insurance and economic performance, and the magnitude of a correlation, but also further reveals the inner conduction mechanism between the two. Our research findings are meaningful for policymakers to choose an appropriate healthcare strategy according to their unique attributes, propelling sustainable economic development.

Scoping review on the link between economic growth, decent work, and early childhood caries

BACKGROUND

Early Childhood Caries (ECC) is a prevalent chronic non-communicable disease that affects millions of young children globally, with profound implications for their well-being and oral health. This paper explores the associations between ECC and the targets of the Sustainable Development Goal 8 (SDG 8).

METHODS

The scoping review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) guidelines. In July 2023, a search was conducted in PubMed, Web of Science, and Scopus using tailored search terms related to economic growth, decent work sustained economic growth, higher levels of productivity and technological innovation, entrepreneurship, job creation, and efforts to eradicate forced labor, slavery, and human trafficking and ECC all of which are the targets of the SDG8. Only English language publications, and publications that were analytical in design were included. Studies that solely examined ECC prevalence without reference to SDG8 goals were excluded.

RESULTS

The initial search yielded 761 articles. After removing duplicates and ineligible manuscripts, 84 were screened. However, none of the identified studies provided data on the association between decent work, economic growth-related factors, and ECC.

CONCLUSIONS

This scoping review found no English publication on the associations between SDG8 and ECC despite the plausibility for this link. This data gap can hinder policymaking and resource allocation for oral health programs. Further research should explore the complex relationship between economic growth, decent work and ECC to provide additional evidence for better policy formulation and ECC control globally.

The redistributive effect of the public health system: the case of Sierra Leone

Universal health coverage (UHC), health equity and reduction of income inequalities are key objectives for the Sierra Leone government. While investing in health systems may drive economic growth, it is less clear whether investing in health systems reduces income inequality. Therefore, a crucial issue is to what extent the Sierra Leone public healthcare system reduces income inequality, and finances and provides healthcare services equitably. We use data from the Sierra Leone Integrated Household Survey 2018 to complete a financing and benefit incidence analysis of the Sierra Leone public healthcare system. We extend these analyses by assessing the redistributive effect of the public healthcare system (i.e. fiscal incidence analysis). We compute the redistributive effect as the change in Gini index induced by the payments for, and provision of, public healthcare services. The financing incidence of the Sierra Leone public healthcare system is marginally progressive (i.e. Kakwani index: 0.011*, P-value <0.1). With regard to public healthcare benefits, while primary healthcare (PHC) benefits are pro-poor, secondary/tertiary benefits are pro-rich. The result is that overall public healthcare benefits are equally distributed (concentration index (CI): 0.008, not statistically different from zero). However, needs are concentrated among the poor, so benefits are pro-rich when needs are considered. We find that the public healthcare system redistributes resources from better-off quintiles to worse-off quintiles (Gini coefficient reduction induced by public healthcare system = 0.5%). PHC receives less financing than secondary/tertiary care but delivers a larger reduction in income inequality. The Sierra Leone public healthcare system redistributes resources and reduces income inequality. However, the redistributive effect occurs largely thanks to PHC services being markedly pro-poor, and the Sierra Leone health system could be more equitable. Policy-makers interested in improving Sierra Leone public health system equity and reducing income inequalities should prioritize PHC investments.

Analysis of economic and educational spillover effects in PEPFAR countries

The United States President's Emergency Plan for AIDS Relief (PEPFAR) has been credited with saving millions lives and helping to change the trajectory of the global human immunodeficiency virus (HIV) epidemic. This study assesses whether PEPFAR has had impacts beyond health by examining changes in five economic and educational outcomes in PEPFAR countries: the gross domestic product (GDP) per capita growth rate; the share of girls and share of boys, respectively, who are out of school; and female and male employment rates. We constructed a panel data set for 157 low- and middle-income countries between 1990 and 2018 to estimate the macroeconomic impacts of PEPFAR. Our PEPFAR group included 90 countries that had received PEPFAR support over the period. Our comparison group included 67 low- and middle-income countries that had not received any PEPFAR support or had received minimal PEPFAR support (<$1M or <$.05 per capita) between 2004 and 2018. We used differences in differences (DID) methods to estimate the program impacts on the five economic and educational outcome measures. This study finds that PEPFAR is associated with increases in the GDP per capita growth rate and educational outcomes. In some models, we find that PEPFAR is associated with reductions in male and female employment. However, these effects appear to be due to trends in the comparison group countries rather than programmatic impacts of PEPFAR. We show that these impacts are most pronounced in COP countries receiving the highest levels of PEPFAR investment.

The influence of environment and Earnings on Prolonged existence and human fertility: A Deeper Dive into Asia's environmentally vulnerable nations

This study inspects the impact of environmental deterioration and income on longevity and fertility in Asian countries, specifically the nations that are highly vulnerable to extreme weather. The study examines the data, covering two decades from 2000 to 2019. The empirical conclusions of the panel ARDL-PMG and the CS-ARDL econometric models indicate that environmental degradation leads to a decline in birth rate and life expectancy, while a rising income has a significant influence over longevity. However, increasing per capita income alone cannot solve the problem of population crisis in climatically susceptible countries. Therefore, the sample countries must prioritize climate action and formulate climate-resilient policies to add more years to the lives of their citizens. Similarly, for increasing childbirth the sample nations need to make peace with nature. The outcomes of this study are strong enough, as both the models support each other's findings, producing similar significant outcomes.

The road to achieving epidemic-ready primary health care

Millions of avoidable deaths arising from the COVID-19 pandemic emphasise the need for epidemic-ready primary health care aligned with public health to identify and stop outbreaks, maintain essential services during disruptions, strengthen population resilience, and ensure health worker and patient safety. The improvement in health security from epidemic-ready primary health care is a strong argument for increased political support and can expand primary health-care capacities to improve detection, vaccination, treatment, and coordination with public health-needs that became more apparent during the pandemic. Progress towards epidemic-ready primary health care is likely to be stepwise and incremental, advancing when opportunity arises based on explicit agreement on a core set of services, improved use of external and national funds, and payment based in large part on empanelment and capitation to improve outcomes and accountability, supplemented with funding for core staffing and infrastructure and well designed incentives for health improvement. Health-care worker and broader civil society advocacy, political consensus, and bolstering government legitimacy could promote strong primary health care. Epidemic-ready primary health-care infrastructure that is able to help prevent and withstand the next pandemic will require substantial financial and structural reforms and sustained political and financial commitment. Governments, advocates, and bilateral and multilateral agencies should seize this window of opportunity before it closes.

Convergence of economic growth and health expenditures in OECD countries: Evidence from non-linear unit root tests

Introduction

The relationship between human capital, health spending, and economic growth is frequently neglected in the literature. However, one of the main determinants of human capital is health expenditures, where human capital is one of the driving forces of growth. Consequently, health expenditures affect growth through this link.

Methods

In the study, these findings have been attempted to be empirically tested. Along this axis, health expenditure per qualified worker was chosen as an indicator of health expenditure, and output per qualified worker was chosen as an indicator of economic growth. The variables were treated with the convergence hypothesis. Due to the non-linear nature of the variables, the convergence hypothesis was carried out with non-linear unit root tests.

Results

The analysis of 22 OECD countries from 1976 to 2020 showed that health expenditure converged for all countries, and there was a significant degree of growth convergence (except for two countries). These findings show that health expenditure convergence has significantly contributed to growth convergence.

Discussion

Policymakers should consider the inclusiveness and effectiveness of health policies while making their economic policies, as health expenditure convergence can significantly impact growth convergence. Further research is needed to understand the mechanisms behind this relationship and identify specific health policies most effective in promoting economic growth.

Greenhouse gas emissions, economic globalization, and health expenditures nexus: does population aging matter in emerging market economies?

Papers on population aging and the effects of environmental quality on health expenditure have critical policy consequences. However, findings in the relevant literature are mixed, and papers generally focus on developed countries. To provide new information to the literature, this paper examines the impact of globalization, economic growth, greenhouse gas emissions, and population aging on health expenditures in emerging market economies with annual data for the period 2000 to 2018. The paper follows a second-generation advanced panel data method that considers cross-sectional dependency. The estimation results reveal that population aging, economic growth, and greenhouse gas emissions have an increasing effect on health expenditures, while globalization has a decreasing effect. Furthermore, one-way causality running from population aging to health expenditures is confirmed, while a feedback causality relationship is observed between health expenditures and other indicators (globalization, economic growth, and greenhouse gas emissions). After all, the outputs of this paper can provide critical policy implications about the relationships between aging, globalization, air quality, and health expenditures in developing countries.

Impact of Coronavirus Disease COVID-19 on the Relationship between Healthcare Expenditures and Sustainable Economic Growth

The coronavirus disease (COVID-19) pandemic led to a catastrophic burden on the healthcare system and increased expenditures for the supporting medical infrastructure. It also had dramatic socioeconomic consequences. The purpose of this study is to identify the empirical patterns of healthcare expenditures' influence on sustainable economic growth in the pandemic and pre-pandemic periods. Fulfilment of the research task involves the implementation of two empirical blocks: (1) development of a Sustainable Economic Growth Index based on public health, environmental, social, and economic indicators using principal component analysis, ranking, Fishburne approach, and additive convolution; (2) modelling the impact of different kinds of healthcare expenditures (current, capital, general government, private, out-of-pocket) on the index using panel data regression modelling (random-effects GLS regression). Regression results in the pre-pandemic period show that the growth of capital, government, and private healthcare expenditures positively influence sustainable economic growth. In 2020-2021, healthcare expenditures did not statistically significantly influence sustainable economic growth. Consequently, more stable conditions allowed capital healthcare expenditures to boost economic growth, while an excessive healthcare expenditure burden damaged economic stability during the COVID-19 pandemic. In the pre-pandemic period, public and private healthcare expenditures ensured sustainable economic growth; out-of-pocket healthcare expenditures dominantly contributed to the pandemic period.

The long-term dynamic relationship between communicable disease spread, economic prosperity, greenhouse gas emissions, and government health expenditures: preparing for COVID-19-like pandemics

The spread of communicable diseases, such as COVID-19, has a detrimental effect on our socio-economic structure. In a dynamic log-run world, socio-economic and environmental factors interact to spread communicable diseases. We investigated the long-term interdependence of communicable disease spread, economic prosperity, greenhouse gas emissions, and government health expenditures in India's densely populated economy using a variance error correction (VEC) approach. The VEC model was validated using stationarity, cointegration, autocorrelation, heteroscedasticity, and normality tests. Our impulse response and variance decomposition analyses revealed that economic prosperity (GNI) significantly impacts the spread of communicable diseases, greenhouse gas emissions, government health expenditures, and GNI. Current health expenditures can reduce the need for future increases, and the spread of communicable diseases is detrimental to economic growth. Developing economies should prioritize economic growth and health spending to combat pandemics. Simultaneously, the adverse effects of economic prosperity on environmental degradation should be mitigated through policy incentives.

Government health expenditures and health outcome nexus: a study on OECD countries

Introduction

The consistent increase in health expenditures is an integral part of health policy. The aim of this study was to investigate the impact of health expenditures on health outcomes in the OECD countries.

Method

We used the system generalized method of moments (GMM) for thirty eight OECD countries using panel data from 1996 to 2020.

Results and discussion

The findings show that health expenditures have a negative impact on infant mortality while positive on life expectancy. The results further verify that the income measured as GDP, number of doctors, and air pollution has a negative effect on infant mortality, while these variables have a positive effect on life expectancy in the studied countries. The outcome of the study suggests that health expenditures need to be properly utilized and improvements can be made in the health policies to increase the investment in health technology. The government should also focus on measures like economic and environmental to have long-lasting health outcomes.

Healthcare in Russia: Macroeconomic Parameters and Structural Issues

The epidemiological crisis of 2020-2021 has revealed a number of imbalances and "bottlenecks" that have developed in the Russian healthcare system over the past 20 years as a result of a policy of limiting development to breakthroughs in individual areas accompanied by optimization of the sector. It became evident that one of the most acute problems is interregional disparity in terms of personnel and resource availability in the healthcare system, which determines the system's ability to respond to challenges and shocks. Solving these problems requires a comprehensive approach: simply increasing the sector's financing is not sufficient and must be accompanied by structural changes, in particular, modifying the education system and training new highly qualified personnel, creating an effective system of territorial distribution of personnel, and radically increasing the availability of high-end equipment, i.e., a transition to a new model of healthcare.

Reassessing the impact of health expenditure on income growth in the face of the global sanitary crisis: the case of developing countries

In response to the COVID-19 pandemic, developing countries are increasing health spending to save lives. Such a response raises questions about the economic impact of this expenditure in terms of income growth that determines the development trajectory of these countries. This paper is the first to apply dynamic linear and threshold panel data models to capture the dynamic impact of health expenditure on growth on a large sample of developing countries, while addressing endogeneity bias and taking into account different levels of human and physical capital, as well as a set of health expenditure indicators. The main results show that while public and private domestic health expenditure increase income growth, external inflows of health expenditure do not. In addition, this positive impact is enhanced by a higher level of human and physical capital, thereby demonstrating complementarity rather than substitutability between investments in health, physical and human capital.

The relationship between health expenditure indicators and economic growth in OECD countries: A Driscoll-Kraay approach

Introduction

The main purpose of the study is to examine the relationship between health expenditure indicators and economic growth in OECD countries.

Methods

In this context, health expenditures and economic indicators data of 21 OECD countries were analyzed by the Driscoll-Kraay standard error approach within the scope of panel data analysis. While Gross Domestic Product (GDP) and income per capita were used as dependent variables, the amount of out-of-pocket health spending, per capita health expenditure, the amount of public health expenditure, the ratio of drug expenditures to gross domestic product, the share of current health expenditures in GDP were used as independent variables.

Results

According to the results, in the model (Model 1) where real GDP level was used as the dependent variable, all health expenditure indicators were positively related to the economic growth. When the estimation results of Model 1 are examined, it is predicted that there will be an increase of 0.09% in GDP in case of a 1% increase in the share allocated to health services from GDP. In case of a 1% increase in the amount of out-of-pocket spending on healthcare, it is foreseen that there may be an increase of 0.04% in the real GDP. In the model (Model 2) where the per capita income variable is the dependent variable, it is seen that the increase in out- of-pocket health spending has a decreasing effect on the per capita income level, while the increase in public expenditures has an increasing effect on the per capita income level. From the findings of Model 2, it was found that if a 1% increase in the share of current health expenditures in GDP, there may be an increase of 0.06% in the amount of per capita income.

Discussion

Concludingly, it is possible to say that that public resources allocated to health services play an important role in the economic growth.

Drivers of respiratory health care demand in Acre state, Brazilian Amazon: a cross-sectional study

Background

The scarce knowledge about the drivers of demand for respiratory health care in the Brazilian Amazon, where the gap of human and physical health care resources is wide, is expanded with two surveys conducted in the west of the region, in Acre state. Potential drivers, informed by a review of twelve recent papers, were classified into seven categories capturing the individual, household, community and macroeconomic dimensions.

Methods

Quantitative field surveys were conducted in 2017 and 2019 based on coupled conglomerate-quota randomization sampling. Adults responded about their own health or their children’s health. The probability of seeking physician care for the latest episode of respiratory illness or dry cough was analysed with multiple nonlinear regressions, having as covariates the potential predictors informed by the literature.

Results

The propensity to seek health care and to purchase medication was larger for children. Influenza-like illness (Despite the exact diagnostic stated by respondents being “influenza”, a virus detection test (such as the PCR test) is not commonly applied, as informed by the Acre state public health service. In consistency, the term “influenza-like illness” is used.) was the most frequently diagnosed disease, followed by pneumonia, suggesting that a health care-seeking rate below 40% may perpetuate health impairment and local contagion. Illnesses’ severity, including the pain experienced, was the main predictor, revealing that subjective perception was more influential than objective individual and household characteristics.

Conclusions

The results suggest that subjective underestimation of respiratory illnesses’ consequences for oneself and for local society could prevent health care from being sought. This is in line with some previous studies but departs from those emphasizing the role of objective factors. Social consequences, of, for instance, a macroeconomic nature, need to be highlighted based on studies detecting long-run relationships among health care demand, health and economic performance at the national level. Depending on the intensity of the trade-off between the costs imposed on the health system by increased demand and on the economy by the reduced productivity of the ill, policy could be adopted to change subjective perceptions of illnesses with nudges and educational and informational interventions.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12889-022-14171-z.

The correlation between economic fluctuation, workforce employment and health expenditure in the BRICS countries

In this paper, we use the Fourier ARDL method (data from 2000 to 2019) to examine whether there is a correlation between economic fluctuation, health expenditure, and employment rate among BRICS countries. Fourier ARDL's model, the same as Bootstrap ARDL model, is to test the long-term cointegration relationship of variables; when there is cointegration, it will test whether there is a causal relationship. When there is no cointegration, short-term Granger causality between variables is tested. Our study shows that, in the long-term, whether South Africa takes economic fluctuation, employment rate or health expenditure as the dependent variable, there is a cointegration relationship with the other two independent variables, but the causal relationship is not significant. In short-term Granger causality tests, the effects of economic fluctuation in Brazil, China, and South Africa on health expenditure lag significantly by one period. Economic fluctuation in Brazil, India and China had a negative effect on employment rate, while South Africa had a positive effect. Health expenditure in Russia and India has a negative effect on employment rate, while China has a positive effect. Employment rates in China and South Africa have a significant positive effect on economic fluctuation, while Russia has a negative effect. India's employment rate has a negative effect on health expenditure, while South Africa's has a positive effect. In short-term causality tests, different countries will exhibit different phenomena. Except for economic fluctuation, where health spending is positive, everything else is negatively correlated, and all of them are positive in South Africa. Finally, we make policy recommendations for the BRICS countries on economic fluctuation, employment rates, and health expenditure.

The association between health expenditure, institutions, and economic growth in MENA countries

Background: Expenditure on health is vital in the development of a country. Furthermore, the current COVID-19 pandemic emphasises the importance of health investments in maintaining a healthier economy worldwide. A substantial amount of empirical research on the relationship between health expenditure and economic growth yields conflicting results. The study intends to investigate the relationship between health spending and economic growth and institutions’ role in causing health spending to promote growth.

Methods: The study uses longitudinal data to examine the relationship between health spending and economic growth in seven MENA countries from 2000 to 2017. The study uses the Phillips Perron (PP) Fisher chi-square stationarity test, indicating that the data series is not stationary. Following this, we used the Pedroni test for cointegration, and the results show long-run relationships between the variables. Next, Granger causality determines the direction of causality. Finally, panel data methods of panel ordinary least squares (Panel OLS), fully modified OLS (FMOLS), and dynamic OLS (DLOS) supplement the findings.

Results: The Pedroni cointegration test (P value<0.0001) indicates that the variables have a long-run cointegrating relationship. On the other hand, the Granger causality test finds no causal relationships between health spending and economic growth. Furthermore, the panel data models show that expenditure on health does not directly contribute to higher economic growth in MENA countries.

Conclusion: The findings of this study indicate that health spending does not lead to increased economic growth; this could be due to poor institutional quality. However, for health spending to positively impact economic growth, these investments in health care must be supplemented by other factors, particularly institutions.

Sustainability of Donor-Funded Health-Related Programs Beyond the Funding Lifecycle in Africa: A Systematic Review

This study aimed to determine if implemented donor-funded health related-programs in Africa were sustained beyond the funding lifecycle and determine their facilitators and impeders. A systematic review was conducted after the documentation of a study protocol. A database search was done across three databases namely Google Scholar, PubMed, and Medline between January 27 and February 15, 2022. All peer-reviewed articles on sustainability of health interventions in Africa published between 2015 and 2021 that provided one or more context-relevant definitions of sustainability were included. Publications with no use of quantitative or qualitative methods and studies with no information on project evaluation after initial implementation were excluded. Screening of titles and abstracts was done, and the full texts of all relevant articles were retrieved. The risk of bias in systematic reviews (ROBIS) tool was used to assess the risk of bias in the systematic review. Overall, 4,876 articles were retrieved, and only nine articles were eligible for inclusion in the review following the removal of duplicates. Overall, sustainability was described in only three of the five regions in Africa. Donor-funded projects were sustained beyond the funding lifecycle in seven (77.8%) studies. Facilitators of sustainability in Africa included community ownership of the project through the engagement of community stakeholders in the design and implementation of such projects, use of locally available resources, sound infrastructure, and the constitution of interdisciplinary team to facilitate capacity building. Impeders to the sustainability of donor-funded projects included weak health systems exemplified in poor documentation and integration of records, lack of financial leadership, shortage of resources, political interference, poor feedback mechanism, and weak donor-community interactions. From the ROBIS tool, a low risk of bias existed in the studies included in the review. Although the included studies appropriately considered the review's research question, seven studies had a low risk of bias in the domains one to three, and two studies had high risk of bias in domain four. To derive maximum benefits from donor-funded health interventions, sustainability of such projects is key. During program planning phase, context-based facilitators of sustainability should be promoted, while impeders are immediately addressed.

Spatial and Temporal Differences in the Health Expenditure Efficiency of China: Reflections Based on the Background of the COVID-19 Pandemic

The outbreak of the COVID-19 pandemic has brought several challenges to China's national health services, causing great risks and uncertainties to people's lives. Considering China's huge population and relatively small medical investment and its good performance in the COVID-19 pandemic, this research utilizes the hybrid meta-frontier model to analyze health expenditure efficiencies of 30 provinces in China from 1999 to 2018 and compares spatial and temporal differences of the efficiencies in regards to regional forward position and national common frontier. The results show an obvious difference in health expenditure efficiency in different provinces along the regional frontier, in which the efficiency gap in the eastern region is the largest. Moreover, the room for improvement in health expenditure efficiency varies from region to region. For the national common frontier, Beijing is the most efficient, while Guizhou is the least. The eastern region owns the most efficient technical level of health expenditure efficiency, and there is a large efficiency distance between it and the western region. The findings offer effective guidance for elevating the expenditure structure and spatial resource allocation of public health and for promoting the equalization of high quality basic medical services.

Economic Growth in Six ASEAN Countries: Are Energy, Human Capital and Financial Development Playing Major Roles?

This study aims to investigate whether energy consumption, human capital and financial development played an important role in economic growth using a panel dataset of six ASEAN countries over the period 1995–2017. Various econometric techniques—the cross-sectional dependence, panel unit root, panel cointegration, long-run panel estimates, and panel Granger causality tests—are applied. The results of panel data analyses show that all the selected variables positively contribute to the economic growth of the countries. However, all the six ASEAN countries still rely primarily on physical capital and labour for their economic growth. The findings of country-wise tests indicate that there exists a positive relationship between economic growth and financial development in Cambodia, while human capital positively contributes to the economic growth of Indonesia, Malaysia, the Philippines, Thailand and Vietnam. The causality test exhibits unidirectional causality from energy consumption to economic growth and from economic growth to financial development in both the short and long run. The findings suggest that inclusive development strategies that provide the opportunity for all sectors to grow will result in the desirable three e’s of sustainable economic development: equitable, effective and efficient.

Causal nexus between health expenditure, health outcome and economic growth: Empirical evidence from Sub-Saharan Africa countries

INTRODUCTION

The relationships among health expenditure, health outcome, and economic growth have been given significant consideration in the current literature. Nevertheless, there are potential gaps in the nature of health-growth nexus that current empirical studies have not thoroughly considered.

METHODOLOGY

This study explores Granger causality and cointegration relationships in a trivariate framework among, health expenditure, health outcome, and economic growth. We used three health outcome measures and a panel vector autoregressive model to study 45 countries in Sub-Saharan Africa between 1990 and 2018. Our innovative panel data evaluation technique allows to ascertain significant causal relationships among the studied variables in the short and long run.

RESULTS

Findings from the study include (1) health expenditure and health outcome Granger-cause economic growth in the long run; (2) economic growth Granger-cause health expenditure in the short run; (3) no causal relationship was found running from health expenditure and health outcome to economic growth in the short-run. The former result (1) may not be surprising, given that the countries considered in this study are relatively less developed countries from Sub-Saharan Africa. Hence, further health improvement may play a statistically significant role in spurring further economic growth.

CONCLUSION

Based on the results, the study presents interesting and possible effective policy perspectives for health improvement in the studied countries. Policies that stimulate health spending are needed to create a better and more industrious society that can support SSA's economic progress. This is because a healthy person may be more productive than someone who is sick, allowing them to produce greater output.

Economic Growth and Health Expenditure Analysis for Turkey: Evidence from Time Series

This study aims to investigate the effects of health expenditure on economic growth in Turkey. For this purpose, time series data of Turkey over the period 1975–2018 were evaluated. Moreover, household consumption, life expectancy at birth, trade, and foreign direct investments were added as control variables. Cointegration analysis was performed to test whether all variables are cointegrated in the long term. Causality test was successfully employed to investigate the relationship between health expenditure and economic growth in the short term. The achieved results exhibited that Johansen Cointegration test results suggest the existence of cointegration among all variables in the long term. In addition, the Granger causality test results indicate unidirectional causality from health expenditure to economic growth in the short term. Existence of a long-term relationship among related variables and a short-term relationship between health expenditure and economic growth displays the importance of investments on health care services in Turkey. Therefore, investments in the health sector should be encouraged and the share allocated by the government for health expenditures from the budget should be increased in Turkey.

Impact of Environment, Life Expectancy and Real GDP per Capita on Health Expenditures: Evidence from the EU Member States

This research explores the impact of environment, life expectancy, and real GDP per capita on health expenditures in a sample of 27 EU member states over the 2000-2018 period through causality and cointegration analyses. The causality analysis revealed a significant unilateral causality from variables of greenhouse gas emissions, life expectancy, and real GDP per capita to health expenditures. In other words, greenhouse gas emissions, life expectancy, and real GDP per capita had a significant impact on health expenditures in the short run. The cointegration analysis indicated that life expectancy and real GDP per capita had a significant positive impact on health expenditures at the overall panel. On the other side, the country level cointegration coefficients revealed that life expectancy had a considerable positive impact on health expenditures, real GDP per capita had a moderate positive impact on the health expenditures in most of the countries in the panel, but the environment proxied by greenhouse gas emissions had a low positive or negative impact on the health expenditures in a limited number of countries.

Does life expectancy, death rate and public health expenditure matter in sustaining economic growth under COVID-19: Empirical evidence from Nigeria?

The current health pandemic that has plagued the global of which the global south-Nigeria is not insulated from is the premise for this empirical investigation. The present study relies on recent annual time-series data to conceptualize the hypothesized claim via Pesaran's Autoregressive distributed lag techniques. Empirical findings from the bounds test traces the long-run relationship between public health expenditure and economic growth over the study span. However, unlike previous studies, we introduce life expectancy and death rates in the model framework. Although health expenditure is not significant, empirical results show that a 1% increase in life expectancy and death rate increases and decreases economic growth by 3.85 and 1.84%, respectively. This suggests the need for Health Policymakers in Nigeria to implement active strategies that reduce the death rate, which is a blueprint for active engagement in the face of a global pandemic such as COVID-19.

Pediatric cancer care in Africa: SIOP Global Mapping Program report on economic and population indicators

INTRODUCTION

Inalignment with the World Health Organization (WHO) Global Initiative for Childhood Cancer (GICC), the International Society of Pediatric Oncology initiated a program to map global pediatric oncology services. As survival rates in Africa are low and data are scant, this continent was mapped first to identify areas with greatest need.

METHODS

Beginning November 2018, an electronic survey was sent to all known stakeholders, followed by email communications and internet searches to verify data. Availability of pediatric oncologists, chemotherapy, surgical expertise, and radiotherapy was correlated with geographic region, World Bank income status, Universal Health Coverage, population < 15 and < 24 years, percentage of gross domestic product spent on healthcare, and Human Development Index (HDI).

RESULTS

Responses were received from 48/54 African countries. All three treatment modalities were reportedly available in 9/48 countries, whereas seven countries reported no pediatric oncology services. Negative correlations were detected between provision of all three services and geographic region (P = 0.01), younger median population age (P = 0.002), low-income country status (P = 0.045), and lower HDI (P < 0.001).

CONCLUSION

This study provides a comprehensive overview of pediatric oncology care in Africa, emphasizing marked disparities between countries: some have highly specialized services, whereas others have no services. A long-term strategy to eliminate disparities in African pediatric cancer care should be aligned with the WHO GICC aims and facilitated by SIOP Africa.

MEETING ABSTRACTS

SIOP maps pediatric oncology services in Africa to address inequalities in childhood cancer services. Geel J, Ranasinghe N, Davidson A, Challinor J, Howard S, Wollaert S, Myezo K, Renner L, Hessissen L, Bouffet E. 51st Annual Congress of the International Society of Paediatric Oncology (SIOP), Lyon, France, October 2019. Pediatric Blood and Cancer Vol 66 S219-S219. Pediatric cancer care in Africa: SIOP Global Mapping Program report on economic and population indicators.

Critical country-level determinants of death rate during Covid-19 pandemic

The COVID-19 pandemic has already led to over 94 million confirmed cases and over 2 million deaths globally (John Hopkins CSSE, 2021). Due to the magnitude of the socio-economic damage of COVID-19 all over the world, we analyzed the critical country-level determinants of the death rate during the COVID-19 pandemic. We have examined the effects of GDP (allocated to pandemics and health), education, gender, cultural factors, number of physicians (per 1000 of the population) on the death rate. A correlation between the death rate and socio-economic conditions has been observed. The finding shows that power distance, individualism, gender, and age affect the death rate more than other socio-economic factors we use. We have also performed the same analysis by using Lockdown levels as a moderator. Lockdown levels have a more significant moderating effect on cultural factors rather than the other socio-economic factors. However, due to the topic's sensitivity, we still need to pay attention to the socio-economic factors that may have lower levels of significant relationship with the death rate, since even 0.1 % of changes in coefficients of our other socio-economic variables could mean thousands of lives. The study results will help health organizations, administration, and policymakers take the necessary steps to combat and manage the pandemic.

Entrepreneurial Income and Wellbeing: Women’s Informal Entrepreneurship in a Developing Context

This study examines the impact of women’s entrepreneurial income on wellbeing. Women entrepreneurs (N = 504) from district Mardan, Khyber Pakhtunkhwa, Pakistan participated in the study. ANOVAs and multiple regressions were used to analyze the impact of predictors on the dependent variables (i.e., per capita income, education, health, entertainment, social, household, and other miscellaneous expenditures, investment, savings, and charity). The findings indicated that women’s informal entrepreneurship has a significant role in family, economic, and societal wellbeing. The results contribute to the understanding of women’s entrepreneurial income on individual and family wellbeing. Women’s informal entrepreneurship plays an important role, particularly in the developing world, consistent with the multiplier effect of women entrepreneurs’’ wellbeing. Measures were suggested to empower such women informal, home-based entrepreneurs in view of the United Nations’ Sustainable Development Goals.

The life expectancy-economic growth nexus in Nigeria: the role of poverty reduction

Health improvement is a crucial determinant of economic growth; however, the impact of health on economic growth is affected by the level of poverty in any nation. Previous studies have focused more on the health-growth nexus, but the role of poverty reduction and the threshold of health required to mitigate the effect of poverty on economic growth were missing. This paper, therefore, examined the life expectancy-growth nexus and the role of poverty reduction with the view to determine the contribution of health to growth and poverty reduction and the threshold of health required to mitigate the adverse effect of poverty on economic growth in Nigeria. Based on the endogenous growth theoretical approach, the link between life expectancy, poverty incidence, and economic growth was estimated using the fully modified ordinary least square method. Findings showed that health contributes positively to economic growth and also mitigates the adverse effect of poverty on economic growth in Nigeria. The study determined the minimum threshold of life expectancy of 64.4 years as a health improvement annual benchmark. Therefore, for Nigeria to achieve sustainable economic growth and significant poverty reduction, policies aimed at achieving the newly determined health improvement threshold from the current annual average of 47.8 years are fundamental.

Association between health expenditures, economic growth and environmental pollution: Long-run and causality analysis from Asian economies

This study examines the association between health expenditures, economic growth (EG) and environmental pollution in Asia both at panel and country level. The separate impact of EG and environmental pollution on public and private health expenditures (PRHEs) are also examined. In doing so the panel cointegration tests with the level break, common correlated effects mean group and heterogeneous panel causality test are employed. The study covers 20 Asian economies and time-period from 1995 to 2017. The results provide evidence in support of a long run association between selected variables. The results explain that EG and environmental pollution are positively associated with total health expenditures as well as with public and PRHEs in all countries. However, the magnitude of environmental pollution coefficient is greater from EG coefficient, thus indicate that environmental pollution is the key determinant in increasing national health expenditures. Causality results demonstrate the existence of two-way causality between health expenditures and EG and unidirectional causality flowing from environmental pollution to health expenditures in Asian economies. Findings of this study have provided some important suggestions to policy makers which can be used to minimize the risk of environmental pollution on health in Asian economies.

Lifestyle Acquired Immunity, Decentralized Intelligent Infrastructures, and Revised Healthcare Expenditures May Limit Pandemic Catastrophe: A Lesson From COVID-19

Throughout history, the human race has often faced pandemics with substantial numbers of fatalities. As the COVID-19 pandemic has now affected the whole planet, even countries with moderate to strong healthcare support and expenditure have struggled to contain disease transmission and casualties. Countries affected by COVID-19 have different demographics, socioeconomic, and lifestyle health indicators. In this context, it is important to find out to what extent these parametric variations are modulating disease outcomes. To answer this, this study selected demographic, socioeconomic, and health indicators e.g., population density, percentage of the urban population, median age, health expenditure per capita, obesity, diabetes prevalence, alcohol intake, tobacco use, case fatality of non-communicable diseases (NCDs) as independent variables. Countries were grouped according to these variables and influence on dependent variables e.g., COVID-19 positive tests, case fatality, and case recovery rates were statistically analyzed. The results suggested that countries with variable median age had a significantly different outcome on positive test rate (P < 0.01). Both the median age (P = 0.0397) and health expenditure per capita (P = 0.0041) showed a positive relation with case recovery. An increasing number of tests per 100 K of the population showed a positive and negative relationship with the number of positives per 100 K population (P = 0.0001) and the percentage of positive tests (P < 0.0001), respectively. Alcohol intake per capita in liter (P = 0.0046), diabetes prevalence (P = 0.0389), and NCDs mortalities (P = 0.0477) also showed a statistical relation to the case fatality rate. Further analysis revealed that countries with high healthcare expenditure along with high median age and increased urban population showed more case fatality but also had a better recovery rate. Investment in the health sector alone is insufficient in controlling the severity of the pandemic. Intelligent and sustainable healthcare both in urban and rural settings and healthy lifestyle acquired immunity may reduce disease transmission and comorbidity induced fatalities, respectively.

Assessment of Health Budgetary Allocation and Expenditure Toward Achieving Universal Health Coverage in Nigeria

Context: The implementation of the Universal Health Coverage (UHC) promotes access to quality health care delivery through cost-effective initiatives to ensure good health and wellbeing without discrimination. This study examines government finance, budgetary allocation, and expenditure as key health development indicators towards achieving the UHC in Nigeria. Evidence Acquisition: Data analyzed in the study were gotten from journal articles, reports and other secondary sources. Searches were conducted in PubMed, Google Scholar, and WHO Library Database with pre-determined search terms. Further publications were identified through snowballing of citations and references. We reviewed only papers written in English with no date restrictions placed on searches. Results: Within the period of analysis, the annual national health budgetary allocation in Nigeria has been below the 2001 Abuja declaration of allocating 15% of the national budget to health. Our analysis also revealed that if the Abuja declaration was implemented, additional allocations of NGN 4.99 trillion should have been injected into the health sector between 2014 and 2020. In addition, Nigeria also lags behind relative to some other low-and middle-income countries in terms of government expenditure to the health sector in achieving the UHC. Conclusions: The inadequate budgetary allocation in Nigeria to healthcare has significantly influenced recurrent and capital health expenditure. It is worthy to note that the insufficient allocation will continue to significantly affect capital expenditure which is a large determinant of the development of any health system. With the current state of healthcare budget allocation in Nigeria, efforts need to be intensified to ensure the achievement of UHC. In the face of achieving UHC, reviewing the system of healthcare financing and ensuring prudent allocation of resources while shifting the focus from out-of-pocket payments for health is essential. We also recommend increase in political commitment towards improving the health of the populace so as to ensure health systems goals of efficiency, equity, quality of care, sustainability, financial risk protection for all citizens are achievable.

Health expenditure, human capital, and economic growth: an empirical study of developing countries

Social security systems were successively established in most developing countries in the 1980s and 1990s. To ensure the long-term sustainability of these newly established systems it is essential to carefully monitor the economic impact. Based on the panel data of 21 developing countries from 2000 to 2016, this paper is the first to apply the panel threshold model to empirically analyze the relationship between national health expenditures and economic growth under different levels of human capital. The results show that health expenditure and economic growth have significant interval effects because of the different levels of human capital. Specifically, when human capital levels are low, health expenditure is significantly negatively correlated with economic growth. When human capital is at a medium level, health expenditure has a positive but not significant impact on economic growth. When the level of human capital is high, the positive economic impact of the health expenditure is significantly enhanced. In addition, subgroup analyses indicate that population aging and low fertility aggravate the negative impact of health expenditures on economic growth. This study provides reliable analysis and can be used by developing countries to maintain a long-term sustainable social security system.

Healthcare Expenditure and Economic Performance: Insights From the United States Data

This research explores the association of public health expenditure with economic performance across the United States. Healthcare expenditure can result in better provision of health opportunities, which can strengthen human capital and improve the productivity, thereby contributing to economic performance. It is therefore important to assess the phenomenon of healthcare spending in a country. Using visual analytics, we collected economic and health data from the Bureau of Economic Analysis and the Bureau of Labor Statistics for the years 2003-2014. The overall results strongly suggest a positive correlation between healthcare expenditure and the economic indicators of income, GDP, and labor productivity. While healthcare expenditure is negatively associated with multi-factor productivity, it is positively associated with the indicators of labor productivity, personal spending, and GDP. The study shows that an increase in healthcare expenditure has a positive relationship with economic performance. There are also variations across states that justify further research. Building on this and prior research, policy implications include that the good health of citizens indeed results in overall better economy. Therefore, investing carefully in various healthcare aspects would boost income, GDP, and productivity, and alleviate poverty. In light of these potential benefits, universal access to healthcare is something that warrants further research. Also, research can be done in countries with single-payer systems to see if a link to productivity exists there. The results support arguments against our current healthcare system's structure in a limited way.

Investigation of Socioeconomic Determinants on Child Death in South Asian Countries: A Panel Cointegration Analysis

This article is aimed to examine the relationship between socioeconomic factors and child mortality in South Asia because the relationship between child mortality and socioeconomic factors cannot be overlooked for better progress. Panel data were obtained from (World Development Indicators) and (Human Development Index) for the period 1990-2017. The data were quantitative. Levin, Lin, and Chu and I'm, Pesaran, and Shin test were used to check the stationarity of data. A cointegration test was applied to check the long-run association. Granger causality test was used to determine the direction of the relationship. Fully modified ordinary least squares and dynamic ordinary least squares techniques were used to examine the long-run and short-run impact of socioeconomic determinants on child mortality. The findings from this study showed the significant impact of education, unemployment, and health expenditure, access to improved water and sanitation facilities, and income inequality on child mortality. Overall results showed that there is a negative association between education and child mortality, access to improved water and access to sanitation facilities and child mortality, and health expenditure and child mortality, but there is a positive association between unemployment and income inequality with child mortality. The rate of child mortality is still very alarming in South Asian countries.

The Impact of Health Investment on Economic Growth: Evidence from China

BACKGROUND

Currently, China is carrying forward "Healthy China" construction. Thus, health investment has gradually become an important issue concerned by the Chinese government. Exploring the influence of health investment on economic growth under this background is of great theoretical and realistic significance for realizing economic transformation and upgrading in China.

METHODS

Thirty-one provincial regions in China were selected as research objects. Based on the panel data during 2000-2017, difference-generalized method of moment (D-GMM) and system-generalized method of moment (S-GMM) were comprehensively used to estimate the dynamic panel model from the national perspective, combining the fixed effects model (FE) estimation method to estimate the static panel model from the regional perspective, so as to investigate the relationships among governmental, residential health investment, and economic growth.

RESULTS

First, the governmental and residential health investments have positive effects on economic growth. Second, from the perspective of different regions, the governmental and residential health investments present positive correlations with economic growth, but the correlations present a progressively decreasing trend from the east to west.

CONCLUSION

The Chinese government needs to steadily increase governmental health investment, elevate the level of residents' health expenditure, promote the development of the health industry, and finally facilitate sustainable economic growth in China.

Effects of Government Healthcare Expenditure on Economic Growth Based on Spatial Durbin Model: Evidence from China

BACKGROUND

The proportion of government healthcare expenditure in China increases due to rapid economic development in recent years. The growth of government healthcare expenditure can promote physical health improvement of human capitals and thereby facilitate economic growth. Hence, exploring the effects of government healthcare expenditure on economic growth is important.

METHODS

Spatial correlation of economic growth under different spatial weights was tested, and the effects of government healthcare expenditure on economic growth were analyzed by constructing a spatial Durbin model with the panel data of 31 provinces in China gathered from 2005 to 2017.

RESULTS

Government healthcare expenditure in China significantly and positively affects economic growth under three spatial weight matrices. The spatial weight of economic distance influences economic growth more significantly compared with the 0-1 spatial weight and the spatial weight of geographical distance. The total and the direct effects of government healthcare expenditure are significantly positive. Furthermore, the direct effects are significant, whereas the indirect effects show different degrees of significance.

CONCLUSION

The total effect of government healthcare expenditure on economic growth is significant and positive, with direct effects exceeding the indirect ones. Hence, the China's government must continue to increase financial investment to public health services to promote high-quality economic growth in the country.

Study of the Relationship between Government Expenditures and Economic Growth for China and Korea

On October 18, 2017, Chinese President Xi Jinping presented the blueprint for building a modernized socialist nation through the realization of the Xiao Kang (every nation enjoys a peaceful and affluent life; it is meaningless to eliminate the poor) social construction at the 19th Congress of China. Subsequent to the 2008 financial crisis, the world has moved on to the new economic status of the “new normal”. China has also entered the era of Xinchang Thai, which is moving from the high-growth to the moderate-growth phase. Therefore, the government of China emphasizes privatization, liberalization, and deregulation. China is also influenced by government policies due to the nature of socialism. This study confirms China’s current stage of economic development, based on Barro’s theory. Thus, we use a quantile regression model and examine the correlation between economic growth and functional classification of government expenditure during Xi Jinping’s term of office. Furthermore, we selected Korea as a comparative country, as the two countries have common features.

Development and application of a framework to estimate health care costs in China: The cervical cancer example

Objectives

Information on healthcare costs in low-and-middle-income countries is limited. This study presents a framework to perform healthcare cost estimates for each province in China.

Methods

This study has two aims. Using cervical cancer as an example, the first aim is to use data (including micro-costing data) from one province to derive estimates for other provinces in China. This used provincial and national Chinese-language statistical reports and considered levels of service delivery, hospital-seeking behaviour, and the urban/rural population distribution. The second aim is to characterise the relationship between the reference costs estimated using the method mentioned above and two sets of cost estimates derived using simplified cost-scaling method with per capita Gross Domestic Product (GDP), and the Human Development Index (HDI). For simplified methods, regression modelling characterised the relationship between province-specific healthcare costs and macro-economic indicators, then we used the exponential fit to extrapolate costs.

Results

Using the reference method, the estimated costs were found to vary substantially by urban/rural regions and between provinces; the ratios of highest to lowest provincial costs were 3.5 for visual inspection with acetic acid (VIA), 4.4 for cold knife conisation (CKC) and 4.6 for stage II cancer treatment. The HDI-based scaling method generally resulted in a better fit to reference costs than the GDP method.

Conclusions

These reference costs for cervical cancer can inform cost-effectiveness evaluation of cervical screening and HPV vaccination in China. HDI-based methods for cost-scaling-based on social, as well as purely economic, factors-have potential to provide more accurate estimates.

The perception of crowding, quality and well-being: a study of Vietnamese public health services

PURPOSE

The purpose of this paper is to examine the extent to which the perception of crowding by medical staff and patients impacts patients' perceived service quality (SQ), overall satisfaction and emotional well-being.

DESIGN/METHODOLOGY/APPROACH

Data were collected from 258 matched pairs of medical staff members and their patients at six public hospitals.

FINDINGS

Medical staff-perceived crowding negatively influences patients' perceived SQ. The perceived SQ then impacts patients' overall satisfaction and emotional well-being. Patients' perceived crowding does not significantly impact their perceived SQ but increases the positive emotional well-being of patients.

ORIGINALITY/VALUE

Scant research has investigated a matched pair of service providers and their customers. This study concentrates on how individuals' perceived human crowding and medical staff SQ affect consumers' emotional well-being. This research leads to the formulation of theoretical and public policy suggestions to improve the quality of interactive services with minimal cost and disruption.

Dynamic linkages among CO2 emissions, health expenditures, and economic growth: empirical evidence from Pakistan

The linkage between high concentration of greenhouse gases (GHGs) and climate change is well recognized as there is severe influence of climate change on public health. Carbon dioxide is most prominent GHG which deteriorates the environment and impacts human health. On the parallel, economic growth also affects health conditions sometimes positively or vice versa. The objective of this research work is to examine the dynamic linkages among CO₂ emissions, health expenditures, and economic growth in the presence of gross fixed capital formation and per capita trade by using auto regressive distributive lag (ARDL) model for Pakistan covering annual data from the year 1995-2017. Our empirical results show that there is significant long run as well as short-term causal relationship between health expenditure, CO₂ emissions, and economic growth in Pakistan. Bidirectional relationship of Granger causality is found between health expenditures and CO₂ emissions, and further between health expenditures and economic growth. Short-run unidirectional causality is running from carbon emissions to health-related expenditures. The bidirectional causal relationship is also investigated between carbon emissions and growth as well as gross fixed capital formation and growth. Then, policy recommendations towards controlling pollution, particularly CO₂ emissions and health expenditures without compromising economic growth are suggested. Graphical abstract .