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Assessing the responsiveness of out-of-pocket healthcare expenditure to macro-fiscal factors and different health financing systems: evidence from the European and OECD area
- Source :
- EuroMed Journal of Business. 17:193-217
- Publication Year :
- 2021
- Publisher :
- Emerald, 2021.
-
Abstract
- PurposeIn this paper, the authors assess the responsiveness of OOP healthcare expenditure to macro-fiscal factors, as well as to tax-based, SHI, mixed systems and voluntary PHI financing. Although the relationship between OOP expenditure, macroeconomy, aggregate public and PHI financing is well documented in the existing empirical literature, little is known for the impact of several macro-fiscal drivers and the existing health financing arrangements associated with voluntary PHI on OOP expenditure.Design/methodology/approachThe authors gather panel data by applying three official organizations’ databases. They elaborate static and dynamic panel data methodology to a dataset of 49 European and OECD countries from 2000 to 2015.FindingsThe authors’ findings do not indicate a considerable impact of GDP growth and general government debt as a share of GDP on OOP payments. Unemployment rate presents as a positive driver of OOP payments in all three compulsory national health systems post to the 2008 economic crisis. OOP payments are significantly influenced by countries’ fiscal capacity to increase general government expenditure to GDP in SHI and mixed health systems. Additionally, study findings present that government health financing, irrespective of the different health systems structure characteristics, and OOP healthcare payments follow different directions. Voluntary PHI financing considerably counteracts OOP payments only in tax-based health systems.Practical implicationsIn the backdrop of a new economic crisis associated to the COVID-19 epidemic, health policy planners have to deal with the emerging unprecedented challenges in financing of health systems, especially for these economies that have to face the fiscal capacity constraints owing to the 2008 financial crisis and its severe recession.Originality/valueTo the best of authors’ knowledge, there is no empirical consensus on the effects of macro-fiscal parameters, different compulsory health systems financing associated with the parallel voluntary PHI institution funding on OOP expenditure, for the majority of European and OECD settings.
- Subjects :
- Finance
Government
business.industry
030503 health policy & services
media_common.quotation_subject
Government debt
Payment
General Business, Management and Accounting
A share
03 medical and health sciences
0302 clinical medicine
Health care
Financial crisis
030212 general & internal medicine
0305 other medical science
business
Health policy
media_common
Panel data
Subjects
Details
- ISSN :
- 14502194
- Volume :
- 17
- Database :
- OpenAIRE
- Journal :
- EuroMed Journal of Business
- Accession number :
- edsair.doi...........a4cf73a55858995d9b17cc37b8a49678
- Full Text :
- https://doi.org/10.1108/emjb-09-2020-0105