Who Benefits from Government Health Spending and Why? A Global Assessment
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World Bank Group, Washington, DC
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This paper uses a common household
survey instrument and a common set of imputation assumptions
to estimate the pro-poorness of government health
expenditure across 69 countries at all levels of income. On
average, government health expenditure emerges as
significantly pro-rich, but there is heterogeneity across
countries: in the majority, government health expenditure is
neither pro-rich nor pro-poor, while in a small minority it
is pro-rich, and in an even smaller minority it is pro-poor.
Government health expenditure on contracted private
facilities emerges as significantly pro-rich for all types
of care, and in almost all Asian countries government health
expenditure overall is significantly pro-rich. The
pro-poorness of government health expenditure at the country
level is significantly and positively correlated with gross
domestic product per capita and government health
expenditure per capita, significantly and negatively
correlated with the share of government facility revenues
coming from user fees, and significantly and positively
correlated with six measures of the quality of a
country's governance; it is not, however, correlated
with the size of the private sector nor with the degree to
which the private sector delivers care disproportionately to
the better-off. Because poorly-governed countries are
underrepresented in the sample, government health
expenditure is likely to be even more pro-rich in the world
as a whole than it is in the countries in this study.
Palabras clave
ABBREVIATIONS, AVERAGE COSTS, BUSINESS DEVELOPMENT, BUSINESS ENVIRONMENT, CAPITATION, CLASSIFICATION, CLINICS, CONSUMER PRICE INDEX, CRIME, DECISION TREE, DESCRIPTION, DEVELOPMENT POLICY, DISEASE CONTROL, DOCTORS, ELASTICITY, EXERCISES, FOREIGN TRADE, FUTURE RESEARCH, FUTURE STUDIES, GDP, GDP PER CAPITA, GOVERNMENT SERVICES, GROSS DOMESTIC PRODUCT, GROSS DOMESTIC PRODUCT PER CAPITA, HEALTH CARE, HEALTH CARE UTILIZATION, HEALTH EXPENDITURE, HEALTH FACILITIES, HEALTH FOR ALL, HEALTH INDICATORS, HEALTH INSURANCE, HEALTH MINISTRIES, HEALTH ORGANIZATION, HEALTH PLANS, HEALTH POLICY, HEALTH SECTOR, HEALTH SERVICE, HEALTH SERVICES, HEALTH STATUS, HEALTH SYSTEM, HOSPITAL ADMISSION, HOSPITALS, HUMAN DEVELOPMENT, IMPUTATION, IMPUTATION METHODS, INCIDENCE ANALYSIS, INCOME, INCOME DISTRIBUTION, INCOME TAXES, INDICES, INPATIENT CARE, IP, LIVING STANDARDS, NATIONAL INCOME, NUTRITION, OPEN ACCESS, OUTPATIENT CARE, PATIENTS, PER CAPITA INCOME, PER CAPITA INCOMES, PRICE CONTROLS, PRIMARY CARE, PRIVATE SECTOR, PRIVATE SECTORS, PUBLIC HEALTH, RESULT, RESULTS, SENSITIVITY ANALYSIS, SUPERVISION, USE VALUE, USER, USERS, USES, VOTERS