Why Do Some Countries Spend More for Health? An Assessment of Sociopolitical Determinants and International Aid for Government Health Expenditures

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dc.creatorLiang, Li-Lin
dc.creatorMirelman, Andrew J.
dc.date2014-07-28T22:18:21Z
dc.date2014-07-28T22:18:21Z
dc.date2014-01
dc.date.accessioned2026-07-01T00:56:52Z
dc.descriptionA consensus exists that rising income levels and technological development are among the key drivers of total health spending. However, determinants of public sector health expenditure are less well understood. This study examines a complex relationship across government health expenditure (GHE), sociopolitical risks, and international aid, while taking into account the impact of national income and fiscal capacity on health spending. The author apply a two-way fixed effects and two-stage least squares regression method to a panel dataset comprising 120 countries for the years 1995 through 2010. Our results show that democratic accountability has a diminishing positive correlation with GHE, and that levels of spending are higher when the government is more stable. Corruption is associated with less spending in developing countries, but with more spending in high-income countries. Furthermore, the author find that development assistance for health (DAH) substitutes for domestically financed government health expenditure (DGHE). For an average country, a 1 percent increase in total DAH or DAH to government is associated with a 0.02 percent decrease in DGHE. Our work highlights that policy reforms that aim to eliminate corruption are fundamental to improving the capacity of developing countries to scale up GHE, and to increasing the efficiency of health care systems in developed countries in containing health care costs. To minimize fungibility, donors may impose stronger monitoring mechanisms for corruption. Delivering aid through NGOs may be an option in countries with high ethnic tensions; however, the ability to do so depends on institutional arrangements and the capacity of NGOs in individual countries.
dc.formatapplication/pdf
dc.formattext/plain
dc.identifierhttp://documents.worldbank.org/curated/en/2014/01/19543916/some-countries-spend-more-health-assessment-sociopolitical-determinants-international-aid-government-health-expenditures
dc.identifierhttps://hdl.handle.net/10986/19035
dc.identifierhttps://doi.org/10.1596/19035
dc.identifier.urihttp://hdl.handle.net/123456789/413360
dc.languageEnglish
dc.languageen_US
dc.publisherWorld Bank, Washington, DC
dc.relationHealth, Nutrition, and Population (HNP) discussion paper;
dc.rightsCC BY 3.0 IGO
dc.rightshttp://creativecommons.org/licenses/by/3.0/igo/
dc.subjectACCOUNTABILITY
dc.subjectAGGREGATE HEALTH EXPENDITURE
dc.subjectAGGREGATE INCOME
dc.subjectANTICORRUPTION
dc.subjectANTICORRUPTION REFORMS
dc.subjectBRIBES
dc.subjectCABINET
dc.subjectCOALITION GOVERNMENT
dc.subjectCORRUPT
dc.subjectCORRUPTION
dc.subjectCORRUPTION IN GOVERNMENT
dc.subjectDEBT
dc.subjectDELIVERY SYSTEM
dc.subjectDEMOCRACIES
dc.subjectDEMOCRACY
dc.subjectDEMOCRATIC ACCOUNTABILITY
dc.subjectDEMOCRATIC SYSTEMS
dc.subjectDETERMINANTS OF HEALTH
dc.subjectECONOMETRIC ANALYSIS OF HEALTH CARE EXPENDITURE
dc.subjectECONOMIC REVIEW
dc.subjectELECTION
dc.subjectEXTERNAL DEBT
dc.subjectFINANCIAL RESOURCES
dc.subjectFISCAL POLICY
dc.subjectFRAUD
dc.subjectHEALTH AFFAIRS
dc.subjectHEALTH CARE
dc.subjectHEALTH CARE COSTS
dc.subjectHEALTH CARE EXPENDITURE
dc.subjectHEALTH CARE FINANCE
dc.subjectHEALTH CARE REFORM
dc.subjectHEALTH CARE SPENDING
dc.subjectHEALTH CARE SYSTEMS
dc.subjectHEALTH COVERAGE
dc.subjectHEALTH ECONOMICS
dc.subjectHEALTH EXPENDITURE
dc.subjectHEALTH EXPENDITURE GROWTH
dc.subjectHEALTH EXPENDITURES
dc.subjectHEALTH FINANCING
dc.subjectHEALTH INSURANCE
dc.subjectHEALTH INSURANCE COVERAGE
dc.subjectHEALTH ORGANIZATION
dc.subjectHEALTH OUTCOMES
dc.subjectHEALTH POLICY
dc.subjectHEALTH PROGRAMS
dc.subjectHEALTH RESOURCES
dc.subjectHEALTH SECTOR
dc.subjectHEALTH SERVICES
dc.subjectHEALTH SPENDING
dc.subjectHEALTH SYSTEMS
dc.subjectHOSPITAL SYSTEMS
dc.subjectHUMAN DEVELOPMENT
dc.subjectHUMAN RESOURCES
dc.subjectINCENTIVE STRUCTURES
dc.subjectINCOME COUNTRIES
dc.subjectINCOME ELASTICITY
dc.subjectINCOME ELASTICITY OF HEALTH CARE
dc.subjectINCOME GROUPS
dc.subjectINFORMAL SECTOR
dc.subjectINSURANCE PREMIUMS
dc.subjectINTERNATIONAL HEALTH CARE
dc.subjectINVESTIGATION
dc.subjectKICKBACKS
dc.subjectLEADERSHIP
dc.subjectLOW-INCOME COUNTRIES
dc.subjectMEDICAL RESOURCES
dc.subjectMEDICAL TECHNOLOGY
dc.subjectMONITORING MECHANISMS
dc.subjectNATIONAL HEALTH
dc.subjectNEPOTISM
dc.subjectNUTRITION
dc.subjectOLDER PEOPLE
dc.subjectPATRONAGE
dc.subjectPOCKET PAYMENT
dc.subjectPOLITICAL INTERESTS
dc.subjectPOLITICAL OPPONENTS
dc.subjectPOLITICAL PARTY
dc.subjectPOLITICAL SYSTEM
dc.subjectPOLITICAL SYSTEMS
dc.subjectPOLITICIANS
dc.subjectPRIVATE HEALTH SERVICES
dc.subjectPRIVATE SECTOR
dc.subjectPROVISION OF HEALTH CARE
dc.subjectPUBLIC HEALTH
dc.subjectPUBLIC HEALTH CARE
dc.subjectPUBLIC HEALTH SPENDING
dc.subjectPUBLIC POLICY
dc.subjectPUBLIC SECTOR
dc.subjectPUBLIC SPENDING
dc.subjectSOCIAL HEALTH INSURANCE
dc.subjectSOCIAL WELFARE
dc.subjectTRANSPARENCY
dc.subjectTUBERCULOSIS
dc.titleWhy Do Some Countries Spend More for Health? An Assessment of Sociopolitical Determinants and International Aid for Government Health Expenditures

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