Investigating the Relationship between Health Expenditures and Human Development Index: A Cross Country Analysis

Z. Rahimi, R. Babaki, Mahnaz Efati
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Abstract

Background: In recent decades, the human development index has become one of the most practical indicators for measuring the level of development in countries. There are several factors that affect the human development index, including health expenditures that increase human development along with manpower and physical capital. The purpose of this study was to investigate the effect of health costs on human development index for the period 2005-18. Methods: The present study examined the effects of health on human development index in different countries. The study population includes 187 countries with 3 types of divisions (continental, oil and income distribution). The data used by the World Bank were collected and analyzed using data panel regression or composite data. Results: Findings from estimation of models indicated that health expenditures in continents of Europe, South America, Africa and Oceania had a positive and significant effect on human development index. But in Asia, the effect of health expenditure was negative and significant. The effect of per capita Gross Domestic Product (GDP) on the continents of Asia, North and South America, Africa and Oceania had been positive and significant, but it was positive and insignificant in continental Europe. In oil-rich countries, the effect of educational expenditures, GDP per capita on human development index was positive and significant, but the effect of health expenditures was positive and insignificant. Also, the effect of mortality index on human development index had been negative and significant. Similar results had been obtained for non-oil countries, albeit with different coefficients. The percentage of health expenditures, compared with GDP, had a direct and significant relationship with the human development index in countries with relatively equal and relatively unequal income distribution; considering the fact that this value for the group of countries with completely unequal income distribution suggested an insignificant value in the model. The percentage of educational expenditures showed a direct and significant relationship on human development in all income groups, and GDP per capita for all groups with different income distributions had a significant and direct effect on the human development index. Also, the under-5 mortality rate in all groups with different income distributions had an inverse and significant relationship with the human development index. Conclusion: Results showed a significant effect of health expenditures on improvement of the health status and development of the studied countries except oil countries, North America and countries with unequal income distribution. Furthermore, increasing the cost of health care is an important step in achieving countries' development goals. Therefore, it is necessary for managers and policy makers of the health system to consider the efficiency in allocating health expenditures to different sectors.
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调查卫生支出与人类发展指数的关系:一个跨国分析
背景:近几十年来,人类发展指数已成为衡量各国发展水平最实用的指标之一。影响人类发展指数的因素有几个,包括促进人类发展以及人力和物质资本的卫生支出。本研究的目的是探讨2005-18年期间卫生费用对人类发展指数的影响。方法:本研究考察了不同国家健康状况对人类发展指数的影响。研究对象包括187个国家,分为三种类型(大陆、石油和收入分配)。世界银行使用的数据是使用数据面板回归或复合数据收集和分析的。结果:模型估计结果表明,欧洲大陆、南美洲、非洲和大洋洲的卫生支出对人类发展指数有显著的积极影响。但在亚洲,卫生支出的影响是消极和显著的。人均国内生产总值对亚洲大陆、南北美洲、非洲和大洋洲的影响是积极和显著的,但对欧洲大陆的影响是积极和微不足道的。在石油资源丰富的国家,教育支出、人均国内生产总值对人类发展指数的影响为显著的正效应,而卫生支出的影响为显著的正效应。死亡率指数对人类发展指数的影响呈显著负向。非石油国家也得到了类似的结果,尽管系数不同。在收入分配相对平等和相对不平等的国家,卫生支出占国内生产总值的百分比与人类发展指数有直接和显著的关系;考虑到这个值对于收入分配完全不平等的一组国家来说,在模型中是一个微不足道的值。教育支出比例对各收入群体的人的发展具有直接显著的影响,不同收入分配群体的人均GDP对人的发展指数具有显著的直接影响。此外,不同收入分配群体的5岁以下儿童死亡率与人类发展指数呈显著负相关关系。结论:除石油国家、北美国家和收入分配不平等国家外,卫生支出对改善健康状况和促进发展均有显著作用。此外,增加保健费用是实现各国发展目标的一个重要步骤。因此,卫生系统的管理者和决策者有必要考虑卫生支出在不同部门的分配效率。
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