Assessing the Allocation of Health Expenditures and Its Impact on Health System Performance Indicators
Subject Areas : علمی
Mahdi Moradi Shaybani
1
,
Bahram Sahabi
2
,
Sajjad Faraji Dizaji
3
,
Ezatollah Abbasian
4
1 - Ph.D. Candidate in Economics, Department of Development and Economic Planning, Faculty of Management and Economics, Tarbiat Modares University, Tehran, Iran
2 - phd Associate Professor, Faculty of Management and Economics, Tarbiat Modares University, Tehran
3 - Associate Professor, Faculty of Management and Economics, Tarbiat Modares University, Tehran
4 - Professor, Department of Financial Engineering, College of Management, University of Tehran, Tehran
Keywords: Budget allocation, Health system, Health expenditures, Iran,
Abstract :
The health budget encompasses a wide range of expenditures collected from various financial sources and expend on the health system. Broadly categorized, the most important of these expenditures include prevention, treatment, education and research, and capital formation of health service–providing institutions. In addition to the importance of revenue collection methods, the allocation of the health budget is also highly imortant and directly affects the overall performance of the health system. The aim of this study is to explore ways of achieving a more efficient allocation of these resources in order to improve the level of health and the productivity of the health system. In this study, after extending the Baltagi health status framework and developing a new model, quarterly time-series data of the Iranian economy from 2001 to 2021 were applied. To assess health status, three main indicators were employed: life expectancy, crude mortality rate, and infant mortality rate. The results show that while health budget expenditures are highly imbalanced—about 85% being allocated to treatment—these expenditures, and particularly treatment expenditures, have a positive and improving effect on all three key health indicators. However, the relatively higher estimated coefficients for preventive expenditures highlight the superior priority of this category compared to treatment. Therefore, prevention expenditures are preferable to treatment expenditures, and increasing their share can contribute to improving health status and performance indicators. Moreover, among education and research expenditures and capital formation of health service–providing institutions, the latter demonstrates higher priority, as it positively affects both life expectancy and crude mortality rate.
Central Bank of I.R. of Iran 2024
OECD, 2017. OECD Health Statistics 2017, Paris. https://doi.org/10.1787/ 888933602139
Statistical Center of Iran 2024
World Development Indicators, World Bank, Washington D.C. (2021)
Abdullah Ghanbari , Hassan Maleki Kaklar, Iraj Molaei Gholanji, (2022). The Impact of Health Expenses on Life Expectancy in Iran, Journal of Accounting and Management vision, 5(65), 90-103. magiran.com/p2467696(In Persian)
Anwar A, Hyder S, Mohamed Nor N and Younis M (2023) Government health expenditures and health outcome nexus: a study on OECD countries. Front. Public Health 11:1123759. doi: 10.3389/fpubh.2023.1123759
Basu S, Berkowitz SA, Phillips RL, Bitton A, Landon BE, Phillips RS. Association of Primary Care Physician Supply With Population Mortality in the United States, 2005-2015. JAMA Intern Med. 2019 Apr 1;179(4):506-514. doi: 10.1001/jamainternmed.2018.7624. PMID: 30776056; PMCID: PMC6450307
Bloem, A., Dippelsman, R., and Maehle, N., Quarterly National Accounts Manual: Concepts, Data Sources, and Compilation. International Monetary Fund, 2001.
Chokshi DA. Income, poverty, and health inequality. JAMA. 2018;319(13): 1312–3. https://doi.org/10.1001/jama.2018.2521.
Cohen JT, Neumann PJ, Weinstein MC. Does preventive care save money? Health economics and the presidential candidates. N Engl J Med 2008;358:661–3.
Ensor T, Cooper S. Overcoming barriers to health service access: influencing the demand side. Health Policy Plan. 2004;19:69–79
Feldman, M. P. and Kogler, D. F. (2010) Chapter 8 - stylized facts in the geography of innovation, in Handbook of The Economics of Innovation, Vol. 1 (Eds.) B. H. Hall and N. Rosenberg, North-Holland, vol. 1 of Handbook of the Economics of Innovation, pp. 381 – 410
Gage AD, Leslie HH, Bitton A, Gregory Jerome J, Joseph JP, Thermidor R, Kruk ME. Does uality influence utilization of primary health care? Evidence from Haiti. Glob Health. 018;14(1):59.
Hernandez de Cos P, Moral-Benito E: Health care expenditure in the OECD countries: efficiency and regulation. In The occassional paper series No 1107. Madrid: Bank of Spain; 2011
Jones, C.I., 2016. The facts of economic growth. In: Taylor, John B., Uhlig, Harald (Eds.), Handbook of Macroeconomics, vol. 2A. Elsevier, pp. 3–69.
Lichtenberg, F.R., 2007. The impact of new drugs on US longevity and medical expenditure, 1990–2003: evidence from longitudinal, disease-level data. American Economic Review 97, 438–443
Maciosek MV, Coffield AB, Edwards NM, Flottemesch TJ, et al. Priorities among effective clinical preventive services: results of a systematic review and analysis. Am J Prev Med 2006;31:52–61.
Murphy, K. M. and Topel, R. H. (2006) The value of health and longevity, Journal of Political Economy, 114, 871–904.
Novignon, J., Olakojo, S.A. & Nonvignon, J. The effects of public and private health care expenditure on health status in sub-Saharan Africa: new evidence from panel data analysis. Health Econ Rev 2, 22 (2012). https://doi.org/10.1186/2191-1991-2-22
Peters DH, Garg A, Bloom G, et al. Poverty and access to health care in developing countries. Ann N Y Acad Sci. 2008;1136:161–71.
Rebecca McKibbin & Bruce A. Weinberg, 2021. "Does Research Save Lives? The Local Spillovers of Biomedical Research on Mortality," NBER Working Papers 29420, National Bureau of Economic Research, Inc
Rogers, E. M. (1962) Diffusion of innovations, New York, Free Press of Glencoe
Sato, R. The impacts of quantity and quality of health clinics on health behaviors and outcomes in Nigeria: analysis of health clinic census data. BMC Health Serv Res 19, 377 (2019). https://doi.org/10.1186/s12913-019-4141-y
Temple NJ. Why prevention can increase health-care spending. Eur J Public Health. 2012 Oct;22(5):618-9. doi: 10.1093/eurpub/ckr139. Epub 2011 Sep 13. PMID: 21914705.