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Is health expenditure effective for achieving healthcare goals? Empirical evidence from South-East Asia Region

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Abstract

This study examines the effectiveness of health expenditure on healthcare goals in South-East Asia Region for the period from 2000 to 2014 using system generalized method of moment model. In this study, aggregate health expenditure data have been divided into two components—public and private. Both public and private health expenditure components are segregated into four categories of expenditure—government health expenditure from domestic sources, external assistance of health to the government, private out-of-pocket (i.e., household expenditure), and private not out-of-pocket (i.e., insurance). Certain health status indicators have been adopted as healthcare goals—life expectancy, infant mortality, universal health coverage index; immunization coverage, the prevalence of undernourishment, and Tb cases detection rate. The empirical result finds that aggregate health expenditure, especially public health expenditure, shows positive effects on the improvement in life expectancy and reduction of infant mortality. But the relationship between health expenditure and healthcare goals is weak (i.e., inelastic) and the elasticity values are numerically small than the non-health factors especially female education and per capita income. We have found a strong positive association between health expenditure and universal health coverage index that implies a 1% increase in public health expenditure leads to a 0.26% rise in healthcare services coverage. Further, female education has shown strong effects on the reduction of undernourishment population and increase immunization coverage. Increased public expenditure on health through domestic revenue generation and improved government effectiveness could be suggestive policy implications for achieving better health outcomes.

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Fig. 1

Source: Author’s estimation from the database from WHO (2017) and World Bank (2017)

Fig. 2

Source: Author’s estimation from the database from WHO (2017) and World Bank (2017)

Fig. 3

Source: Author’s estimation from the database from WHO (2017)

Fig. 4

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Notes

  1. Access to basic primary health care services to developing counties, which involved universal, community-based preventive and curative services, with substantial community involvement, was affirmed as a fundamental human rights by the Declaration of Alma-Ata in 1978 (Hall and Taylor 2003).

  2. Table 4 (Appendix) provides the list of SEAR countries and the performance of certain healthcare goals—life expectancy, infant mortality, universal health coverage index, immunization coverage index, Tb cases detection rate and prevalence of undernourishment between the period 2000 and 2014.

  3. For the detailed analysis about measuring universal health coverage index, please follow Tracking Universal Health Coverage (2017) Global monitoring report of World Health Organization, and World Bank.

  4. We have excluded one of the SEAR countiries namely Democratic People’s Republic of Korea due to unavailability of sufficient data.

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Acknowledgements

The earlier version of the manuscript had presented in the 3rd International Public Policy Association (IPPA) conference at the Lee Kuan Yew (LKY) School of Public Policy, National University of Singapore, 2017. This work had started when I was a doctoral scholar in the Department of Humanities and Social Sciences, IIT Madras, Chennai. We are thankful to the conference participants and anonymous reviewers as well as the editor of the journal for useful comments and suggestions on the paper. All error is ours.

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This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

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Authors and Affiliations

  1. School of Public Health, AIPH University, Bhubaneswar, 752101, Odisha, India

    Deepak Kumar Behera

  2. Department of Humanities and Social Sciences, Indian Institute of Technology Madras, Chennai, 600036, India

    Umakant Dash

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Correspondence to Deepak Kumar Behera.

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Appendix

Appendix

See Tables 3 and 4.

Table 3 Variable descriptions
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Table 4 Trends of healthcare goals in South-East Asia Region (SEAR)
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Behera, D.K., Dash, U. Is health expenditure effective for achieving healthcare goals? Empirical evidence from South-East Asia Region. Asia-Pac J Reg Sci 4, 593–618 (2020). https://doi.org/10.1007/s41685-020-00158-4

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