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Health System and Health Expenditure Productivity Changes in Indian States: Has It Changed for the Better in the Post-reform Period?

  • Debashis Acharya
  • Biresh K. Sahoo
  • T. K. Venkatachalapathy
Chapter
Part of the New Frontiers in Regional Science: Asian Perspectives book series (NFRSASIPER, volume 38)

Abstract

In this chapter, we make an attempt to examine the health system productivity changes and health expenditure productivity changes for 17 major Indian states in the post-reform period. The time period of 2004–2005 to 2014–2015 is chosen owing to consistent availability of data. Further, an attempt is made to see if the states’ income growth has any role in their behaviour of health system/expenditure productivity change. Both the productivity changes are calculated in per capita terms too. The selection of inputs and outputs for measuring productivity changes are guided by consistent availability of data across the states for our time period. The results of productivity changes are mixed in nature, though all the productivity changes are volatile as depicted by the coefficient of variation. Some of the measures witness higher fluctuation in the last 3 years of the study. Some of the possible reasons may be attributed to the nature of allocation of health expenditure in the revenue and capital accounts. Most of the states have legislated the Fiscal Responsibility and Budget Management Bill by now. This might have constrained the states to spend adequately on health. Moreover, health being primarily state subject governance in the sector in terms of proper allocation of budget and timely utilisation of the budget allocated matters a lot for the infrastructure to be in place.

Keywords

Health system productivity change Health expenditure productivity change Indian states Data envelopment analysis 

References

  1. Acharya D, Sahoo BK (2017) Chapter 9: Dynamic macroeconomic performance of Indian states: some post reform evidence. In: Batabyal A, Nijkamp P (eds) Regional growth and sustainable development in Asia. Springer, Cham, pp 181–197CrossRefGoogle Scholar
  2. Acharya D, Vaidyanathan G, Muraleedharan VR, Dheenadayalan DS, Dash U (2011) Do the poor benefit from public spending on healthcare in India? results from benefit (utilisation) incidence analysis in Tamil Nadu and Orissa. CREHS research report, April. http://www.crehs.lshtm.ac.uk/India_BUIA.pdf
  3. Arellano M, Bond S (1991) Some tests of specification for panel data: Monte Carlo evidence and an application to employment equations. Rev Econ Stud 58(2):277–297CrossRefGoogle Scholar
  4. Caves DW, Christensen LR, Diewert WE (1982) Multilateral comparisons of output, input, and productivity using superlative index numbers. Econ J 92(365):73–86CrossRefGoogle Scholar
  5. Charnes A, Cooper WW, Rhodes E (1978) Measuring the efficiency of decision making units. Eur J Oper Res 2(6):429–444CrossRefGoogle Scholar
  6. Dash U, Vaishnavi SD, Muraleedharan VR, Acharya D (2007) Benchmarking the performance of public hospitals in Tamil Nadu: an application of data envelopment analysis. J Health Manag 9(1):59–74CrossRefGoogle Scholar
  7. Duggal R (2001) Evolution of health policy in India. CEHATGoogle Scholar
  8. Färe R, Grosskopf S, Norris M, Zhang Z (1994) Productivity growth, technical progress, and efficiency change in industrialized countries. Am Econ Rev 84(1):66–83Google Scholar
  9. Mohanty RK, Bhanumurthy NR (2018) Assessing public expenditure efficiency at Indian States, NIPFP working paper, 225. NIPFP, New DelhiGoogle Scholar
  10. Muraleedharan VR, Dash U, Gilson L (2011) Chapter 6: Tamil Nadu 1980s–2005: a successful story in India. In: Balabanova D et al (eds) ‘Good health at Low Cost’ 25 years on What makes an effective health system? LSHTM, pp 159–192, LondonGoogle Scholar
  11. Report of the Bhore Committee (1946) https://hi.nhp.gov.in/bhore-committee-1946_pg
  12. Sahoo BK, Acharya D (2012) Constructing macroeconomic performance index of Indian states using DEA. J Econ Stud 39(1):63–83CrossRefGoogle Scholar
  13. Shetty U, Pakkala TPM (2010) Technical efficiencies of healthcare system in major states of India: an application of NP-RDM of DEA formulation. J Health Manag 12(4):501–518CrossRefGoogle Scholar

Copyright information

© Springer Nature Singapore Pte Ltd. 2019

Authors and Affiliations

  • Debashis Acharya
    • 1
  • Biresh K. Sahoo
    • 2
  • T. K. Venkatachalapathy
    • 1
  1. 1.School of EconomicsUniversity of HyderabadGachibowliIndia
  2. 2.Xavier Institute of ManagementXavier University BhubaneswarBhubaneswarIndia

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