Inequality of Health Spending and Public Health Outcome in Countries of the WHO’s Eastern Mediterranean Regional Office (EMRO)

Document Type: Short Communication

Authors

1 Economic Research Institute, Tarbiat Modares University, Tehran, Iran

2 Faculty of Management and Economics, Tarbiat Modares University, Tehran, Iran

3 Health Economics Department, Health Management Research Center, Baqiyatallah University of Medical sciences, Tehran, Iran

4 Health Economics Department, Faculty of Management and Economics, Tarbiat Modares University, Tehran, Iran

Abstract

Introduction: There are little attention about health spending and public health outcomes especially in the WHO’s Eastern Mediterranean Region. This  paper  presents  an  overview  on  health  spending  and  public health  outcomes  in the WHO Eastern Mediterranean countries during 1995-2011.

Methods: This study conducted in 2013 use of health expenditure and public health outcome of 19 WHOs Eastern Mediterranean Region countries during 17 years (1995-2011). Data were including: Per capita health expenditure in current US dollar, Life expectancy at birth, Infant Mortality Rate per 1,000 live births, Under-5 years Mortality Rate per 1,000 live births. Data collected from the latest World Bank published data until 2013. The Descriptive statistics were used to study by using Excel 2007.

Results: In this region, the minimum spending on health (by Pakistan) was about 60 times less than maximum spending (by Qatar). Maximum amount of infant and children mortality rate were respectively 9 and 10 times more than the minimum. Also a decreasing returns to scale of health spending seen between countries. So that countries with better public health status need to pay much more than countries with poor public health status to increase 1 year life expectancy or to save 1 infant or child from premature death.

Conclusion: There is a large inequality among countries of the WHO Eastern Mediterranean region in both health spending and public health outcomes. Due to a decreasing return to scale, allocation financial aids to countries with poor health status can help converging health status in the region and decrease inequalities. 

Keywords


1.   Bokhari FA, Gai Y, Gottret P. Government health expenditures and health outcomes. Health Econ. 2007;16(3):257-73.

2.   Lozano R, Wang H, Foreman KJ, Rajaratnam JK, Naghavi M, Marcus JR, et al. Progress towards Millennium Development Goals 4 and 5 on maternal and child mortality: an updated systematic analysis. Lancet. 2011;378(9797):1139-65.

3.   Rasooly MH, Govindasamy P, Aqil A, Rutstein S, Arnold F, Noormal B, et al. Success in reducing maternal and child mortality in Afghanistan. Glob Public Health. 2014;9(sup1):29-42.

4.   Tang KC, Ståhl T, Bettcher D, De Leeuw E. The Eighth Global Conference on Health Promotion: health in all policies: from rhetoric to action. Health Promot Int. 2014;29(suppl 1):11-8.

5.   Murray CJ, Laakso T, Shibuya K, Hill K, Lopez AD. Can we achieve Millennium Development Goal 4? New analysis of country trends and forecasts of under-5 mortality to 2015. Lancet. 2007;370(9592):1040-54.

6.   Mays GP, Smith SA. Evidence links increases in public health spending to declines in preventable deaths. Health Affairs. 2011;30(8):1585-93.

7.   Novignon J, Olakojo SA, 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. 2012;2(1):1-8.

8.   Rajkumar AS, Swaroop V. Public spending and outcomes: Does governance matter? J Dev Econ. 2008;86(1):96-111.

9.   Joumard I, André C, Nicq C. Health care systems: efficiency and institutions. 2010.

10. Lavado RF, Graves CM, Haakenstad A, Bui AL, Brooks BP, Shoemaker B, et al. A systematic analysis of national health accounts from 1990 to 2010. Lancet. 2013;381:S80.

11. Poullier J-P. Patterns of global health expenditures: results for 191 countries. World Health Organization; 2002.

12. Organization WH. Regional Health Systems Observatory-EMRO. World Health Organization. 2011.

13. Alwan A. Addressing health challenges in the five regional priority areas: progress in one year. EMHJ. 2014;20(10).

14. Meskarpour-Amiri M, Mehdizadeh P, Barouni M, Dopeykar N, Ramezanian M. Assessment the trend of inequality in the distribution of intensive care beds in Iran: using GINI index. Glob J Health Scie. 2014;6(6):28-35.

15. Kruk ME, Freedman LP. Assessing health system performance in developing countries: a review of the literature. Health Policy. 2008;85(3):263-76.

16. Mays GP, McHugh MC, Shim K, Perry N, Lenaway D, Halverson PK, et al. Institutional and economic determinants of public health system performance. Am J Public Health. 2006;96(3):523-31.

17. Day KM, Tousignant J. Health Spending, Health Outcomes, and Per Capita Income in Canada: A Dynamic Analysis: Department of Finance, Economic and Fiscal Policy Branch; 2005.

18. Anyanwu JC, Erhijakpor AE. Health expenditures and health outcomes in Africa. Afr Dev Rev. 2009;21(2):400-33.

19. Sen K, Bonita R. Global health status: two steps forward, one step back. Lancet. 2000;356(9229):577-82.

20. Baschieri A. Health inequities in the Eastern Mediterranean Region: selected country case studies. 2014.

21. Kim TK, Lane SR. Government health expenditure and public health outcomes: a comparative study among 17 countries and implications for US health care reform. Am Int J Contemp Res. 2013;3(9):8-13.

22. Yaqub J, Ojapinwa T, Yussuff R. Public health expenditure and health outcome in nigeria: the impact of governance. Eur Scie J. 2012;8(13).

23. Gani A. Health care financing and health outcomes in Pacific Island countries. Health Policy Plan. 2009;24(1):72-81.