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Spending more money, saving more lives? The relationship between avoidable mortality and healthcare spending in 14 countries

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  • Richard Heijink
  • Xander Koolman
  • Gert Westert

Abstract

Healthcare expenditures rise as a share of GDP in most countries, raising questions regarding the value of further spending increases. Against this backdrop, we assessed the value of healthcare spending growth in 14 western countries between 1996 and 2006. We estimated macro-level health production functions using avoidable mortality as outcome measure. Avoidable mortality comprises deaths from certain conditions “that should not occur in the presence of timely and effective healthcare”. We investigated the relationship between total avoidable mortality and healthcare spending using descriptive analyses and multiple regression models, focussing on within-country variation and growth rates. We aimed to take into account the role of potential confounders and dynamic effects such as time lags. Additionally, we explored a method to estimate macro-level cost-effectiveness. We found an average yearly avoidable mortality decline of 2.6–5.3 % across countries. Simultaneously, healthcare spending rose between 1.9 and 5.9 % per year. Most countries with above-average spending growth demonstrated above-average reductions in avoidable mortality. The regression models showed a significant association between contemporaneous and lagged healthcare spending and avoidable mortality. The time-trend, representing an exogenous shift of the health production function, reduced the impact of healthcare spending. After controlling for this time-trend and other confounders, i.e. demographic and socioeconomic variables, a statistically significant relationship between healthcare spending and avoidable mortality remained. We tentatively conclude that macro-level healthcare spending increases provided value for money, at least for the disease groups, countries and years included in this study. Copyright Springer-Verlag 2013

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  • Richard Heijink & Xander Koolman & Gert Westert, 2013. "Spending more money, saving more lives? The relationship between avoidable mortality and healthcare spending in 14 countries," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 14(3), pages 527-538, June.
    • Handle: RePEc:spr:eujhec:v:14:y:2013:i:3:p:527-538
    DOI: 10.1007/s10198-012-0398-3
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    14. Andrea Ciaccio, 2023. "The Impact of a Cost-containment Measure on the Quality of Regional Health Services in Italy: a Parametric and a Non-parametric Approach," Working Papers 2023: 24, Department of Economics, University of Venice "Ca' Foscari".
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    21. A. O. Baranov & V. N. Pavlov & Iu. M. Slepenkova & T. O. Tagaeva, 2018. "Dynamic Input-Output Model with a Human Capital Block Applied to Forecasting of the Russian Economy," Studies on Russian Economic Development, Springer, vol. 29(6), pages 654-664, November.
    22. Pedro Antonio Martín Cervantes & Nuria Rueda López & Salvador Cruz Rambaud, 2020. "Life Expectancy at Birth in Europe: An Econometric Approach Based on Random Forests Methodology," Sustainability, MDPI, vol. 12(1), pages 1-17, January.
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