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International comparisons of health expenditure: Theory, data and econometric analysis

In: Handbook of Health Economics

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Author Info
Gerdtham, Ulf-G.
Jonsson, Bengt
Abstract

Comparisons of aggregate health expenditure across different countries have become popular over the last three decades as they permit a systematic investigation of the impact of different institutional regimes and other explanatory variables. Over the years, several regression analyses based on cross-section and panel data have been used to explain the international differences in health expenditure. A common result of these studies is that aggregate income appears to be the most important factor explaining health expenditure variation between countries and that the size of the estimated income elasticity is high and even higher than unity which in that case indicates that health care is a "luxury" good. Additional results indicates, for example, that the use of primary care "gatekeepers" lowers health expenditure and also that the way of remunerating physicians in the ambulatory care sector appears to influence health expenditure; capitation systems tend to lead to lower expenditure than fee-for-service systems. Finally, we also list some issues for the future. We demand more efforts on theory of the macroeconomic analysis of health expenditure, which is underdeveloped at least relative to the macroeconometrics of health expenditure. We also demand more replications based on updated data and methods that seeks to unify the many differing results of previous Studies.

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This chapter was published in: A. J. Culyer & J. P. Newhouse (ed.) Handbook of Health Economics, , chapter 01, pages 11-53, 2000.

This item is provided by Elsevier in its series Handbook of Health Economics with number 1-01.

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Related research
This chapter was published in the following book, which is listed on IDEAS:
A. J. Culyer & J. P. Newhouse (ed.), 2000. "Handbook of Health Economics," Handbook of Health Economics, Elsevier, edition 1, volume 1, number 1, September. [Downloadable!] (restricted)
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I1 - Health, Education, and Welfare - - Health

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  4. Moreno-Serra, Rodrigo & Wagstaff, Adam, 2009. "System-wide impacts of hospital payment reforms : evidence from central and eastern Europe and central Asia," Policy Research Working Paper Series 4987, The World Bank. [Downloadable!]
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  6. Fabio Pammolli & Massimo Riccaboni & Laura Magazzini, 2008. "The Sustainability of European Health Care Systems: Beyond Income and Ageing," Working Papers 52, Università di Verona, Dipartimento di Scienze economiche. [Downloadable!]
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  7. Roel van Elk & Esther Mot & Philip Hans Franses, 2009. "Modelling health care expenditures," CPB Discussion Papers 121, CPB Netherlands Bureau for Economic Policy Analysis. [Downloadable!]
  8. Guillem López & Marc Sáez, 2001. "A Multilevel Analysis on the Determinants of Regional Health Care Expenditure. A Note," Economics Working Papers 572, Department of Economics and Business, Universitat Pompeu Fabra. [Downloadable!]
  9. Guillem López & Marc Sáez, 2001. "A Multilevel Analysis on the Determinants of Regional Health Care Expenditure. A Note," Working Papers, Research Center on Health and Economics 572, Department of Economics and Business, Universitat Pompeu Fabra. [Downloadable!]
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