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Some problems with international comparisons of health spending – and a suggestion about how to quantify the size of the problems

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  • Melberg, Hans Olav

    ()
    (Department of Health Management and Health Economics)

Abstract

This paper investigates the extent to which conclusions from international comparison of health spending depend on different adjustment methods. The analysis shows, first, that health spending figures differ significantly because of different accounting standards. More specifically, spending on long term nursing care is not treated the same way in all the countries. Next, the rankings differ depending on whether spending is adjusted for purchasing power parity and health specific purchasing power adjustment. Finally, the paper examines the problem of how to quantify the degree to which an adjustment method changes the outcome of a comparison. A rank based approach sum changes in rank and compare this to maximum rank change possible. A share based approach sum changes in each units share of the total. Both approaches create a measure that is bounded between zero and one, but the share based approach also captures changes that do not result in rank differences.

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File URL: http://www.med.uio.no/helsam/forskning/nettverk/hero/publikasjoner/skriftserie/2011/2011_4.pdf
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Bibliographic Info

Paper provided by Oslo University, Health Economics Research Programme in its series HERO On line Working Paper Series with number 2011:4.

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Length: 17 pages
Date of creation: 07 Nov 2011
Date of revision:
Handle: RePEc:hhs:oslohe:2011_004

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Postal: HERO / Institute of Health Management and Health Economics P.O. Box 1089 Blindern, N-0317 Oslo, Norway
Phone: 2307 5309
Fax: 2307 5310
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Web page: http://www.hero.uio.no/eng.html
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Related research

Keywords: Income inequality; health inequality; socioeconomic status; welfare states; concentration index; health spending per capita; OECD; Norway;

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  1. Alan M. Garber & Jonathan Skinner, 2008. "Is American Health Care Uniquely Inefficient?," Journal of Economic Perspectives, American Economic Association, vol. 22(4), pages 27-50, Fall.
  2. John Nixon & Philippe Ulmann, 2006. "The relationship between health care expenditure and health outcomes," The European Journal of Health Economics, Springer, vol. 7(1), pages 7-18, March.
  3. Gerdtham, Ulf-G. & Lothgren, Mickael, 2000. "On stationarity and cointegration of international health expenditure and GDP," Journal of Health Economics, Elsevier, vol. 19(4), pages 461-475, July.
  4. Gerdtham, Ulf-G. & Jonsson, Bengt, 2000. "International comparisons of health expenditure: Theory, data and econometric analysis," Handbook of Health Economics, in: A. J. Culyer & J. P. Newhouse (ed.), Handbook of Health Economics, edition 1, volume 1, chapter 1, pages 11-53 Elsevier.
  5. Tom Stargardt, 2008. "Health service costs in Europe: cost and reimbursement of primary hip replacement in nine countries," Health Economics, John Wiley & Sons, Ltd., vol. 17(S1), pages S9-S20.
  6. Gerdtham, Ulf-G. & Jonsson, Bengt, 1991. "Conversion factor instability in international comparisons of health care expenditure," Journal of Health Economics, Elsevier, vol. 10(2), pages 227-234, July.
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