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Medicine and democracy: The importance of institutional quality in the relationship between health expenditure and health outcomes in the MENA region

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  • Marwân-Al-Qays Bousmah

    (AMU - Aix Marseille Université, EHESS - École des hautes études en sciences sociales, GREQAM - Groupement de Recherche en Économie Quantitative d'Aix-Marseille - EHESS - École des hautes études en sciences sociales - AMU - Aix Marseille Université - ECM - École Centrale de Marseille - CNRS - Centre National de la Recherche Scientifique)

  • Bruno Ventelou

    (GREQAM - Groupement de Recherche en Économie Quantitative d'Aix-Marseille - EHESS - École des hautes études en sciences sociales - AMU - Aix Marseille Université - ECM - École Centrale de Marseille - CNRS - Centre National de la Recherche Scientifique, SESSTIM - U912 INSERM - Aix Marseille Univ - IRD - Sciences Economiques et Sociales de la Santé & Traitement de l'Information Médicale - IRD - Institut de Recherche pour le Développement - AMU - Aix Marseille Université - INSERM - Institut National de la Santé et de la Recherche Médicale)

  • Mohammad Abu-Zaineh

    (GREQAM - Groupement de Recherche en Économie Quantitative d'Aix-Marseille - EHESS - École des hautes études en sciences sociales - AMU - Aix Marseille Université - ECM - École Centrale de Marseille - CNRS - Centre National de la Recherche Scientifique)

Abstract

Evidence suggests that the effect of health expenditure on health outcomes is highly context-specific and may be driven by other factors. We construct a panel dataset of 18 countries from the Middle East and North Africa region for the period 1995–2012. Panel data models are used to estimate the macro-level determinants of health outcomes. The core finding of the paper is that increasing health expenditure leads to health outcomes improvements only to the extent that the quality of institutions within a country is sufficiently high. The sensitivity of the results is assessed using various measures of health outcomes as well as institutional variables. Overall, it appears that increasing health care expenditure in the MENA region is a necessary but not sufficient condition for health outcomes improvements.

Suggested Citation

  • Marwân-Al-Qays Bousmah & Bruno Ventelou & Mohammad Abu-Zaineh, 2016. "Medicine and democracy: The importance of institutional quality in the relationship between health expenditure and health outcomes in the MENA region," Post-Print hal-01440296, HAL.
    • Handle: RePEc:hal:journl:hal-01440296
    DOI: 10.1016/j.healthpol.2016.06.005
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    Cited by:

    1. Deepak Kumar Behera & Umakant Dash, 2020. "Is health expenditure effective for achieving healthcare goals? Empirical evidence from South-East Asia Region," Asia-Pacific Journal of Regional Science, Springer, vol. 4(2), pages 593-618, June.
    2. Chiappini, Raphaël & Coupaud, Marine & Viaud, François, 2022. "Does attracting FDI affect population health? New evidence from a multi-dimensional measure of health," Social Science & Medicine, Elsevier, vol. 301(C).
    3. Al-Shboul, Mohammad & Al Rawashdeh, Rami, 2022. "The impact of institutional quality and resources rent on health: The case of GCC," Resources Policy, Elsevier, vol. 78(C).
    4. Olatunde Julius Omokanmi & Ridwan Lanre Ibrahim & Olumide Olusegun Olaoye, 2025. "The moderating roles of healthcare expenditure in the fossil fuel consumption‐ mortality rate conflicts in fossil fuel‐dependent sub‐Saharan African countries," Natural Resources Forum, Blackwell Publishing, vol. 49(3), pages 2917-2936, August.
    5. Barkat, Karim & Sbia, Raschid & Maouchi, Youcef, 2019. "Empirical evidence on the long and short run determinants of health expenditure in the Arab world," The Quarterly Review of Economics and Finance, Elsevier, vol. 73(C), pages 78-87.
    6. Issa Dianda & Idrissa Ouedraogo, 2021. "The synergistic effect of government health spending and institutional quality on health capital accumulation in WAEMU countries," Economics Bulletin, AccessEcon, vol. 41(2), pages 495-506.
    7. Ahcène Zehnati & Marwân-al-Qays Bousmah & Mohammad Abu-Zaineh, 2021. "Public–private differentials in health care delivery: the case of cesarean deliveries in Algeria," International Journal of Health Economics and Management, Springer, vol. 21(3), pages 367-385, September.
    8. Banerjee, Rajabrata & Mishra, Vinod & Maruta, Admasu Asfaw, 2021. "Energy poverty, health and education outcomes: Evidence from the developing world," Energy Economics, Elsevier, vol. 101(C).

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