Les déterminants des dépenses de santé : une approche macroéconomique

This paper first presents a time-series analysis of factors influencing aggregate health care expenditure in some OECD countries. We focus on supply-side factors (especially the diffusion of medical technologies) and first estimate a single model on six countries. The results suggest that financial incentives may explain a part of the discrepancies observed between these countries. We then test this hypothesis on panel data for 20 OECD countries, following Gerdtham (1992, 1995), and thus introduce a linear trend for each type of health care system : integrated (like the British NHS), based on Fee-For-Service reimbursement (like France), or based on contracts between providers and insurers (like Germany). We compute an income elasticity around 0.7 (this is Gerdtham's estimation when introducing institutional specificities), and find that the growth of health care expenditure per capita is 0.6 point higher in countries with Fee-For-Service reimbursement than in other countries.