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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.

Suggested Citation

  • Melberg, Hans Olav, 2011. "Some problems with international comparisons of health spending – and a suggestion about how to quantify the size of the problems," HERO Online Working Paper Series 2011:4, University of Oslo, Health Economics Research Programme.
    • Handle: RePEc:hhs:oslohe:2011_004
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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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    References listed on IDEAS

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    6. 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.
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    Cited by:

    1. Xiang Luo & Xinhai Lu & Zuo Zhang & Yue Pan, 2020. "Regional differences and rural public expenditure cyclicality: evidence from transitory and persistent shocks in China," The Annals of Regional Science, Springer;Western Regional Science Association, vol. 65(2), pages 281-318, October.
    2. Gang Chen & Brett Inder & Paula Lorgelly & Bruce Hollingsworth, 2013. "The Cyclical Behaviour Of Public And Private Health Expenditure In China," Health Economics, John Wiley & Sons, Ltd., vol. 22(9), pages 1071-1092, September.
    3. Francette Koechlin & Paul Konijn & Luca Lorenzoni & Paul Schreyer, 2017. "Comparing Hospitals and Health Prices and Volumes Across Countries: A New Approach," Social Indicators Research: An International and Interdisciplinary Journal for Quality-of-Life Measurement, Springer, vol. 131(1), pages 43-64, March.

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    JEL classification:

    • H51 - Public Economics - - National Government Expenditures and Related Policies - - - Government Expenditures and Health

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