Time series analysis of private healthcare expenditures GDP: cointegration results with structural breaks
This paper analyses the time-series behaviour of private health expenditure and GDP to understand whether there is long-term equilibrium relationship between these two variables and estimate income elasticity of private health expenditure. The study uses cointegration analysis with structural breaks and estimates these relationships using FM OLS (fully modified ordinary least squares) method. The findings suggest that income elasticity of private health expenditures is 1.95 indicating that for every one per cent increase in per capita income the private health expenditure has gone up by 1.95 per cent. The private health expenditure was 2.4 per cent of GDP in 1960 and this has risen to 5.8 per cent in 2003. In nominal terms it has grown at the rate of 11.3 per cent since 1960 and during 1990’s the growth rate is 18 per cent per annum. The study discusses four reasons for this high growth experience. These are: (i) financing mechanisms including provider payment system, (ii) demographic trends and epidemiological transition, (iii) production function of private health services delivery system, and (iv) dwindling financing support to public health system. In developing countries where per se the need for spending on health is high, high levels of private health expenditures pose serious challenge to policy makers. The sheer size of these expenditures once it has risen to high levels can impede control of health expenditures itself. The high private health expenditures are also cause of concern because most of these expenditures are out-of-pocket, insurance mechanisms cover small segment of population, provider payment systems are primarily based on fee-for-services and the professional regulation and accountability systems are weak and non-functioning in many ways. It is not clear whether these expenditures are sustainable as it can have number of undesirable consequences making the health system high cost, unaffordable, and vulnerable to provider payment system.
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- Robin L. Lumsdaine & David H. Papell, 1997.
"Multiple Trend Breaks And The Unit-Root Hypothesis,"
The Review of Economics and Statistics,
MIT Press, vol. 79(2), pages 212-218, May.
- Tom Doan, . "LPUNIT: RATS procedure to implement Lumsdaine-Papell unit root test with structural breaks," Statistical Software Components RTS00110, Boston College Department of Economics.
- Amsler, Christine & Lee, Junsoo, 1995. "An LM Test for a Unit Root in the Presence of a Structural Change," Econometric Theory, Cambridge University Press, vol. 11(02), pages 359-368, February.
- McCoskey, Suzanne K. & Selden, Thomas M., 1998. "Health care expenditures and GDP: panel data unit root test results," Journal of Health Economics, Elsevier, vol. 17(3), pages 369-376, June.
- Perron, Pierre, 1989.
"The Great Crash, the Oil Price Shock, and the Unit Root Hypothesis,"
Econometric Society, vol. 57(6), pages 1361-1401, November.
- Perron, P, 1988. "The Great Crash, The Oil Price Shock And The Unit Root Hypothesis," Papers 338, Princeton, Department of Economics - Econometric Research Program.
- Granger, C. W. J., 1980. "Long memory relationships and the aggregation of dynamic models," Journal of Econometrics, Elsevier, vol. 14(2), pages 227-238, October.
- Granger, C. W. J. & Newbold, P., 1974. "Spurious regressions in econometrics," Journal of Econometrics, Elsevier, vol. 2(2), pages 111-120, July.
- Gbesemete, Kwame P. & Gerdtham, Ulf-G., 1992. "Determinants of health care expenditure in Africa: A cross-sectional study," World Development, Elsevier, vol. 20(2), pages 303-308, February.
- Johansen, S., 1991.
"Determination of Cointegration Rank in the Presence of a Linear Trend,"
76a, Helsinki - Department of Economics.
- Johansen, Soren, 1992. "Determination of Cointegration Rank in the Presence of a Linear Trend," Oxford Bulletin of Economics and Statistics, Department of Economics, University of Oxford, vol. 54(3), pages 383-97, August.
- Di Matteo, Livio & Di Matteo, Rosanna, 1998. "Evidence on the determinants of Canadian provincial government health expenditures: 1965-1991," Journal of Health Economics, Elsevier, vol. 17(2), pages 211-228, April.
- Peter C. B. Phillips & Bruce E. Hansen, 1990. "Statistical Inference in Instrumental Variables Regression with I(1) Processes," Review of Economic Studies, Oxford University Press, vol. 57(1), pages 99-125.
- Hitiris, Theo & Posnett, John, 1992. "The determinants and effects of health expenditure in developed countries," Journal of Health Economics, Elsevier, vol. 11(2), pages 173-181, August.
- Allan w. Gregory & Bruce E. Hansen, 1992.
"residual-Based Tests for Cointegration in Models with Regime Shifts,"
862, Queen's University, Department of Economics.
- Gregory, Allan W. & Hansen, Bruce E., 1996. "Residual-based tests for cointegration in models with regime shifts," Journal of Econometrics, Elsevier, vol. 70(1), pages 99-126, January.
- Gregory, A.W. & Hansen, B.E., 1992. "Residual-Based Tests for Cointegration in Models with Regime Shifts," RCER Working Papers 335, University of Rochester - Center for Economic Research (RCER).
- George Karatzas, 2000. "On the determination of the US aggregate health care expenditure," Applied Economics, Taylor & Francis Journals, vol. 32(9), pages 1085-1099.
- Hansen, Paul & King, Alan, 1996. "The determinants of health care expenditure: A cointegration approach," Journal of Health Economics, Elsevier, vol. 15(1), pages 127-137, February.
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