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The drivers of public health spending: Integrating policies and institutions


  • Christine de la Maisonneuve


  • Rodrigo Moreno-Serra
  • Fabrice Murtin


  • Joaquim Oliveira Martins



This paper investigates the impact of policies and institutions on health expenditures for a large panel of OECD countries for the period 2000-10. We use a set of 20 policy and institutional indicators developed by the OECD characterising the main supply-side, demand-side, and public management, coordination and financing features of health systems. The impact of these indicators is tested alongside control variables related to demographic (dependency ratio) and non-demographic (income, prices and technology) drivers of health expenditures per capita. Overall, there is a reasonably good fit between the expected signs of the coefficients for the institutional indicators and the actual estimates. By integrating the role of policies and institutions, together with the other primary determinants, our analysis is able to explain most of the cross-country variation in public health expenditures. Les déterminants des dépenses publiques de santé : Le rôle des politiques et des institutions Ce papier analyse l’impact des politiques et des institutions sur les dépenses de santé pour un large ensemble de pays de l’OCDE durant la période 2000-10. Nous utilisons un groupe de 20 indicateurs politiques et institutionnels développés par l’OCDE et qui caractérisent principalement l’offre, la demande, la gestion publique, la coordination et le financement des systèmes de santé. L’incidence de ces indicateurs est évaluée conjointement avec des variables de contrôle en lien avec les déterminants démographiques (taux de dépendance) et non démographiques (revenu, prix et technologie) des dépenses de santé par tête. Globalement, il existe une adéquation satisfaisante entre les signes attendus des coefficients des indicateurs institutionnels et les estimations. En intégrant le rôle des politiques et des institutions avec les autres déterminants principaux, notre analyse réussit à expliquer la majorité de la variation entre pays des dépenses publiques de santé.

Suggested Citation

  • Christine de la Maisonneuve & Rodrigo Moreno-Serra & Fabrice Murtin & Joaquim Oliveira Martins, 2016. "The drivers of public health spending: Integrating policies and institutions," OECD Economics Department Working Papers 1283, OECD Publishing.
  • Handle: RePEc:oec:ecoaaa:1283-en
    DOI: 10.1787/5jm2f76rnhkj-en

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    Cited by:

    1. Vianna, Andre C. & Mollick, Andre V., 2018. "Institutions: Key variable for economic development in Latin America," Journal of Economics and Business, Elsevier, vol. 96(C), pages 42-58.
    2. Yan Feng & Toby Watt & Anita Charlesworth & Grace Marsden & Adam Roberts & Jon Sussex, 2017. "What Determines the Health Care Expenditure of High Income Countries? A Dynamic Estimation," Applied Economics and Finance, Redfame publishing, vol. 4(6), pages 1-16, November.
    3. Christine Lewis & Patrice Ollivaud, 2020. "Policies for Switzerland’s ageing society," OECD Economics Department Working Papers 1600, OECD Publishing.
    4. Mueller, Michael & Morgan, David, 2017. "New insights into health financing: First results of the international data collection under the System of Health Accounts 2011 framework," Health Policy, Elsevier, vol. 121(7), pages 764-769.

    More about this item


    cross-country variation; demographic and non-demographic effects; dépenses publiques de santé; effets démographiques et non démographiques; estimations linéaires et non linéaires; health policies and institutions; linear and non-linear estimates; public health expenditures; variation entre pays;

    JEL classification:

    • C1 - Mathematical and Quantitative Methods - - Econometric and Statistical Methods and Methodology: General
    • H51 - Public Economics - - National Government Expenditures and Related Policies - - - Government Expenditures and Health
    • I12 - Health, Education, and Welfare - - Health - - - Health Behavior
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
    • J11 - Labor and Demographic Economics - - Demographic Economics - - - Demographic Trends, Macroeconomic Effects, and Forecasts

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