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The drivers of public health spending: Integrating policies and institutions

Listed author(s):
  • 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.

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Paper provided by OECD Publishing in its series OECD Economics Department Working Papers with number 1283.

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Date of creation: 09 Mar 2016
Handle: RePEc:oec:ecoaaa:1283-en
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