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Health Expenditure, GDP Growth and the Financial Crisis: A Panel Data Analysis for OECD European Countries


  • Joana Cima

    () (CEF.UP and Faculdade de Economia, Universidade do Porto)

  • Alvaro S Almeida

    () (CEF.UP and Faculdade de Economia, Universidade do Porto)


This study analyses the dynamics of Gross Domestic Product and health expenditure for 25 OECD European countries from 1993 to 2015. The novelty of this work is in the joint evaluation of the impact of the Great Recession of the XXI century and the post-crisis period on the growth dynamics of both variables. We estimate a Vector Error Correction model with countries’ fixed effects, and amongst other findings, we conclude that the growth dynamics of health expenditure did not change significantly during the crisis. We perform additional assessments with a third variable related to the population’s health status that show there was a higher rate of people reporting poor health during the crisis and in the following periods, and the health status is caused by GDP rather than health spending. Moreover, we decompose the analysis by health financing scheme, and we observe that countries mostly financed by compulsory health insurance scheme had a worsened health status even though there was no decrease in the growth of health expenditure. These findings are a relevant contribution to the comprehensive and recent literature about the impact of the financial crisis on health. We show there was no direct impact of the Great Recession on the process that determines health expenditure growth, and that a possible deterioration in health during the recession goes beyond the effect on health spending of economic growth.

Suggested Citation

  • Joana Cima & Alvaro S Almeida, 2018. "Health Expenditure, GDP Growth and the Financial Crisis: A Panel Data Analysis for OECD European Countries," FEP Working Papers 602, Universidade do Porto, Faculdade de Economia do Porto.
  • Handle: RePEc:por:fepwps:602

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    References listed on IDEAS

    1. Toth, Federico, 2016. "Classification of healthcare systems: Can we go further?," Health Policy, Elsevier, vol. 120(5), pages 535-543.
    2. Badi H. Baltagi & Raffaele Lagravinese & Francesco Moscone & Elisa Tosetti, 2017. "Health Care Expenditure and Income: A Global Perspective," Health Economics, John Wiley & Sons, Ltd., vol. 26(7), pages 863-874, July.
    3. Son Hong Nghiem & Luke Brian Connelly, 2017. "Convergence and determinants of health expenditures in OECD countries," Health Economics Review, Springer, vol. 7(1), pages 1-11, December.
    4. Petra Baji & Márta Péntek & Imre Boncz & Valentin Brodszky & Olga Loblova & Nóra Brodszky & László Gulácsi, 2015. "The impact of the recession on health care expenditure — How does the Czech Republic, Hungary, Poland and Slovakia compare to other OECD countries?," Society and Economy, Akadémiai Kiadó, Hungary, vol. 37(1), pages 73-88, March.
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    7. Alberto Marino & David Morgan & Luca Lorenzoni & Chris James, 2017. "Future trends in health care expenditure: A modelling framework for cross-country forecasts," OECD Health Working Papers 95, OECD Publishing.
    8. Böhm, Katharina & Schmid, Achim & Götze, Ralf & Landwehr, Claudia & Rothgang, Heinz, 2013. "Five types of OECD healthcare systems: Empirical results of a deductive classification," Health Policy, Elsevier, vol. 113(3), pages 258-269.
    9. Simou, Effie & Koutsogeorgou, Eleni, 2014. "Effects of the economic crisis on health and healthcare in Greece in the literature from 2009 to 2013: A systematic review," Health Policy, Elsevier, vol. 115(2), pages 111-119.
    10. Jofre-Bonet, Mireia & Serra-Sastre, Victoria & Vandoros, Sotiris, 2018. "The impact of the Great Recession on health-related risk factors, behaviour and outcomes in England," Social Science & Medicine, Elsevier, vol. 197(C), pages 213-225.
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    More about this item


    health expenditure; income; health status;

    JEL classification:

    • I10 - Health, Education, and Welfare - - Health - - - General
    • I13 - Health, Education, and Welfare - - Health - - - Health Insurance, Public and Private

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