IDEAS home Printed from https://ideas.repec.org/p/yor/hectdg/10-29.html
   My bibliography  Save this paper

Health systems’ responsiveness and its characteristics: a cross-country comparative analysis

Author

Listed:
  • Robone, S
  • Rice, N
  • Smith, P

Abstract

This paper investigates the influence of aggregate country-level characteristics on health system responsiveness, using data on 62 countries present in the World Health Survey. While evidence exists on variations in reported levels of health system responsiveness across countries, the literature is sparse on the determinants of responsiveness, particularly of system wide characteristics (World Health Report, 2000). We attempt to bridge this gap in the literature by considering simultaneously several plausible country-level characteristics as potential determinants of health system responsiveness. These characteristics refer to the way health care systems are organised and funded, the socio-demographic traits of the populations served and the economic, cultural and institutional characteristics of countries. We pay particular attention to the role of health care expenditures per capita while controlling for potential confounding factors. Data on responsiveness and socio-demographic characteristics of respondents are taken from the World Health Survey, a survey launched by the World Health Organization in 2001. Information on the country-level characteristics are obtained from the United Nations Development Program (UNDP), the World Value Survey and the Polity IV Project database. The empirical analysis is performed by adopting a two step procedure. First, we increase the crosscountry comparability of the data by adjusting for variation in the way survey respondents rate an objective level of responsiveness using the hierarchical ordered probit (hopit) model. Secondly, we investigate the influence of health spending per capita and other country characteristics on the adjusted country-level measures of responsiveness. Our results suggest that the most relevant determinants of responsiveness appear to be health expenditure per capita, health care expenditure in the public sector and population levels of education.

Suggested Citation

  • Robone, S & Rice, N & Smith, P, 2010. "Health systems’ responsiveness and its characteristics: a cross-country comparative analysis," Health, Econometrics and Data Group (HEDG) Working Papers 10/29, HEDG, c/o Department of Economics, University of York.
  • Handle: RePEc:yor:hectdg:10/29
    as

    Download full text from publisher

    File URL: https://www.york.ac.uk/media/economics/documents/herc/wp/10_29.pdf
    File Function: Main text
    Download Restriction: no
    ---><---

    References listed on IDEAS

    as
    1. Owen O'Donnell & Eddy van Doorslaer & Ravi P. Rannan-Eliya & Aparnaa Somanathan & Shiva Raj Adhikari & Deni Harbianto & Charu C. Garg & Piya Hanvoravongchai & Mohammed N. Huq & Anup Karan & Gabriel M., 2007. "The Incidence of Public Spending on Healthcare: Comparative Evidence from Asia," The World Bank Economic Review, World Bank, vol. 21(1), pages 93-123.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Gianluca Fiorentini & Silvana Robone & Rossella Verzulli, 2018. "How do hospital‐specialty characteristics influence health system responsiveness? An empirical evaluation of in‐patient care in the Italian region of Emilia‐Romagna," Health Economics, John Wiley & Sons, Ltd., vol. 27(2), pages 266-281, February.
    2. Fiorentini, Gianluca & Ragazzi, Giovanni & Robone, Silvana, 2015. "Are bad health and pain making us grumpy? An empirical evaluation of reporting heterogeneity in rating health system responsiveness," Social Science & Medicine, Elsevier, vol. 144(C), pages 48-58.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. World Bank, 2008. "Sri Lanka : Addressing the Needs of an Aging Population," World Bank Publications - Reports 8105, The World Bank Group.
    2. Wagstaff, Adam & Lindelow, Magnus, 2008. "Can insurance increase financial risk?: The curious case of health insurance in China," Journal of Health Economics, Elsevier, vol. 27(4), pages 990-1005, July.
    3. Sudipto Mundle, 2018. "Fifty years of Asian experience in the spread of education and healthcare," WIDER Working Paper Series wp-2018-97, World Institute for Development Economic Research (UNU-WIDER).
    4. Mundle, Sudipto, 2018. "Development of Education and Health Services in Asia and the Role of the State," Working Papers 18/239, National Institute of Public Finance and Policy.
    5. Van de Poel, Ellen & Van Doorslaer, Eddy & O’Donnell, Owen, 2012. "Measurement of inequity in health care with heterogeneous response of use to need," Journal of Health Economics, Elsevier, vol. 31(4), pages 676-689.
    6. Mingsheng Chen & Yuxin Zhao & Lei Si, 2014. "Who Pays for Health Care in China? The Case of Heilongjiang Province," PLOS ONE, Public Library of Science, vol. 9(10), pages 1-11, October.
    7. Anselmi, Laura & Lagarde, Mylène & Hanson, Kara, 2015. "Going beyond horizontal equity: An analysis of health expenditure allocation across geographic areas in Mozambique," Social Science & Medicine, Elsevier, vol. 130(C), pages 216-224.
    8. Flores, Gabriela & O’Donnell, Owen, 2016. "Catastrophic medical expenditure risk," Journal of Health Economics, Elsevier, vol. 46(C), pages 1-15.
    9. Sparrow, Robert & Suryahadi, Asep & Widyanti, Wenefrida, 2013. "Social health insurance for the poor: Targeting and impact of Indonesia's Askeskin programme," Social Science & Medicine, Elsevier, vol. 96(C), pages 264-271.
    10. Dhiman Das, 2017. "Public expenditure and healthcare utilization: the case of reproductive health care in India," International Journal of Health Economics and Management, Springer, vol. 17(4), pages 473-494, December.
    11. Eddy van Doorslaer & Owen O'Donnell & Ravindra P. Rannan-Eliya & Aparnaa Somanathan & Shiva Raj Adhikari & Charu C. Garg & Deni Harbianto & Alejandro N. Herrin & Mohammed Nazmul Huq & Shamsia Ibragimo, 2007. "Catastrophic payments for health care in Asia," Health Economics, John Wiley & Sons, Ltd., vol. 16(11), pages 1159-1184.
    12. Biplab Dhak, 2015. "Demographic Change and Catastrophic Health Expenditure in India," Social Indicators Research: An International and Interdisciplinary Journal for Quality-of-Life Measurement, Springer, vol. 122(3), pages 723-733, July.
    13. Eddy van Doorslaer & Owen O'Donnell, 2008. "Measurement and Explanation of Inequality in Health and Health Care in Low-Income Settings," WIDER Working Paper Series DP2008-04, World Institute for Development Economic Research (UNU-WIDER).
    14. Abdur Razzaque Sarker & Marufa Sultana & Khorshed Alam & Nausad Ali & Nurnabi Sheikh & Raisul Akram & Alec Morton, 2021. "Households' out‐of‐pocket expenditure for healthcare in Bangladesh: A health financing incidence analysis," International Journal of Health Planning and Management, Wiley Blackwell, vol. 36(6), pages 2106-2117, November.
    15. repec:jet:dpaper:dpaper391 is not listed on IDEAS
    16. Adam Wagstaff & Winnie Yip & Magnus Lindelow & William C. Hsiao, 2009. "China's health system and its reform: a review of recent studies," Health Economics, John Wiley & Sons, Ltd., vol. 18(S2), pages 7-23, July.
    17. Adam Wagstaff, 2012. "Benefit‐incidence analysis: are government health expenditures more pro‐rich than we think?," Health Economics, John Wiley & Sons, Ltd., vol. 21(4), pages 351-366, April.
    18. Sudipto Mundle, 2018. "Fifty years of Asian experience in the spread of education and healthcare," WIDER Working Paper Series 97, World Institute for Development Economic Research (UNU-WIDER).
    19. Parmar, Divya & Banerjee, Aneesh, 2019. "How do supply- and demand-side interventions influence equity in healthcare utilisation? Evidence from maternal healthcare in Senegal," Social Science & Medicine, Elsevier, vol. 241(C).
    20. Anup Karan & Sakthivel Selvaraj & Ajay Mahal, 2014. "Moving to Universal Coverage? Trends in the Burden of Out-Of-Pocket Payments for Health Care across Social Groups in India, 1999–2000 to 2011–12," PLOS ONE, Public Library of Science, vol. 9(8), pages 1-13, August.
    21. Shreya Banerjee & Indrani Roy Chowdhury, 2020. "Inequities in curative health-care utilization among the adult population (20–59 years) in India: A comparative analysis of NSS 71st (2014) and 75th (2017–18) rounds," PLOS ONE, Public Library of Science, vol. 15(11), pages 1-23, November.

    More about this item

    Keywords

    Health systems responsiveness; Anchoring vignettes; Health care expenditures;
    All these keywords.

    NEP fields

    This paper has been announced in the following NEP Reports:

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:yor:hectdg:10/29. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Jane Rawlings (email available below). General contact details of provider: https://edirc.repec.org/data/deyoruk.html .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.