Prague Economic Papers 2023, 32(2):205-224 | DOI: 10.18267/j.pep.830

Human Resources for Health and Health Outcomes: Panel Data Analysis

Lucie Kureková ORCID...a, Pavlína Hejdukova ORCID...a, Lenka Komárková ORCID...b
a University of West Bohemia, Faculty of Economics, Pilsen, Czech Republic
b Prague University of Economics and Business, Faculty of Management, Jindřichův Hradec, Czech Republic

This study aims to evaluate the effects of selected key factors on health outcomes. Unfortunately, statistical reporting in this field is not harmonized, and in some countries it is completely absent. For this reason, valuable information for health determinant analysis may be lacking or overlooked. Using two different databases, we obtained data from 61 countries for the period 2000-2015. To analyse panel data with over 660 observations, a linear mixed model was applied. This paper contributes to the health economics debate by statistically testing the relationship between health outcomes and variables such as healthcare personnel, healthcare expenditure and infrastructure. The results confirm the importance of healthcare expenditure and healthcare infrastructure. However, the size and direction of the effect vary among countries with different income levels. In regard to human resources, the number of doctors proved to have a significant effect only in lower-income countries.

Keywords: human resources for health, mortality rate, econometric model, panel data
JEL classification: B23, H51, H75, I18, O15

Received: April 30, 2022; Revised: January 21, 2023; Accepted: February 24, 2023; Published: April 26, 2023  Show citation

ACS AIP APA ASA Harvard Chicago Chicago Notes IEEE ISO690 MLA NLM Turabian Vancouver
Kureková, L., Hejdukova, P., & Komárková, L. (2023). Human Resources for Health and Health Outcomes: Panel Data Analysis. Prague Economic Papers32(2), 205-224. doi: 10.18267/j.pep.830
Download citation

References

  1. Anand, S., Bärnighausen, T. (2004). Human resources and health outcomes: cross-country econometric study. The Lancet, 364(9445), 1603-1609. https://doi.org/10.1016/S0140-6736(04)17313-3 Go to original source...
  2. Bedir, S. (2016). Healthcare expenditure and economic growth in developing countries. Advances in Economics and Business, 4(2), 76-86. https://doi.org/10.13189/aeb.2016.040202 Go to original source...
  3. Bloom, D., Canning, D., Malaney, P. N. (1999). Demographic Change and Economic Growth in Asia. CID Working Paper 15. Cambridge, MA: Harvard University. Retrieved December 17, 2021, from https://www.hks.harvard.edu/centers/cid/publications/faculty-working-papers/demographic-change-and-economic-growth-asia
  4. Butler, M., Schultz, T. J., Halligan, P., Sheridan, A., Kinsman, L., Rotter, T. et al. (2019) Hospital nurse-staffing models and patient-and staff-related outcomes. Cochrane Database of Systematic Reviews, 4. https://doi.org/10.1002/14651858.CD007019.pub3 Go to original source...
  5. Cepparulo, A., Giuriato, L. (2021). The residential healthcare for the elderly in Italy: some considerations for post-COVID-19 policies. The European Journal of Health Economics, 1-15. https://doi.org/10.1007/s10198-021-01388-9 Go to original source...
  6. Čermáková K., Jašová E. (2019). Analysis of the Negative and Positive Impact of Institutional Factors on Unemployment in Visegrad Countries. International Journal of Economic Sciences, 8(1), 20-34. https://doi.org/0.52950/ES.2019.8.1.002 Go to original source...
  7. Chaudhry, R., Dranitsaris, G., Mubashir, T., Bartoszko, J., Riazi, S. (2020). A country level analysis measuring the impact of government actions, country preparedness and socioeconomic factors on COVID-19 mortality and related health outcomes. EClinicalMedicine, 25, 100464. https://doi.org/10.1016/j.eclinm.2020.100464 Go to original source...
  8. Chen, L., Evans, T., Anand, S. (2004). Boufford J., Brown H., Chowdhury M., et al. Human resources for health: overcoming the crisis. The Lancet, 364(9449), 1984-1990. https://doi.org/10.1016/S0140-6736(04)17482-5 Go to original source...
  9. Cho, S. H., Lee, J. Y., You, S. J., Song, K. J., Hong, K. J. (2020). Nurse staffing, nurses prioritization, missed care, quality of nursing care, and nurse outcomes. International Journal of Nursing Practice, 26(1), e12803. https://doi.org/10.1111/ijn.12803 Go to original source...
  10. Chopra, M., Munro, S., Lavis, J. N., Vist, G., Bennett, S. (2008). Effects of policy options for human resources for health: an analysis of systematic reviews. The Lancet, 371(9613), 668-674. https://doi.org/10.1016/S0140-6736(08)60305-0 Go to original source...
  11. Coccia, M. (2021). High health expenditures and low exposure of population to air pollution as critical factors that can reduce fatality rate in COVID-19 pandemic crisis: a global analysis. Environmental Research, 199, 111339. https://doi.org/10.1016/j.envres.2021.111339 Go to original source...
  12. Correia, T., Dussault, G., Pontes, C. (2015). The impact of the financial crisis on human resources for health policies in three southern-Europe countries. Health Policy, 119(12), 1600-1605. https://doi.org/10.1016/j.healthpol.2015.08.009 Go to original source...
  13. Deaton, A. (2013). The great escape: health, wealth, and the origins of inequality. Princeton: Princeton University Press. Go to original source...
  14. Dempsey, C., Reilly, B., Buhlman, N. (2014). Improving the patient experience: real-world strategies for engaging nurses. JONA: The Journal of Nursing Administration, 44(3), 142-151. https://doi.org/10.1097/NNA.0000000000000042 Go to original source...
  15. Donald, F., Martin-Misener, R., Carter, N., Donald, E. E., Kaasalainen, S., Wickson-Griffiths, A., ... DiCenso, A. (2013). A systematic review of the effectiveness of advanced practice nurses in long-term care. Journal of advanced nursing, 69(10), 2148-2161. https://doi.org/10.1111/jan.12140 Go to original source...
  16. Easterlin, R. A. (1996). Growth triumphant: The twenty-first century in historical perspective. University of Michigan Press. Go to original source...
  17. Easterlin, R. A. (1999). How beneficent is the market? A look at the modern history of mortality. European Review of Economic History, 3(3), 257-294. https://doi.org/10.1017/S1361491699000131 Go to original source...
  18. Elgin, C., Basbug, G., Yalaman, A. (2020). Economic policy responses to a pandemic: Developing the COVID-19 economic stimulus index. Covid Economics, 1(3), 40-53.
  19. Farahani, M., Subramanian, S. V., Canning, D. (2009). The effect of changes in health sector resources on infant mortality in the short-run and the long-run: a longitudinal econometric analysis. Social science & medicine, 68(11), 1918-1925. https://doi.org/10.1016/j.socscimed.2009.03.023 Go to original source...
  20. Fujii, T. (2018). Sources of health financing and health outcomes: A panel data analysis. Health Economics, 27(12), 1996-2015. https://doi:10.1002/hec.3817 Go to original source...
  21. Glied, S., Levy, H. (2020). The potential effects of coronavirus on national health expenditures. Jama, 323(20), 2001-2002. https://doi.org/10.1001/jama.2020.6644 Go to original source...
  22. Griffiths, P., Recio-Saucedo, A., Dall'Ora, C., Briggs, J., Maruotti, A., Meredith, P., et al. (2018). The association between nurse staffing and omissions in nursing care: a systematic review. Journal of advanced nursing, 74(7), 1474-1487. https://doi.org/10.1111/jan.13564 Go to original source...
  23. Gupta, N., Castillo-Laborde, C., Landry, M. D. (2011). Health-related rehabilitation services: assessing the global supply of and need for human resources. BMC Health Services Research, 11, 276-286. https://doi.org/10.1186/1472-6963-11-276 Go to original source...
  24. Hall, A. (2020). Quality of life and value assessment in health care. Health Care Analysis, 28(1), 45-61. https://doi.org/10.1007/s10728-019-00382-w Go to original source...
  25. Hejduková, P., Kureková, L. (2016). National health systems' performance: evaluation WHO indicators. Procedia-Social and Behavioral Sciences, 230, 240-248. https://doi.org/10.1016/j.sbspro.2016.09.031 Go to original source...
  26. Hejduková, P., Kureková, L. (2017). Healthcare Systems and Performance Evaluation: Comparison of Performance Indicators in V4 countries Using Models of Composite Indicators. E&M Economics and Management, 20(3), 133-146. https://doi.org/10.15240/tul/001/2017-3-009 Go to original source...
  27. Hejduková, P., Kureková L. (2019). Selective migration analysis: a case study of the migration of Polish healthcare staff. Modern Management Review, 26(4), 25-35. Go to original source...
  28. Jamison, D. T., Murphy, S. M., Sandbu, M. E. (2016). Why has under-5 mortality decreased at such different rates in different countries?. Journal of health economics, 48, 16-25. https://doi.org/10.1016/j.jhealeco.2016.03.002 Go to original source...
  29. Jebeli, S. S. H., Hadian, M., Souresrafil, A. (2019). Study of health resource and health outcomes: Organization of economic corporation and development panel data analysis. Journal of education and health promotion, 8, 70. https://10.4103/jehp.jehp_101_18. eCollection 2019 Go to original source...
  30. Kadeřábková, B., Jašová, E., Holman, R. (2020). Analysis of substitution changes in the Phillips curve in V4 countries over the course of economic cycles. International Journal of Economic Sciences, 9(2), 39-54. https://doi.org/ 10.52950/ES.2020.9.2.003 Go to original source...
  31. Karabulut, G., Zimmermann, K. F., Bilgin, M. H., Doker, A. C. (2021). Democracy and COVID-19 outcomes. Economics letters, 203, 109840. https://doi.org/10.1016/j.econlet.2021.109840 Go to original source...
  32. Lankshear, A. J., Sheldon, T. A., Maynard, A. (2005). Nurse staffing and healthcare outcomes: a systematic review of the international research evidence. Advances in Nursing Science, 28(2), 163-174. Go to original source...
  33. Lavery, M. R., Acharya, P., Sivo, S. A., Xu, L. (2019). Number of predictors and multicollinearity: What are their effects on error and bias in regression?. Communications in Statistics-Simulation and Computation, 48(1), 27-38. https://doi.org/10.1080/03610918.2017.1371750 Go to original source...
  34. Martín, J. J. M., Puerto Lopez del Amo Gonzalez, M., Dolores Cano Garcia, M. (2011). Review of the literature on the determinants of healthcare expenditure. Applied Economics, 43(1), 19-46. https://doi.org/10.1080/00036841003689754 Go to original source...
  35. Needleman, J., Hassmiller, S. (2009). The Role Of Nurses In Improving Hospital Quality And Efficiency: Real-World Results: Nurses have key roles to play as hospitals continue their quest for higher quality and better patient safety. Health Affairs, 28(3), 625-633. https://doi.org/10.1377/hlthaff.28.4.w625 Go to original source...
  36. Neethu, L., Helan, A. P. (2021). The Health Issues And Problems Faced By Returnees From Gulf Countries In Kerala. International Journal of Economic Sciences, 10(1), 71-83. https://doi.org/ 10.52950/ES.2021.10.1.005 Go to original source...
  37. Nixon, J., Ulmann, P. (2006). The relationship between health care expenditure and health outcomes. The European Journal of Health Economics, 7(1), 7-18. https://doi.org/10.1007/s10198-005-0336-8 Go to original source...
  38. Or, Z., Wang, J., Jamison, D. (2005). International differences in the impact of doctors on health: a multilevel analysis of OECD countries. Journal of health economics, 24(3), 531-560. https://doi.org/10.1016/j.jhealeco.2004.09.003 Go to original source...
  39. Pinheiro, J., Bates, D. (2006). Mixed-effects models in S and S-PLUS. New York, NY: Springer
  40. Powles, J. (2001). Healthier progress: historical perspectives on the social and economic determinants of health. The social origins of health and well-being, 3-24. Go to original source...
  41. Preston, S. H. (1975). The changing relation between mortality and level of economic development. Population studies, 29(2), 231-248. Go to original source...
  42. Preston, S. H. (2007). Causes and consequences of mortality declines in less developed countries during the twentieth century. In Population and Economic Change in Developing Countries (pp. 289-360). Chicago: University of Chicago Press.
  43. Qin, X., Hsieh, C. R. (2014). Economic growth and the geographic maldistribution of health care resources: Evidence from China, 1949-2010. China Economic Review, 31, 228-246. https://doi.org/10.1016/j.chieco.2014.09.010 Go to original source...
  44. Ray, D., Linden, M. (2019). Health expenditure, longevity, and child mortality: dynamic panel data approach with global data. International Journal of Health Economics and Management, 20(1), 99-119. https://doi.org/10.1007/s10754-019-09272-z Go to original source...
  45. Ricketts, T. C., Holmes, G. M. (2007). Mortality and physician supply: does region hold the key to the paradox?. Health services research, 42(6p1), 2233-2251. https://doi.org/10.1111/j.1475-6773.2007.00728.x Go to original source...
  46. Robinson, J., Wharrad, H. (2000). Invisible nursing: exploring health outcomes at a global level. Relationships between infant and under-5 mortality rates and the distribution of health professionals, GNP per capita, and female literacy. Journal of advanced Nursing, 32(1), 28-40. https://doi.org/10.1046/j.1365-2648.2000.01458.x Go to original source...
  47. Speybroeck, N., Kinfu, Y., Dal Poz, M.R. and Evans, D.B. (2006). Reassessing the relationship between human resources for health, intervention coverage and health outcomes. Geneva: World Health Organization Publications; p.1.
  48. Steinmann, L., Telser, H., Zweifel, P. S. (2007) Aging and future healthcare expenditure: a consistent approach. Forum for Health Economics & Policy, 10(2). https://doi.org/10.2202/1558-9544.1041 Go to original source...
  49. Traczynski, J., Udalova, V. (2018). Nurse practitioner independence, health care utilization, and health outcomes. Journal of Health Economics, 58, 90-109. https://doi.org/10.1016/j.jhealeco.2018.01.001 Go to original source...
  50. Trougakos, J. P., Chawla, N., McCarthy, J. M. (2020). Working in a pandemic: Exploring the impact of COVID-19 health anxiety on work, family, and health outcomes. Journal of Applied Psychology, 105(11), 1234. https://doi.org/10.1037/apl0000739 Go to original source...
  51. U.S. Department of Health and Human Services. (2020). Determinants of Health. Office of Disease Prevention and Health Promotion. Retrieved March 22, 2021, from https://www.healthypeople.gov/2020/about/foundation-health-measures/Determinants-of-Health
  52. Vallejo-Torres, L., Morris, S. (2018). Primary care supply and quality of care in England. The European Journal of Health Economics, 19(4), 499-519. https://doi.org/10.1007/s10198-017-0898-2 Go to original source...
  53. Wilson, S., Bremner, A., Hauck, Y., Finn, J. (2011). The effect of nurse staffing on clinical outcomes of children in hospital: a systematic review. International Journal of Evidence-Based Healthcare, 9(2), 97-121. https://doi.org/10.1111/j.1744-1609.2011.00209.x Go to original source...
  54. World Bank Group. (2021). World Development Indicators. Retrieved March 22, 2021, from https://databank.worldbank.org/source/world-development-indicators
  55. World Health Organization. (2004). World report on knowledge for better health: strengthening health systems. Retrieved December 17, 2021, from https://apps.who.int/iris/handle/10665/43058
  56. World Health Organization. (2015). Health workforce 2030: towards to global strategy on human resources for health. Retrieved December 17, 2021, from https://apps.who.int/iris/handle/10665/330092
  57. World Health Organization. (2016a). Global strategy on human resources for health: Workforce 2030. Retrieved December 17, 2021 from, https://apps.who.int/iris/bitstream/handle/10665/250368/9789241511131-eng.pdf
  58. World Health Organization. (2016b). World Health Report: working together for health. Retrieved December 17, 2021, form https://www.who.int/whr/2006/whr06_en.pdf
  59. World Health Organization. (2017). Determinants of Health. Retrieved March 22, 2021, from https://www.who.int/news-room/q-a-detail/determinants-of-health.
  60. World Health Organization. (2018). Millennium Development Goals (MDGs). Retrieved January 20, 2023, from https://www.who.int/news-room/fact-sheets/detail/millennium-development-goals-(mdgs)
  61. World Health Organization. (2021). Statistical Information System. Retrieved March 22, 2021, from https://www.who.int/data/gho/data/indicators
  62. Yuksekdag, Y. (2018). Health without care? Vulnerability, medical brain drain, and health worker responsibilities in underserved contexts. Health Care Analysis, 26(1), 17-32. https://doi.org/10.1007/s10728-017-0342-x Go to original source...

This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (CC BY NC ND 4.0), which permits non-comercial use, distribution, and reproduction in any medium, provided the original publication is properly cited. No use, distribution or reproduction is permitted which does not comply with these terms.