H51 - National Government Expenditures and HealthReturn

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.

The New Rural Cooperative Medical Service System (NRCMS) in China has been established to ensure improved medical care support for all categories of Chinese peasants to offset their burden of excessive medical care expenditures. The primary aim of this paper is to identify an appropriate alternative modelling approach for the patients' medical expenditures. Data were collected from Jiaojiang city through cluster and multistage random sampling procedure, which was comprised of 4,630 enrolled rural people under NRCMS. The paper presented the first comparison of common econometric medical expenditures modelling approaches. Major findings reveal that the Generalized Linear Model (GLM) predictive accuracy appears to be better than the Finite Mixture Model (FMM) and GLM (log link) was the best performer among all approaches. It may be attributed due to the structural difference of medical expenditures between China and other developing countries compared to the developed countries. This suggests that the Chinese government may find an alternative to choose GLM approach among others to minimize the peasants' medical expenditures under NRCMS.

Growing concern about fiscal sustainability with respect to the population ageing has given rise to a large debate on the role of age in the context of health care expenditure. Growing evidence on the so called death related costs hypothesis arguing that the positive relationship between age of the cohort and related health care expenditure is the result of growing probability of death changes significantly influencing of the projections. The aim of this paper is to explore the importance of the death related costs hypothesis in the Czech health expenditure data and the impact of the hypothesis on the projection of the financial sustainability of the Czech health care system.