Public Health Expenditure

Background: Diagnostic health laboratory services are regarded as an integral part of the
national health infrastructure across all countries. Clinical laboratory tests contribute
substantially to health system goals of increasing quality of care and improving patient
outcomes.
Objectives: This study aimed to analyse current laboratory expenditures at the primary
healthcare (PHC) level in South Africa as processed by the National Health Laboratory Service
and to determine the potential cost savings of introducing laboratory demand management.
Methods: A retrospective cross-sectional analysis of laboratory expenditures for the 2013/2014
financial year across 11 pilot National Health Insurance health districts was conducted.
Laboratory expenditure tariff codes were cross-tabulated to the PHC essential laboratory tests
list (ELL) to determine inappropriate testing. Data were analysed using a Microsoft Access
database and Excel software.
Results: Approximately R35 million South African Rand (10%) of the estimated R339 million
in expenditures was for tests that were not listed within the ELL. Approximately 47% of
expenditure was for laboratory tests that were indicated in the algorithmic management of
patients on antiretroviral treatment. The other main cost drivers for non-ELL testing included
full blood count and urea, as well as electrolyte profiles usually requested to support
management of patients on antiretroviral treatment.
Conclusions: Considerable annual savings of up to 10% in laboratory expenditure are
possible at the PHC level by implementing laboratory demand management. In addition,
to achieve these savings, a standardised PHC laboratory request form and some form of
electronic gatekeeping system that must be supported by an educational component should
be implemented

Health holds an important position in maintaining economic development since it is both a prerequisite for and an outcome of economic development. This means that health contributes greatly to the attainment of sustainable development and health outcomes. The importance of health is demonstrated in the Millennium Development Goals (MDGs) where three of the eight goals are aimed at improving health outcomes. Despite progress made by other middle-income countries in achieving health-related MDGs, South Africa is still worse off in respect of health outcomes and experiences a challenge in attaining positive outcomes for these goals. This study’s main focus was to identify the association between public health expenditure and health outcomes in South Africa’s nine provinces from 2002 to 2016. The study implemented fixed effects and a random effects panel data estimation technique to control for time effects and individual provincial heterogeneity. This was followed by employing the Haus...

Health forms the basic foundation of the quality of human life, which is an ultimate ingredient towards the productivity and efficiency of an economy. The rapid growth of health expenditure has emerged as an enormous concern for many households and governments globally. This study used time-series data for the period 1985–2018 in unearthing the drivers of healthcare expenditure in Kenya, with a central focus on the role of health shocks. The study also sought to assess whether structural breaks mattered in a healthcare expenditure model. A public healthcare expenditure model was estimated using the Autoregressive Distributed Lag (ARDL) model. The findings revealed the presence of a long-run relationship between public health expenditure and its determinants in Kenya. Population growth rate and CO2 emissions (proxy to respiratory illnesses) were found to significantly and positively determine public health expenditure in the short run. This impact was insignificant in the long run. Similarly, GDP per capita and the number of HIV/AIDs infections positively and significantly determined public health expenditure in the long run. A key finding of this study highlighted the importance of testing for structural breaks in analyzing a time-series healthcare expenditure model. Previously, this is something that has been largely omitted in the Kenyan healthcare context. The structural break dummy variables significantly determined public health expenditure and, therefore, their incorporation in the model yielded a more accurate forecast with better econometric estimates. The findings will be useful in informing the government’s health budgetary allocation as well as the design of appropriate shock mitigation policies. This is paramount for the country in achieving not only Universal Health Coverage but also high-quality medical care to its citizens as envisioned in the 'Big Four Agenda' government priorities.

This study focused on the Child Rights Act and how relevant stakeholders, institutions and agencies have been
able to guarantee the attainment of these rights through budgetary provisions. Therefore, the main objective of
this study is to determine the effects of public healthcare expenditure on the attainment of these rights. To this
end, the study employed the Grossman human capital development model and fitted a time series data obtained
from World Development Indicators and CBN statistical bulletin using OLS and TSLS. In the process, we
observed that public healthcare expenditure has been on the increase, while the under-five mortality rate has
been falling but not in the same proportion. Secondly, we observed that public healthcare expenditure is
statistically significant with under-five mortality rate but with an infinitesimal magnitude of 0.017% (OLS) and
0.035% (TSLS). Public education expenditure is positively but has no statistically significant relationship with
primary school enrolment. It was discovered that the incidence of mortality is higher than the child school
enrolment. The findings also show that location and accessibility to both health and education facilities are
important in explaining under-five mortality and primary school enrolment respectively. We therefore suggest
that more proportion of the public healthcare expenditure should be allotted to the welfare of the under-five,
thereby fulfilling the Child Rights Act

Health holds an important position in maintaining economic development since it is both a prerequisite for and an outcome of economic development. This means that health contributes greatly to the attainment of sustainable development and health outcomes. The importance of health is demonstrated in the Millennium Development Goals (MDGs) where three of the eight goals are aimed at improving health outcomes. Despite progress made by other middle-income countries in achieving health-related MDGs, South Africa is still worse off in respect of health outcomes and experiences a challenge in attaining positive outcomes for these goals. This study's main focus was to identify the association between public health expenditure and health outcomes in South Africa's nine provinces from 2002 to 2016. The study implemented fixed effects and a random effects panel data estimation technique to control for time effects and individual provincial heterogeneity. This was followed by employing ...

Health is important for sustainable economic performance of a country. This study seeks to investigate the effectiveness of public health spending on health outcomes. This is obtained by estimating a health production function for Kenya. In the study, infant mortality rate is used to measure health outcomes. The study uses time series data running from 1984 to 2015. The data is obtained from World Bank database and Kenya National Bureau of Statistics Economic Surveys. Error Correction Model (ECM) is adopted due to presence of cointegration. The results show that public expenditure on average influence health outcomes in Kenya. These results therefore provide evidence to support that increase in public expenditure improves health outcomes. The other factor that is found to be important determinant of health outcomes in Kenya is child immunization. The major policy implication of this study is that Kenyan government should increase budgetary allocation to health sector. In addition, government of Kenya should allocate more resources to child immunization.

This study explored the determinants of public health expenditure in Pakistan by utilizing different socioeconomic variables. The time series data from the period 1980 to 2009 has been used for the analysis. The results of Augmented Dickey–Fuller unit root test depicted that variables have different order of integrations. Results of OLS showed that income, primary school enrollment and urban population have positive impact on public health expenditure while unemployment rate has negative impact on public health expenditure.

Health is important for sustainable economic performance of a country. This study seeks to investigate the effectiveness of public health spending on health outcomes. This is obtained by estimating a health production function for Kenya. In the study, infant mortality rate is used to measure health outcomes. The study uses time series data running from 1984 to 2015. The data is obtained from World Bank database and Kenya National Bureau of Statistics Economic Surveys. Error Correction Model (ECM) is adopted due to presence of cointegration. The results show that public expenditure on average influence health outcomes in Kenya. These results therefore provide evidence to support that increase in public expenditure improves health outcomes. The other factor that is found to be important determinant of health outcomes in Kenya is child immunization. The major policy implication of this study is that Kenyan government should increase budgetary allocation to health sector. In addition, government of Kenya should allocate more resources to child immunization.

Health holds an important position in maintaining economic development since it is both a prerequisite for and an outcome of economic development. This means that health contributes greatly to the attainment of sustainable development and health outcomes. The importance of health is demonstrated in the Millennium Development Goals (MDGs) where three of the eight goals are aimed at improving health outcomes. Despite progress made by other middle-income countries in achieving health-related MDGs, South Africa is still worse off in respect of health outcomes and experiences a challenge in attaining positive outcomes for these goals. This study's main focus was to identify the association between public health expenditure and health outcomes in South Africa's nine provinces from 2002 to 2016. The study implemented fixed effects and a random effects panel data estimation technique to control for time effects and individual provincial heterogeneity. This was followed by employing the Hausman specification test to identify the fixed effects model as the appropriate estimator for the study. The study also employed the seemingly unrelated regression (SUR) model and the least squares dummy variable (LSDV) model to examine the impact of public health expenditure on each province separately. The findings elucidated that the relationship between public health expenditure and health outcomes in South Africa varied across provinces depending on provincial management and infrastructure availability.

Past few decades have witnessed a convergence of politicised health policy goals and paradigms across all OECD member states, this new movement was given a great deal of focus here in New Zealand especially due to the unmasking of system-wide defects during past cycles of economic recessions. This document will briefly highlight the characteristics of New Zealand's fiscal capacity for flexible reform and the highly contested health budget balancing strategies enacted in previous decades. This critical analysis will allow the National Health Board to produce policy proposals to allow for political leverage on behalf of the Ministry of Health in creating a new health budget reform to coincide with popular OECD fiscal strategies for overall cost-containment. A unique dichotomy of public health expenditure behaviour is apparent amongst most countries that coincide with their GDP. Low & Middle Income Countries (including BRICS) are characterised by relatively low GDP and even lower Total Health Expenditure as a percentage of GDP whereas High Income Countries (HIC) have higher GDP with a higher percentage funnelled towards public health expenditure. This trend is relatively homogenous across most countries in these two groups. Health expenditure is directly linked to increases in health indicators (eg. higher longevity, lower maternal & infant mortality, longer QALY/DALY etc) upto a critical point where efficiency gains in health outcomes require even greater financial investment . This saturation point has been reached in New Zealand as is apparent by our higher than average OECD health indicators (eg. average life expectancy, infant mortality) which is now requiring a relatively high percentage of our GDP to maintain at current levels. Though there is no ad hoc ideal amount to say how much a HIC must spend, there is a critical level when issues of long term fiscal sustainability become apparent. The recent economic downturn showed how susceptible we are to