Does environmental quality influence health expenditures? empirical evidence from a panel of selected OECD countries

In this paper we examine the role of environmental quality in determining per capita health expenditures. We take a panel cointegration approach in order to explore the possibility of estimating both short-run and long-run impacts of environmental quality. Our empirical analysis is based on eight OECD countries, namely Austria, Denmark, Iceland, Ireland, Norway, Spain, Switzerland, and the UK for the period 1980–1999. We find that per capita health expenditure, per capita income, carbon monoxide emissions, sulphur oxide emissions and nitrogen oxide emissions are panel cointegrated. While short-run elasticities reveal that income and carbon monoxide emissions exert a statistically significant positive effect on health expenditures, in the long-run in addition to income and carbon monoxide, we find that sulphur oxide emissions have a statistically significant positive impact on health expenditures.

Examining structural breaks and growth rates in international health expenditures

Over the last decade, there has been a growing interest in examining health expenditures. In this paper, we study the behaviour of health expenditures in the G3 countries (USA, the UK, and Japan) and three European countries (the UK, Switzerland and Spain) over the period 1960–2000 from a different perspective, in that we examine: (1) whether there is a common structural break in health expenditures across the G3 and European countries; (2) whether structural breaks have slowed down health expenditure growth rates in these countries or vice versa. Our main findings are that: (1) health expenditures share a common break in both bivariate and trivariate cases, and structural breaks and break intervals suggest that either one or a combination of events (second oil price shock, the 1987 stock market crash and/or recessions) have contributed to the commonality of break in health expenditures in the G3, while the oil price shocks have been instrumental in the commonality of breaks for the European countries; (2) except for the UK, structural breaks have slowed down growth rates in health expenditures for the USA, Japan, Switzerland and Spain.

Are health expenditures and GDP characterized by asymmetric behaviour? Evidence from 11 OECD countries

In this article, we examine whether per-capita health expenditures and per-capita GDP for 11 OECD countries can be characterized by asymmetric behaviour. We achieve this goal by using the nonparametric Triples test suggested by Randles et al. (1980). We examine two forms of asymmetries, namely deepness and steepness. Our main finding is that for 6 out of 11 countries, namely for the USA, the UK, Japan, Spain, Finland and Iceland, either per-capita health expenditures or per-capita GDP are characterized by asymmetric behaviour. This finding to some extent casts doubt on those studies that model the relationship between health and GDP using unit-root and cointegration tests that assume symmetric disturbances.

A nonlinear approach to testing the unit root null hypothesis : an application to international health expenditures

In this article, we examine the unit root null hypothesis for per capita total Health Expenditures (HEs), per capita private HEs and per capita public HEs for 29 Organization for Economic Co-operation and Development (OECD) countries. The novelty of our work is that we use a new nonlinear unit root test that allows for one structural break in the data series. We find that for around 45% of the countries, we are able to reject the unit root hypothesis for each of the three HE series. Moreover, using Monte Carlo simulations, we show that our proposed unit root model has better size and power properties than the widely used Augmented Dickey–Fuller (ADF) and Lagrange Multiplier (LM) type tests.

Health system costs of diseases and injury in Australia 1993-94 : an analysis of costs, service use and mortality for major disease and injury groups

Provides a systematic analysis of the health system use and costs associated with specific disease and injury groups in Australia in 1993-94. The estimates are presented in a consistent format and are derived using a methodology that ensures the results add across disease, age and sex groups to total Australian health expenditures for 1993-94.

Mental health care system optimization from a health-economics perspective: where to sow and where to reap?

Health care expenditure (as % of GDP) has been rising in all OECD countries over the last decades. Now, in the context of the economic downturn, there is an even more pressing need to better guarantee the sustainability of health care systems. This requires that policy makers are informed about optimal allocation of budgets. We take the Dutch mental health system in the primary care setting as an example of new ways to approach optimal allocation.

An investigation of the behaviour of Australia's business cycle

In this paper we examine the relative importance of permanent and transitory shocks in explaining variations in income, consumption and investment at business cycle horizons for Australia. We use the common trend–common cycle restrictions to estimate a variance decomposition of shocks, and find that over short horizons the bulk of the variations in income and investment are due to permanent shocks, while transitory shocks explain the bulk of the variations in consumption. The former finding is consistent with real business cycle models which attribute business cycles to aggregate supply shocks, while the findings for consumption are consistent with the Keynesian view, which attributes business cycles to aggregate demand shocks.

Do institutions, inequality and cultural differences affect cadaveric versus live-kidney harvesting

This paper empirically investigates the role of institutions, income inequality,  cultural differences and health expenditures on cadaveric versus total kidney  transplants scrutinizing information gathered from 63 countries over the period  1998-2002. We show that improvements in income equality and the rule of law encourage cadaveric kidney transplants in low-income countries. We find that cultural differences affect the number of cadaveric kidney transplants both in low- and high-income countries.

The contribution of workplace characteristics to the risk of Type 2 Diabetes

Diabetes has a significant economic impact on individuals, families, health systems, and countries [1]. In 2010 it was estimated that the global health expenditure on diabetes was US376 billion (€292 billion), equating to 12% of health expenditure and US1330 (€1031) per person [2]. A separate estimate in 2010 reported that diabetes cost the US US174 billion (€135 billion), with US58 billion (€45 billion) in indirect costs equating to over US2000 (€1551) on average per person with diabetes [3]. The World Health Organization estimates that between 2005 and 2030 the proportion of deaths caused by diabetes will double and global health expenditures associated with diabetes are expected to reach US490 billion (€380 billion) [1,2]. In 2003, it was estimated that diabetes cost Australia AUS6 billion (US6 billion, €5 billion), with AUS21 million (US22 million, €17 million) in indirect costs such as lost workdays and lost productivity equating to approximately AUS35 (US35, €28) per person with diabetes [4].

A behavioural therapy approach to self-management: the Flinders Program

Chronic diseases, including diabetes, represent the most prevalent problem in healthcare today. They are the most common cause of disability and consume the largest part of health expenditures internationally. Most diabetes care is provided by people with diabetes and their family or supporters. Therefore, understanding how to enhance diabetes self-management is of primary importance in addressing this growing burden. The effective self-management of type 2 diabetes is closely linked to environmental factors and a person’s lifestyle. In this article, the authors describe the Flinders Chronic Condition Self-Management Program, which highlights the person’s perspective, and provide an example of its practical application in an Aboriginal population in South Australia.

The role of dietary choices and medical expenditures on health outcomes when health shocks are endogenous

This paper presents a theoretical framework that incorporates both a role for preventive actions (through food choices) and treatment (through medical services) to improve health outcomes. In particular, we allow for an agent's calorie decision to alter the distribution of future health shocks. Once a shock is realized, medical care can be used to improve health outcomes. Thus this model can help us determine the role of the preventive actions and treatments in producing better health outcomes and study the links between an agent's choice of medical services and her diet. This framework suggests that wealthier individuals, on average, have lower morbidity rates and lead a healthier lifestyle than lower income agents. Finally, our numerical exercise captures U.S. cross-sectional facts regarding the choice of diet, medical expenditures as well as health and non-food expenditures.

Primary health-care costs associated with special health care needs up to age 7 years: Australian population-based study.

We studied infants and children with and without special health care needs (SHCN) during the first 8 years of life to compare the (i) types and costs to the government's Medicare system of non-hospital health-care services and prescription medication in each year and (ii) cumulative costs according to persistence of SHCN.

Addressing migration-related social and health inequalities in Australia: call for research funding priorities to recognise the needs of migrant populations

Objective Migrants constitute 26% of the total Australian population and, although disproportionately affected by chronic diseases, they are under-represented in health research. The aim of the present study was to describe trends in Australian Research Council (ARC)- and National Health and Medical Research Council (NHMRC)-funded initiatives from 2002 to 2011 with a key focus on migration-related research funding.Methods Data on all NHMRC- and ARC-funded initiatives between 2002 and 2011 were collected from the research funding statistics and national competitive grants program data systems, respectively. The research funding expenditures within these two schemes were categorised into two major groups: (1) people focused (migrant-related and mainstream-related); and (2) basic science focused. Descriptive statistics were used to summarise the data and report the trends in NHMRC and ARC funding over the 10-year period.Results Over 10 years, the ARC funded 15 354 initiatives worth A$5.5 billion, with 897 (5.8%) people-focused projects funded, worth A$254.4 million. Migrant-related research constituted 7.8% of all people-focused research. The NHMRC funded 12 399 initiatives worth A$5.6 billion, with 447 (3.6%) people-focused projects funded, worth A$207.2 million. Migrant-related research accounted for 6.2% of all people-focused initiatives.Conclusions Although migrant groups are disproportionately affected by social and health inequalities, the findings of the present study show that migrant-related research is inadequately funded compared with mainstream-related research. Unless equitable research funding is achieved, it will be impossible to build a strong evidence base for planning effective measures to reduce these inequalities among migrants.What is known about the topic? Immigration is on the rise in most developing countries, including Australia, and most migrants come from low- and middle-income countries. In Australia, migrants constitute 26% of the total Australian population and include refugee and asylum seeker population groups. Migrants are disproportionately affected by disease, yet they have been found to be under-represented in health research and public health interventions.What does this paper add? This paper highlights the disproportions in research funding for research among migrants. Despite migrants being disproportionately affected by disease burden, research into their health conditions and risk factors is grossly underfunded compared with the mainstream population.What are the implications for practitioners? Migrants represent a significant proportion of the Australian population and hence are capable of incurring high costs to the Australian health system. There are two major implications for practitioners. First, the migrant population is constantly growing, therefore integrating the needs of migrants into the development of health policy is important in ensuring equity across health service delivery and utilisation in Australia. Second, the health needs of migrants will only be uncovered when a clear picture of their true health status and other determinants of health, such as psychological, economic, social and cultural, are identified through empirical research studies. Unless equitable research funding is achieved, it will be impossible to build a strong evidence base for planning effective measures to reduce health and social inequalities among migrant communities.