Analyzing whether countries are equally efficient at improving longevity for men and women

Abstract

Objectives: We examined the efficiency of country-specific health care spending in improving life expectancies for men and women.

Methods: We estimated efficiencies of health care spending for 27 Organisation for Economic Co-operation and Development (OECD) countries during the period 1991 to 2007 using multivariable regression models, including country fixed-effects and controlling for time-varying levels of national social expenditures, economic development, and health behaviors.

Results: Findings indicated robust differences in health-spending efficiency. A 1% annual increase in health expenditures was associated with percent changes in life expectancy ranging from 0.020 in the United States (95% confidence interval [CI] = 0.008, 0.032) to 0.121 in Germany (95% CI = 0.099, 0.143). Health-spending increases were associated with greater life expectancy improvements for men than for women in nearly every OECD country.

Conclusions: This is the first study to our knowledge to estimate the effect of country-specific health expenditures on life expectancies of men and women. Future work understanding the determinants of these differences has the potential to improve the overall efficiency and equity of national health systems.

FIGURE 1—

Months of life expectancy gained at birth from 1% increase in total health expenditures per capita: 1991–2007. Note. Whiskers indicate 95% confidence intervals. Estimates represent average change associated with a 1% increase in total health expenditures per capita each year for 1991–2007. Figures calculated using country-specific coefficients on total health expenditures and the mean figures for total health expenditure and life expectancy. Organisation for Economic Co-operation and Development (OECD) figure calculated using the OECD-wide coefficient, and the international means for health expenditures and life expectancy.

FIGURE 2—

Months of life expectancy gained at birth from $100 increase in total health expenditures per capita: 1991–2007. Note. Whiskers indicate 95% confidence intervals. Estimates represent average change associated with a $100 increase in total health expenditures per capita each year for 1991–2007. Figures calculated using country specific coefficients on total health expenditures and the mean figures for total health expenditure and life expectancy. Organisation for Economic Co-operation and Development (OECD) figure calculated using the OECD-wide coefficient, and the international means for health expenditures and life expectancy.