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. 2018 Nov 22;14(1):113.
doi: 10.1186/s12992-018-0430-1.

Health care expenditure and health outcome nexus: new evidence from the SAARC-ASEAN region

Mohammad Mafizur Rahman  1 , Rasheda Khanam  2 , Maisha Rahman  3
Affiliations

Health care expenditure and health outcome nexus: new evidence from the SAARC-ASEAN region

Mohammad Mafizur Rahman et al. Global Health. .

Abstract

Background: The total health expenditure (as a percentage of GDP) and health outcomes in the region of South Asian Association for Regional Cooperation (SAARC) and Association for South East Asian Nations (ASEAN) are lower than that of the OECD region and the world. This study investigated the relationship between different types of healthcare expenditures (public, private and total) and three main health status outcomes - life expectancy at birth, crude death rate and infant mortality rate - in the region.

Methodology: Using the World Bank data set for 15 countries over a 20-year period (1995-2014), a panel data analysis was conducted where relevant fixed and random effect models were estimated to determine the effects of healthcare expenditure on health outcomes. The main variables studied were total health expenditure, public health expenditure, private health expenditure, GDP per capita, improved sanitation, life expectancy at birth, crude death rate and infant mortality rate.

Results: Total health expenditure, public health expenditure and private health expenditure significantly reduced infant mortality rates, and, the extent of effect of private health expenditure was greater than that of public health expenditure. Private health expenditure also had a significant role in reducing the crude death rate. Per capita income growth and improved sanitation facilities also had significant positive roles in improving population health in the region.

Conclusions: Health expenditure in the SAARC-ASEAN region should be increased as our results indicated that it improved the health status of the population in the region. Public sector health funds must be appropriately and efficiently used, and accountability and transparency regarding spending of public health funds should be ensured. Finally, government and private institutes should implement appropriate strategies to improve sanitation facilities.

Keywords: ASEAN; Health status outcomes; Healthcare expenditure; Panel data; SAARC.

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Competing interests

The authors declare that they have no competing interest.

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Figures

Fig. 1
Fig. 1
Health status outcomes for selected regions (selected years). Source: Word Development Indicators, World Bank, 2016
See this image and copyright information in PMC

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