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The European Journal of Health Economics
Published in: The European Journal of Health Economics 1/2012

01-02-2012 | Original Paper

Decomposing the determinants of health care expenditure: the case of Spain

Authors: David Cantarero Prieto, Santiago Lago-Peñas

Published in: The European Journal of Health Economics | Issue 1/2012

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Abstract

The aim of this paper is to analyze the determinants of regional health-care expenditure in Spain. The coexistence of several models concerning the degree of spending power decentralization and financing systems makes Spain a singular case. It also allows us to draw conclusions relevant to other countries in decentralizing their health-care systems, and to understand cross-country differences with estimated parameters. Using data from the Spanish regions for the period 1992–2005, we show that the estimated health public expenditure income elasticity does change depending on the omission of relevant variables, econometric specifications and techniques, and institutional arrangements. Moreover, while demographic structure is a very relevant factor when explaining health-care expenditure dynamics, multicollinearity biases econometric parameter estimates.
Footnotes
1
The Arellano-Bond dynamic panel estimator (xtabond) [1] was also used as an alternative in preliminary estimates, including two lags of the dependent variable in the model in order to reject the null hypothesis of no second-order serial correlation in the residuals. Basic results were the same.
 
2
Results hold when only one interaction was included in the econometric specification.
 
Literature
1.
Arellano, M., Bond, S.: Some tests of specification for panel data: Monte carlo evidence and an application to employment equations. Rev. Econ. Stud. 58, 277–297 (1991)CrossRef
2.
Ariste, R., Car, J.: Nouvelles considerations sur l′etude des determinants des dépenses de santé des gouvernements provinciaux au Canada: 1966–1998, Health Canada Applied Research and Analisis Directorate. (2001)
3.
4.
Bac, C., Le Pen, Y.: An international comparison of health expenditure determinants, 10th International Conferences on Panel Data, Berlin, July 5–6. (2002)
5.
Baltagi, B.H., Wu, P.X.: Unequally spaced panel data regression with AR(1) disturbances. Econ. Theory 15, 814–823 (1999)CrossRef
6.
Beck, N., Katz, J.N.: What to do (and not to do) with time-series cross-section data. Am. Polit. Sci. Rev. 89, 634–647 (1995)CrossRef
7.
Bhargava, A., Franzini, L., Narendranathan, W.: Serial correlation and the fixed effects model. Rev. Econ. Stud. 49, 533–549 (1982)CrossRef
8.
Blomqvist, A.G., Carter, R.A.L.: Is health care really a luxury? J. Health Econ. 16, 207–229 (1997)PubMedCrossRef
9.
Cantarero, D.: Decentralization and health care expenditure: the spanish case. Appl. Econ. Lett 12(15), 963–966 (2005)CrossRef
10.
Carrion-i-Silvestre, J.L.: Health care expenditure and GDP: are they broken stationary? J. Health. Econ. 24, 839–853 (2005)PubMedCrossRef
11.
Costa-Font, J., Pons-Novell, J.: Public health expenditure and spatial interactions in a decentralized national health system. Health Econ. 16, 291–306 (2007)PubMedCrossRef
12.
Costa-Font, J., Moscone, F.: The impact of decentralization and inter-territorial interactions on Spanish health expenditure. Empir. Econ. 34, 167–184 (2008)CrossRef
13.
Costa-Font, J., Gemmill, M., Rubert, G.: Re-visiting the health care luxury good hypothesis: Aggregation, precision and publication biases?. Health Econometrics and Data Group Working Paper 09/02, University of York. (2009)
14.
Crivelli, L., Filippini, M., Mosca, I.: Federalism and regional health care expenditures: an empirical analysis for the Swiss cantons. Health Econ. 10(1), 20–26 (2005)
15.
Devlin, N., Hansen, P.: Health care spending and economic outpt: granger causality. Appl. Econ. Lett. 8, 561–564 (2001)CrossRef
16.
Di Matteo, L., Di Matteo, R.: Evidence on the determinants of Canadian provincial government health expenditures: 1965–1991. J. Health Econ. 17, 211–228 (1998)PubMedCrossRef
17.
Di Matteo, L.: The income elasticity of health care spending a comparison of parametric and nonparametric approaches. Eur. J. Health Econ. 4, 20–29 (2003)PubMedCrossRef
18.
Di Matteo, L.: The macro determinants of health expenditure in the United States and Canada: assessing the impact of income, age distribution and time. Health Policy 71, 23–42 (2005)PubMedCrossRef
19.
Freeman, D.G.: Is health care a necessity or a luxury? Pooled estimates of income elasticity from US state-level data. Appl. Econ. 35, 495–502 (2003)CrossRef
20.
Giannoni, M., Hitiris, T.: The regional impact of health care expenditure: the case of Italy. Appl. Econ. 34(14), 1829–1836 (2002)CrossRef
21.
Hitiris, T.: Health care expenditure and integration in the countries of the European Union. Appl. Econ. 29, 1–6 (1997)CrossRef
22.
Hitiris, T., Nixon, J.: Convergence of health care expenditure in the EU countries. Appl. Econ. Lett. 8, 223–228 (2001)CrossRef
23.
Hitiris, T., Posnett, J.: The determinants and effects of health expenditure in developed countries. J. Health Econ. 11, 173–181 (1992)PubMedCrossRef
24.
Kleiman, E.: The determinants of national outlay on health. Macmillan, London (1974)
25.
López-i-Casasnovas, G., Saez, M.: A multilevel analysis on the determinants of regional health care expenditure. A note. Eur. J. Health Econ. 8, 59–65 (2007)CrossRef
26.
Newhouse, J.: Medical care expenditure: a cross national survey. J. Hum. Resour. 12, 115–125 (1977)PubMedCrossRef
27.
Newhouse, J.: Medical care costs: how much welfare loss? J. Econ. Perspect. 6, 3–21 (1992)PubMed
28.
Plumpër, T., Troger, V.:The Estimation of Time-Invariant Variables in Panel Analyses with Unit Fixed Effects. University of Konstanz and Max-Planck-Institute for Research into Economic Systems. (2004a)
29.
Plumpër, T., Troger, V.:Efficient Estimation of Rarely Changing Variables in Fixed Effects Models. University of Konstanz and Max-Planck-Institute for Research into Economic Systems. (2004b)
30.
Sen, A.: Is health care a luxury? new evidence from OECD Data. Int. J. Health Care Finance Econ. 5, 147–164 (2005)PubMedCrossRef
31.
Vatter, A., Ruefli, C.: Do political factors matter for health care expenditure? A comparative study of Swiss cantons. J. Public Policy 23(3), 301–323 (2003)CrossRef
Metadata
Title
Decomposing the determinants of health care expenditure: the case of Spain
Authors
David Cantarero Prieto
Santiago Lago-Peñas
Publication date
01-02-2012
Publisher
Springer-Verlag
Published in
The European Journal of Health Economics / Issue 1/2012
Print ISSN: 1618-7598
Electronic ISSN: 1618-7601
DOI
https://doi.org/10.1007/s10198-010-0276-9

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