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Published in: Cost Effectiveness and Resource Allocation 1/2018

Open Access 01-12-2018 | Research

Global health worker salary estimates: an econometric analysis of global earnings data

Authors: Juliana Serje, Melanie Y. Bertram, Callum Brindley, Jeremy A. Lauer

Published in: Cost Effectiveness and Resource Allocation | Issue 1/2018

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Abstract

Background

Human resources are consistently cited as a leading contributor to health care costs; however the availability of internationally comparable data on health worker earnings for all countries is a challenge for estimating the costs of health care services. This paper describes an econometric model using cross sectional earnings data from the International Labour Organization (ILO) that the World Health Organizations (WHO)-Choosing Interventions that are Cost-effective programme (CHOICE) has used to prepare estimates of health worker earnings (in 2010 USD) for all WHO member states.

Methods

The ILO data contained 324 observations of earnings data across 4 skill levels for 193 countries. Using this data, along with the assumption that data were missing not at random, we used a Heckman two stage selection model to estimate earning data for each of the 4 skill levels for all WHO member states.

Results

It was possible to develop a prediction model for health worker earnings for all countries for which GDP data was available. Health worker earnings vary both within country due to skill level, as well as across countries. As a multiple of GDP per capita, earnings show a negative correlation with GDP—that is lower income countries pay their health workers relatively more than higher income countries.

Conclusions

Limited data on health worker earnings is a limiting factor in estimating the costs of global health programmes. It is hoped that these estimates will support robust health care intervention costings and projections of resources needs over the Sustainable Development Goal period.
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Literature
1.
go back to reference Nations U. Sustainable development knowledge platform. New Orleans: Nations U; 2016. Nations U. Sustainable development knowledge platform. New Orleans: Nations U; 2016.
2.
go back to reference Jakovljevic M, Potapchik E, Popovich L, Barik D, Getzen TE. Evolving health expenditure landscape of the BRICS nations and projections to 2025. Health Econ. 2017;26:844–52.CrossRefPubMed Jakovljevic M, Potapchik E, Popovich L, Barik D, Getzen TE. Evolving health expenditure landscape of the BRICS nations and projections to 2025. Health Econ. 2017;26:844–52.CrossRefPubMed
3.
go back to reference Cometto G, Scheffler R, Liu J, Maeda A, Tomblin-Murphy G, Hunter D, Campbell J. Health workforce needs, demand and shortages to 2030: an overview of forecasted trends in the global health labour market. In: DI Buchan J, Campbell J, editors. Health employment and economic growth: an evidence base. Geneva: World Health Organization; 2017. Cometto G, Scheffler R, Liu J, Maeda A, Tomblin-Murphy G, Hunter D, Campbell J. Health workforce needs, demand and shortages to 2030: an overview of forecasted trends in the global health labour market. In: DI Buchan J, Campbell J, editors. Health employment and economic growth: an evidence base. Geneva: World Health Organization; 2017.
4.
go back to reference Santric-Milicevic M, Vasic V, Terzic-Supic Z. Do health care workforce, population, and service provision significantly contribute to the total health expenditure? An econometric analysis of Serbia. Hum Resour Health. 2016;14:50.CrossRefPubMedPubMedCentral Santric-Milicevic M, Vasic V, Terzic-Supic Z. Do health care workforce, population, and service provision significantly contribute to the total health expenditure? An econometric analysis of Serbia. Hum Resour Health. 2016;14:50.CrossRefPubMedPubMedCentral
5.
go back to reference World Health Organization. Global health expenditure database. Geneva: World Health Organization; 2014. World Health Organization. Global health expenditure database. Geneva: World Health Organization; 2014.
6.
go back to reference Lauer J, Soucat A, Araujo E, Bertram MY, Edejer T, Brindley C, Dale E, Tan A. Paying for needed health workers for the SDGs: An analysis of fiscal and financial space. In: Buchan J, Dillon I, Campbell J, editors. Health employment and economic growth: an evidence base. Geneva: World Health Organization; 2017. Lauer J, Soucat A, Araujo E, Bertram MY, Edejer T, Brindley C, Dale E, Tan A. Paying for needed health workers for the SDGs: An analysis of fiscal and financial space. In: Buchan J, Dillon I, Campbell J, editors. Health employment and economic growth: an evidence base. Geneva: World Health Organization; 2017.
7.
go back to reference Hernandez-Pena P, Drager S, Evans DB, Tan-Torres Edejer T, Dal Poz MR. Measuring expenditure for the health workforce:evidence and challenges. In: Organization WH, editor. Background Paper for the World Health Report 2006. Geneva: World Health Organization; 2006. Hernandez-Pena P, Drager S, Evans DB, Tan-Torres Edejer T, Dal Poz MR. Measuring expenditure for the health workforce:evidence and challenges. In: Organization WH, editor. Background Paper for the World Health Report 2006. Geneva: World Health Organization; 2006.
8.
go back to reference Hernandez-Peña P, Poullier JP, Van Mosseveld CJ, Van de Maele N, Cherilova V, Indikadahena C, Lie G, Tan-Torres T, Evans DB. Health worker remuneration in WHO Member States. Bull World Health Organ. 2013;91:808–15.CrossRefPubMedPubMedCentral Hernandez-Peña P, Poullier JP, Van Mosseveld CJ, Van de Maele N, Cherilova V, Indikadahena C, Lie G, Tan-Torres T, Evans DB. Health worker remuneration in WHO Member States. Bull World Health Organ. 2013;91:808–15.CrossRefPubMedPubMedCentral
9.
go back to reference van Doorslaer E, Wagstaff A, Bleichrodt H, Calonge S, Gerdtham UG, Gerfin M, Geurts J, Gross L, Hakkinen U, Leu RE, et al. Income-related inequalities in health: some international comparisons. J Health Econ. 1997;16:93–112.CrossRefPubMed van Doorslaer E, Wagstaff A, Bleichrodt H, Calonge S, Gerdtham UG, Gerfin M, Geurts J, Gross L, Hakkinen U, Leu RE, et al. Income-related inequalities in health: some international comparisons. J Health Econ. 1997;16:93–112.CrossRefPubMed
10.
go back to reference Jakovljevic M, Groot W, Souliotis K. Editorial: health care financing and affordability in the emerging global markets. Front Public Health. 2016;4:2.PubMedPubMedCentral Jakovljevic M, Groot W, Souliotis K. Editorial: health care financing and affordability in the emerging global markets. Front Public Health. 2016;4:2.PubMedPubMedCentral
11.
go back to reference Johns B, Baltussen R, Hutubessy R. Programme costs in the economic evaluation of health interventions. Cost Effectiveness Resour Alloc. 2003;1:1.CrossRef Johns B, Baltussen R, Hutubessy R. Programme costs in the economic evaluation of health interventions. Cost Effectiveness Resour Alloc. 2003;1:1.CrossRef
12.
13.
go back to reference International Labour Organization. International standard classification of occupations (ISCO-08). Geneva: Organization IL; 2012. International Labour Organization. International standard classification of occupations (ISCO-08). Geneva: Organization IL; 2012.
14.
go back to reference Vujicic M, Zurn P, Diallo K, Adams O, Poz MRD. The role of wages in the migration of health care professionals from developing countries. Hum Resour Health. 2004;2:3.CrossRefPubMedPubMedCentral Vujicic M, Zurn P, Diallo K, Adams O, Poz MRD. The role of wages in the migration of health care professionals from developing countries. Hum Resour Health. 2004;2:3.CrossRefPubMedPubMedCentral
16.
go back to reference Schafer JL, John W. Graham: missing data: our view of the state of the art. Psychol Methods. 2002;7(2):2147–77.CrossRef Schafer JL, John W. Graham: missing data: our view of the state of the art. Psychol Methods. 2002;7(2):2147–77.CrossRef
17.
go back to reference Allison PD. Multiple imputation for missing data. Sociol Methods Res. 2016;23:301–9. Allison PD. Multiple imputation for missing data. Sociol Methods Res. 2016;23:301–9.
18.
19.
go back to reference Heckman JJ. Sample selection bias as a specification error. Econometrica. 1979;47:153–61.CrossRef Heckman JJ. Sample selection bias as a specification error. Econometrica. 1979;47:153–61.CrossRef
20.
go back to reference Amemiya T. Censored or truncated regression models. J Econ. 1984;24:1–62.CrossRef Amemiya T. Censored or truncated regression models. J Econ. 1984;24:1–62.CrossRef
21.
go back to reference Humphreys B. Dealing with zeros in economic data. Edmonton: University of Alberta DoE; 2013. Humphreys B. Dealing with zeros in economic data. Edmonton: University of Alberta DoE; 2013.
22.
go back to reference Puhani P, UoSG SIAW. The Heckman correction for sample selection and its critique. J Econ Surv. 2017;14:53–68.CrossRef Puhani P, UoSG SIAW. The Heckman correction for sample selection and its critique. J Econ Surv. 2017;14:53–68.CrossRef
23.
go back to reference Jarque CM, Bera AK. Efficient tests for normality, homoscedasticity and serial independence of regression residuals. Econ Lett. 1980;6:255–9.CrossRef Jarque CM, Bera AK. Efficient tests for normality, homoscedasticity and serial independence of regression residuals. Econ Lett. 1980;6:255–9.CrossRef
24.
go back to reference Mills JP. Table of the ratio: area to bounding ordinate, for any portion of normal curve. Biometrika. 1926;18:395–400.CrossRef Mills JP. Table of the ratio: area to bounding ordinate, for any portion of normal curve. Biometrika. 1926;18:395–400.CrossRef
25.
go back to reference White H. Maximum likelihood estimation of misspecified models. Econometrica. 1982;50:1–25.CrossRef White H. Maximum likelihood estimation of misspecified models. Econometrica. 1982;50:1–25.CrossRef
26.
go back to reference van Mosseveld C, Hernández-Peña P, Arán D, Cherilova V, Mataria A. How to ensure quality of health accounts. Health Policy. 2016;120:544–51.CrossRefPubMed van Mosseveld C, Hernández-Peña P, Arán D, Cherilova V, Mataria A. How to ensure quality of health accounts. Health Policy. 2016;120:544–51.CrossRefPubMed
27.
go back to reference World Health Organization. A system of health accounts. 2011th ed. Geneva: World Health Organization; 2014. World Health Organization. A system of health accounts. 2011th ed. Geneva: World Health Organization; 2014.
28.
go back to reference Jakovljevic M, Yamada T. Editorial: role of Health Economic Data in policy making and reimbursement of new medical technologies. Front Pharmacol. 2017;8:662.CrossRefPubMedPubMedCentral Jakovljevic M, Yamada T. Editorial: role of Health Economic Data in policy making and reimbursement of new medical technologies. Front Pharmacol. 2017;8:662.CrossRefPubMedPubMedCentral
29.
30.
go back to reference McCoy D, Bennett S, Witter S, Pond B, Baker B, Gow J, Chand S, Ensor T, McPake B. Salaries and incomes of health workers in sub-Saharan Africa. Lancet. 2008;371:675–81.CrossRefPubMed McCoy D, Bennett S, Witter S, Pond B, Baker B, Gow J, Chand S, Ensor T, McPake B. Salaries and incomes of health workers in sub-Saharan Africa. Lancet. 2008;371:675–81.CrossRefPubMed
Metadata
Title
Global health worker salary estimates: an econometric analysis of global earnings data
Authors
Juliana Serje
Melanie Y. Bertram
Callum Brindley
Jeremy A. Lauer
Publication date
01-12-2018
Publisher
BioMed Central
Published in
Cost Effectiveness and Resource Allocation / Issue 1/2018
Electronic ISSN: 1478-7547
DOI
https://doi.org/10.1186/s12962-018-0093-z

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