scholarly journals Comparative analysis of indicators that determine the effectiveness of the implementation of socio-economic determinants of health in Europe and Ukraine

Author(s):  
Alla Kotvitska ◽  
Alina Volkova ◽  
Iuliia Korzh ◽  
Iryna Surikova

The introduction of national strategies aimed at improving the well-being of the population of the country is one of the current approaches to reforming the public policies of the countries of the world. It is the socioeconomic determinants of health that determine the conditions in which people are born, grow, live and getting old, as well as the spheres of influence on these conditions, such as public policy, state of economic development, demographic trends, etc. The aim. In this way, our research has focused on a comparative analysis of macroeconomic indicators that determine the effectiveness of socioeconomic determinants of healthсare in Europe and Ukraine, that are used to provide scientific justification for the construction of humanistic models for the provision of pharmaceutical care to the population in the context of the rapid stratification of Ukrainian society according to socioeconomic indicators. Materials and methods. The research methodology is based on the principles of systems analysis and an interdisciplinary scientific and systemic approach. The study used the empirical method, the method of comparative analysis and synthesis of statistical data, the graphical method. Results. A comparative analysis of the socioeconomic determinants of health in the countries of the European region and in Ukraine was carried out on three levels of indicators: the level of health-care expenditure, the structure of health-care expenditure and expenditure on medicines. The analysis revealed that in 2019, the average health expenditure of the countries analyzed was 8.2 % of GDP. Only two of the 34 countries - Ukraine and Turkey - have a rate below the 5 % that recommended by WHO. Public health financing schemes and compulsory health insurance are the main funding mechanisms in all countries, with the exception of Cyprus. Ukraine, Russia, Greece, Latvia and Bulgaria have the largest share of direct costs to patients as a source of health care financing. The results of the analysis of the medicine expenditure indicator as a proportion of total health expenditure showed that the highest level was in Bulgaria (35.4 %), the lowest in Denmark (6.4 %). Overall, five countries have high levels of pharmaceutical expenditures. In most European countries, the cost of purchasing medicines has been found to range from 346 to 619 USD per person per year. The highest value of this indicator from the European region is in Switzerland (894 USD per person), and the lowest is in Ukraine (73 USD). Based on the results of the comparative analysis, the countries were grouped according to key indicators into three categories - high, medium and low. Conclusions. A comparative analysis of key indicators of the socio-economic determinants of health in the country of the European region has been carried out

2008 ◽  
Vol 3 (2) ◽  
pp. 165-195 ◽  
Author(s):  
UNTO HÄKKINEN ◽  
PEKKA MARTIKAINEN ◽  
ANJA NORO ◽  
ELINA NIHTILÄ ◽  
MIKKO PELTOLA

AbstractThis study revisits the debate on the ‘red herring’, i.e. the claim that population aging will not have a significant impact on health care expenditure (HCE), using a Finnish data set. We decompose HCE into several components and include both survivors and deceased individuals into the analyses. We also compare the predictions of health expenditure based on a model that takes into account the proximity to death with the predictions of a naïve model, which includes only age and gender and their interactions. We extend our analysis to include income as an explanatory variable. According to our results, total expenditure on health care and care of elderly people increases with age but the relationship is not as clear as is usually assumed when a naïve model is used in health expenditure projections. Among individuals not in long-term care, we found a clear positive relationship between expenditure and age only for health centre and psychiatric inpatient care. In somatic care and prescribed drugs, the expenditure clearly decreased with age among deceased individuals. Our results emphasize that even in the future, health care expenditure might be driven more by changes in the propensity to move into long-term care and medical technology than age and gender alone, as often claimed in public discussion. We do not find any strong positive associations between income and expenditure for most non-LTC categories of health care utilization. Income was positively related to expenditure on prescribed medicines, in which cost-sharing between the state and the individual is relatively high. Overall, our results indicate that the future expenditure is more likely to be determined by health policy actions than inevitable trends in the demographic composition of the population.


2021 ◽  
Author(s):  
Alfred EBOH ◽  
Steve METIBOBA

Abstract Background: As a way of tackling child mortality, many countries in the world depend on their respective health-care system. But governments of most countries in Africa are yet to provide robust funding of their health-care systems as many people still depend on the out-of-pocket payment to receive health services. Against this backdrop, this study used annual panel data to assess the effect of health-care expenditure and immunisation on the under-five mortality rate in 30 selected African countries for the period 2000-2017. Methods: Multiple regression technique was adopted for the data analysis and the robust fixed regression estimator was preferred to the random effects as determined by Hausman test.Results: The findings indicated that domestic government general health expenditure had a significant negative effect on the under-five mortality rate. However, the effect of domestic private health expenditure on under-five mortality was not significant while external health expenditure had a significant negative effect on under-five mortality rate. The impact of diphtheria immunisation on under-five mortality was significant. Conclusions: Except domestic private health expenditure, government and external forms of health expenditure coupled with diphtheria immunisation were significant factors for the reduction of the under-five mortality in the selected countries.


2019 ◽  
Vol 5 ◽  
pp. 233372141985545 ◽  
Author(s):  
Williams Agyemang-Duah ◽  
Charles Peprah ◽  
Francis Arthur-Holmes

In spite of the growing literature on prevalence and patterns of health care use in later life globally, studies have generally overlooked subjective standpoints of vulnerable Ghanaian older people obstructing the achievement of the United Nations’ health-related Sustainable Development Goals. We examined the prevalence and patterns of health care use among poor older people in the Atwima Nwabiagya District of Ghana. Cross-sectional data were obtained from an Aging, Health, Lifestyle and Health Services Survey conducted between June 1 and 20, 2018 ( N = 200). Chi-square and Fisher’s exact tests were carried out to estimate the differences between gender and health care utilization with significant level of less than or equal to 0.05. Whereas, 85% of the respondents utilized health care, females were higher utilizers (88% vs. 75%) but males significantly incurred higher health care expenditure. The majority utilized health services on monthly basis (38%) and consulted public health care providers (77%). While 68% utilized services from hospitals, most sourced health information from family members (54%) and financed their health care through personal income (45%). The study found that the Livelihood Empowerment Against Poverty grant played a little role in reducing health poverty. Stakeholders should review social programs that target poor older people in order to improve their well-being and utilization of health care.


2019 ◽  
Vol 15 (4) ◽  
pp. 419-439 ◽  
Author(s):  
Martin Hensher ◽  
John Tisdell ◽  
Ben Canny ◽  
Craig Zimitat

AbstractThe strong and positive relationship between gross domestic product (GDP) and health expenditure is one of the most extensively explored topics in health economics. Since the global financial crisis, a variety of theories attempting to explain the slow recovery of the global economy have predicted that future economic growth will be slower than in the past. Others have increasingly questioned whether GDP growth is desirable or sustainable in the long term as evidence grows of humanity's impact on the natural environment. This paper reviews recent data on trends in global GDP growth and health expenditure. It examines a range of theories and scenarios concerning future global GDP growth prospects. It then considers the potential implications for health care systems and health financing policy of these different scenarios. In all cases, a core question concerns whether growth in GDP and/or growth in health expenditure in fact increases human health and well-being. Health care systems in low growth or ‘post-growth’ futures will need to be much more tightly focused on reducing overtreatment and low value care, reducing environmental impact, and on improving technical and allocative efficiency. This will require much more concerted policy and regulatory action to reduce industry rent-seeking behaviours.


2004 ◽  
Vol 5 (3) ◽  
pp. 179-187
Author(s):  
Ermanno Attanasio

Pharmaceutical products are relevant for their contribution to the medicine progress and in health peoples improvement, altough this evidence goes back to the forthy years with the reduction in mortality, morbidity and hospitalisation rates. The ambivalence of drugs, both remedy and poison, needs a careful assessment of risks and benefits. Primitive estimates of health treatments evaluation occurred in the human history but the modern concept of evaluation in health care derived from cost-benefit analysis (welfare economics) and technology assessment. Then a new discipline, pharmacoeconomics and outcomes research, developed with the contribution of health economics, clinical medicine, pharmacology, statistics and epidemiology. Pharmaceutical products are also relevant because of their responsability of health expenditure growth. From 1992, in Italy, several legislative actions were made to face up the pharmaceutical expenditure. The most important one (L. 537/1993) achieved the maximum decrease of 16,8%, in 1994, and modified radically the pharmaceutical policy. Nevertheless, in the following six years the pharmaceutical expenditure grew more than 93%. New actions were made fixing the pharmaceutical expenditure to 13% of health expenditure, any excess being charged to Regions. In the new version for the current year, the excesses will be paid-back by pharmaceutical companies (60%) and Regions (40%). Furtherly, the creation of Agenzia Italiana del Farmaco increases the relevance of cost-effectiveness analyses for drugs reimbursement. However, pharmacoeconomic evaluations have still many methodological problems. Economic variables should be treated in the same manner of biomedical or epidemiological data, that is, by confidence intervals and sample sizes. There would be an “economic significance” besides to clinical and statistical ones. In this way, pharmacoeconomics and outcomes research would be able to add rationality to health care expenditure.


PEDIATRICS ◽  
1978 ◽  
Vol 62 (4) ◽  
pp. 622-622

In developed countries, generally 5% to 8% of GNP is spent on health care; during the past decade, health care expenditure has increased at a more rapid rate than GNP. Expenditure on pharmaceuticals represents 10% to 20% of the total health expenditure. In developing countries, figures vary widely but the pharmaceutical expenditure per capita per year may be below one U.S. dollar and may be as high as 50% of the total health care expenditure....


Author(s):  
Orhan Torul

This study investigates the relationship between health care expenditure and income inequality empirically. Using data from a large panel of countries covering a sizeable period of time, how level and composition of health care expenditures correlate with income inequality is studied via the panel data fixed effects estimation methodology. These estimations yield several robust findings. First, there is a significant positive correlation between income inequality and reliance on private resources for health care financing. Second, there exists a significant negative correlation between health care expenditure per capita and income inequality. Third, there is a significant negative correlation between income inequality and health care expenditure as a share of GDP. Next, this study analyzes a select group of well-established democracies with developed economies to detect if health expenditure and income inequality variables correlate with public beliefs and preferences. Empirical analyses reveal that indeed belief and preferences accord well with policy choices.


2013 ◽  
Vol 23 (8) ◽  
pp. 951-961 ◽  
Author(s):  
Simon Chang ◽  
Yang He ◽  
Chee-Ruey Hsieh

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