The effect of health financing systems on health system outcomes: A cross-country panel analysis

Jacopo Gabani; Sumit Mazumdar; Marc Suhrcke

doi:10.1002/hec.4635

The effect of health financing systems on health system outcomes: A cross-country panel analysis

Jacopo Gabani, Sumit Mazumdar, Marc Suhrcke

Health & Health Systems

Research output: Contribution to journal › Article › peer-review

Abstract

Abstract Several low- and middle-income countries are considering health financing system reforms to accelerate progress toward universal health coverage (UHC). However, empirical evidence of the effect of health financing systems on health system outcomes is scarce, partly because it is difficult to quantitatively capture the ?health financing system?. We assign country-year observations to one of three health financing systems (i.e., predominantly out-of-pocket, social health insurance (SHI) or government-financed), using clustering based on out-of-pocket, contributory SHI and non-contributory government expenditure, as a percentage of total health expenditures. We then estimate the effect of these different systems on health system outcomes, using fixed effects regressions. We find that transitions from OOP-dominant to government-financed systems improved most outcomes more than did transitions to SHI systems. Transitions to government financing increases life expectancy (+1.3 years, p

Original language	English
Pages (from-to)	574-619
Number of pages	46
Journal	Health Economics
Volume	32
Issue number	3
Early online date	9 Nov 2022
DOIs	https://doi.org/10.1002/hec.4635
Publication status	Published - Mar 2023

Bibliographical note

Funding Information:
We would like to thank Dr. Rodrigo Moreno‐Serra for thoughtful comments, participants and especially discussants at the Health Economics Study Group meeting 2020, the IHEA conference 2021, the World Bank Health Financing Global Solutions Group seminar in October 2021, and the Centre for Health Economics seminar in February 2021. Jacopo Gabani receives funding via the Alan Maynard PhD scholarship from the University of York, Centre for Health Economics. The funder had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Publisher Copyright:
© 2022 The Authors. Health Economics published by John Wiley & Sons Ltd.

Keywords

health expenditure
health financing
health system
social health insurance
universal health coverage

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10.1002/hec.4635

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abstract = "Abstract Several low- and middle-income countries are considering health financing system reforms to accelerate progress toward universal health coverage (UHC). However, empirical evidence of the effect of health financing systems on health system outcomes is scarce, partly because it is difficult to quantitatively capture the ?health financing system?. We assign country-year observations to one of three health financing systems (i.e., predominantly out-of-pocket, social health insurance (SHI) or government-financed), using clustering based on out-of-pocket, contributory SHI and non-contributory government expenditure, as a percentage of total health expenditures. We then estimate the effect of these different systems on health system outcomes, using fixed effects regressions. We find that transitions from OOP-dominant to government-financed systems improved most outcomes more than did transitions to SHI systems. Transitions to government financing increases life expectancy (+1.3 years, p ",

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The effect of health financing systems on health system outcomes: A cross-country panel analysis

Abstract

Bibliographical note

Keywords

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