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fbtwitterlinkedinvimeoflicker grey 14rssslideshare1
Kanavos, Panagiotis Grigoriou
Languages: English
Types: Doctoral thesis
Health\ud care\ud now\ud accounts\ud for\ud just\ud under\ud 10%\ud of\ud national\ud income\ud in\ud most\ud developed\ud OEeD\ud countries.\ud Yet,\ud despite\ud its\ud importance\ud in\ud the\ud overall\ud economy,\ud the\ud factors\ud that\ud drive\ud health\ud care\ud expenditure\ud remain\ud only\ud imperfectly\ud understood.\ud This\ud thesis\ud shows\ud that\ud the\ud determinants\ud of\ud health\ud care\ud expenditures\ud are\ud simply\ud too\ud diverse\ud amongst\ud different\ud countries\ud to\ud be\ud brought\ud within\ud a\ud common\ud denominator\ud such\ud as\ud GDP,\ud as\ud it\ud has\ud been\ud argued\ud for\ud decades.\ud It\ud also\ud shows\ud that\ud the\ud assumption\ud that\ud health\ud care\ud is\ud a\ud homogeneous\ud good\ud across\ud countries\ud is\ud over-simplistic\ud and\ud arbitrary,\ud and\ud finds\ud ample\ud evidence\ud showing\ud that\ud health\ud care\ud is\ud not\ud a\ud luxury\ud good,\ud as\ud widely\ud suggested.\ud The\ud contribution\ud of\ud the\ud thesis\ud is\ud on\ud methodological,\ud theoretical\ud and\ud empirical\ud grounds.\ud In\ud terms\ud of\ud methodology,\ud the\ud thesis\ud shows\ud that\ud there\ud are\ud significant\ud flaws\ud in\ud several\ud areas\ud that\ud influence\ud our\ud thinking\ud concerning\ud the\ud determinants\ud of\ud health\ud care\ud expenditures\ud and\ud offers\ud alternative\ud ways\ud of\ud analysis\ud and\ud appraisal.\ud Flaws\ud were\ud shown\ud in:\ud the\ud relationship\ud between\ud health\ud expenditure\ud and\ud GDP;\ud the\ud importance\ud of\ud factors\ud such\ud as\ud ageing;\ud the\ud macroeconomic\ud context\ud and\ud the\ud burden\ud of\ud disease;\ud the\ud measurement\ud of\ud key\ud variables\ud used\ud in\ud empirical\ud analysis\ud such\ud as\ud health\ud spending,\ud national\ud income,\ud technology,\ud and\ud health\ud prices;\ud the\ud method\ud of\ud analysis\ud that\ud has\ud been\ud pursued;\ud and\ud the\ud conversion\ud factors\ud used\ud to\ud translate\ud prices\ud and\ud monetary\ud variables\ud across\ud countries\ud into\ud a\ud single\ud and\ud comparable\ud denominator.\ud The\ud thesis\ud makes\ud a\ud theoretical\ud contribution\ud of\ud the\ud analysis\ud of\ud health\ud care\ud expenditures,\ud assuming\ud that\ud health\ud care\ud is\ud at\ud least\ud a\ud quasi-public\ud good.\ud The\ud proposed\ud conceptual\ud framework\ud explicitly\ud links\ud the\ud determinants\ud of\ud health\ud care\ud expenditures\ud to\ud the\ud theory\ud of\ud public\ud finance\ud and\ud allows\ud flexible\ud adjustments\ud by\ud decision-makers\ud to\ud account\ud for\ud changes\ud in\ud technology,\ud prices,\ud and\ud the\ud macroeconomic\ud environment.\ud The\ud impact\ud of\ud the\ud macroeconomy\ud on\ud health\ud spending\ud is\ud assessed\ud by\ud evaluating\ud whether\ud the\ud rate\ud of\ud growth\ud of\ud income\ud has\ud any\ud influence\ud on\ud the\ud demand\ud for\ud health\ud and\ud whether\ud the\ud fiscal\ud deficit\ud impacts\ud on\ud health\ud spending\ud and\ud to\ud what\ud extent.\ud The\ud proposed\ud framework\ud incorporates\ud technology\ud and\ud this\ud is\ud an\ud advance\ud from\ud the\ud published\ud literature,\ud which\ud has\ud almost\ud invariably\ud considered\ud technology\ud to\ud be\ud a\ud residual\ud factor.\ud Finally,\ud the\ud thesis\ud recognises\ud that\ud the\ud lag\ud structure\ud of\ud the\ud model,\ud the\ud availability\ud of\ud data,\ud and\ud knowledge\ud of\ud the\ud relationship\ud between\ud disease\ud and\ud need\ud for\ud services\ud are\ud not\ud sufficient\ud to\ud test\ud for\ud the\ud impact\ud of\ud lifestyle\ud and\ud disease\ud factors\ud on\ud health\ud spending.\ud The\ud empirical\ud investigation\ud provides\ud conclusive\ud evidence\ud of\ud the\ud non-importance\ud of\ud GOP\ud in\ud explaining\ud health\ud care\ud spending\ud trends\ud over\ud time.\ud Consumption\ud is\ud shown\ud to\ud be\ud a\ud predictor\ud of\ud health\ud expenditures;\ud technology\ud is\ud an\ud important\ud cost-push\ud factor\ud across\ud countries;\ud the\ud macroeconomy\ud exerts,\ud in\ud general,\ud significant\ud pressure\ud on\ud health\ud care\ud expenditure;\ud however,\ud the\ud impact\ud of\ud health\ud care\ud reforms\ud does\ud not\ud show\ud any\ud significant\ud impact\ud on\ud health\ud care\ud expenditures;\ud and\ud the\ud number\ud of\ud doctors\ud per\ud capita\ud has\ud little\ud or\ud no\ud association\ud with\ud health\ud care\ud expenditures.
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