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Broader health coverage is good for the nation's health: evidence from country level panel data

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  • Rodrigo Moreno-Serra
  • Peter C. Smith

Abstract

type="main" xml:id="rssa12048-abs-0001"> Progress towards universal health coverage involves providing people with access to needed health services without entailing financial hardship and is often advocated on the grounds that it improves population health. The paper offers econometric evidence on the effects of health coverage on mortality outcomes at the national level. We use a large panel data set of countries, examined by using instrumental variable specifications that explicitly allow for potential reverse causality and unobserved country-specific characteristics. We employ various proxies for the coverage level in a health system. Our results indicate that expanded health coverage, particularly through higher levels of publicly funded health spending, results in lower child and adult mortality, with the beneficial effect on child mortality being larger in poorer countries.

Suggested Citation

  • Rodrigo Moreno-Serra & Peter C. Smith, 2015. "Broader health coverage is good for the nation's health: evidence from country level panel data," Journal of the Royal Statistical Society Series A, Royal Statistical Society, vol. 178(1), pages 101-124, January.
    • Handle: RePEc:bla:jorssa:v:178:y:2015:i:1:p:101-124
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    File URL: http://hdl.handle.net/10.1111/rssa.2014.178.issue-1
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    Cited by:

    1. Ryota Nakamura & James Lomas & Karl Claxton & Farasat Bokhari & Rodrigo Moreno-Serra & Marc Suhrcke & Peter Berman, 2020. "Assessing the Impact of Health Care Expenditures on Mortality Using Cross-Country Data," World Scientific Book Chapters, in: Paul Revill & Marc Suhrcke & Rodrigo Moreno-Serra & Mark Sculpher (ed.), Global Health Economics Shaping Health Policy in Low- and Middle-Income Countries, chapter 1, pages 3-49, World Scientific Publishing Co. Pte. Ltd..
    2. Paul Revill & Simon Walker & Jason Madan & Andrea Ciaranello & Takondwa Mwase & Diana M Gibb & Karl Claxton & Mark J Sculpher, 2014. "Using cost-effectiveness thresholds to determine value for money in low- and middle-income country healthcare systems: Are current international norms fit for purpose?," Working Papers 098cherp, Centre for Health Economics, University of York.
    3. Rieger, Matthias & Wagner, Natascha & Bedi, Arjun S., 2017. "Universal health coverage at the macro level: Synthetic control evidence from Thailand," Social Science & Medicine, Elsevier, vol. 172(C), pages 46-55.
    4. Niek Stadhouders & Xander Koolman & Christel van Dijk & Patrick Jeurissen & Eddy Adang, 2019. "The marginal benefits of healthcare spending in the Netherlands: Estimating cost‐effectiveness thresholds using a translog production function," Health Economics, John Wiley & Sons, Ltd., vol. 28(11), pages 1331-1344, November.
    5. Sean Dougherty & Luca Lorenzoni & Alberto Marino & Fabrice Murtin, 2022. "The impact of decentralisation on the performance of health care systems: a non-linear relationship," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 23(4), pages 705-715, June.
    6. Rieger, M. & Wagner, N. & Bedi, A.S., 2015. "Macroeconomic impacts of Universal Health Coverage : Synthetic control evidence from Thailand," ISS Working Papers - General Series 609, International Institute of Social Studies of Erasmus University Rotterdam (ISS), The Hague.
    7. Barlow, Pepita, 2018. "Does trade liberalization reduce child mortality in low- and middle-income countries? A synthetic control analysis of 36 policy experiments, 1963-2005," LSE Research Online Documents on Economics 102664, London School of Economics and Political Science, LSE Library.
    8. Jessica Ochalek & James Lomas & Karl Claxton, 2015. "Cost per DALY averted thresholds for low- and middle-income countries: evidence from cross country data," Working Papers 122cherp, Centre for Health Economics, University of York.
    9. Jessica Ochalek & Karl Claxton & Paul Revill & Mark Sculpher & Alexandra Rollinger, 2016. "Supporting the development of an essential health package: principles and initial assessment for Malawi," Working Papers 136cherp, Centre for Health Economics, University of York.
    10. Agier, Isabelle & Ly, Antarou & Kadio, Kadidiatou & Kouanda, Seni & Ridde, Valéry, 2016. "Endorsement of universal health coverage financial principles in Burkina Faso," Social Science & Medicine, Elsevier, vol. 151(C), pages 157-166.
    11. Peter J. Neumann & David D. Kim & Thomas A. Trikalinos & Mark J. Sculpher & Joshua A. Salomon & Lisa A. Prosser & Douglas K. Owens & David O. Meltzer & Karen M. Kuntz & Murray Krahn & David Feeny & An, 2018. "Future Directions for Cost-effectiveness Analyses in Health and Medicine," Medical Decision Making, , vol. 38(7), pages 767-777, October.
    12. Mujaheed Shaikh & Afschin Gandjour, 2019. "Pharmaceutical expenditure and gross domestic product: Evidence of simultaneous effects using a two‐step instrumental variables strategy," Health Economics, John Wiley & Sons, Ltd., vol. 28(1), pages 101-122, January.
    13. Hauck, K. & Martin, S. & Smith, P.C., 2016. "Priorities for action on the social determinants of health: Empirical evidence on the strongest associations with life expectancy in 54 low-income countries, 1990–2012," Social Science & Medicine, Elsevier, vol. 167(C), pages 88-98.
    14. Rodrigo Moreno-Serra & Misael Anaya-Montes & Peter C Smith, 2019. "Potential determinants of health system efficiency: Evidence from Latin America and the Caribbean," PLOS ONE, Public Library of Science, vol. 14(5), pages 1-21, May.
    15. Jacopo Gabani & Sumit Mazumdar & Marc Suhrcke, 2023. "The effect of health financing systems on health system outcomes: A cross‐country panel analysis," Health Economics, John Wiley & Sons, Ltd., vol. 32(3), pages 574-619, March.
    16. Dolores Jiménez‐Rubio & Judit Vall Castelló, 2020. "Limiting health‐care access to undocumented immigrants: A wise option?," Health Economics, John Wiley & Sons, Ltd., vol. 29(8), pages 878-890, August.
    17. Wa Ntita Serge Kabongo & Josue Mbonigaba, 2017. "Demand-side Determinants of Access to Healthcare Services: Empirical Evidence from Africa," SPOUDAI Journal of Economics and Business, SPOUDAI Journal of Economics and Business, University of Piraeus, vol. 67(4), pages 3-22, October-D.
    18. Emanuele Arcà & Francesco Principe & Eddy Van Doorslaer, 2020. "Death by austerity? The impact of cost containment on avoidable mortality in Italy," Health Economics, John Wiley & Sons, Ltd., vol. 29(12), pages 1500-1516, December.
    19. Barlow, Pepita, 2018. "Does trade liberalization reduce child mortality in low- and middle-income countries? A synthetic control analysis of 36 policy experiments, 1963-2005," Social Science & Medicine, Elsevier, vol. 205(C), pages 107-115.
    20. Beth Woods & Paul Revill & Mark Sculpher & Karl Claxton, 2015. "Country-level cost-effectiveness thresholds: initial estimates and the need for further research," Working Papers 109cherp, Centre for Health Economics, University of York.
    21. Ochalek, Jessica & Manthalu, Gerald & Smith, Peter C., 2020. "Squaring the cube: Towards an operational model of optimal universal health coverage," Journal of Health Economics, Elsevier, vol. 70(C).

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