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Determinants of prepaid systems of healthcare financing: a worldwide country-level perspective

Author

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  • Andrea M. Leiter

    (University of Innsbruck)

  • Engelbert Theurl

    (University of Innsbruck)

Abstract

In this paper we examine determinants of prepaid modes of health care financing in a worldwide cross-country perspective. We use three different indicators to capture the role of prepaid modes in health care financing: (i) the share of total prepaid financing as percent of total current health expenditures, (ii) the share of voluntary prepaid financing as percent of total prepaid financing, and (iii) the share of compulsory health insurance as percent of total compulsory prepaid financing. In the econometric analysis, we refer to a panel data set comprising 154 countries and covering the time period 2000–2015. We apply a static as well as a dynamic panel data model. We find that the current structure of prepaid financing is significantly determined by its different forms in the past. The significant influence of GDP per capita, governmental revenues, the agricultural value added, development assistance for health, degree of urbanization and regulatory quality varies depending on the financing structure we look at. The share of the elderly and the education level are only of minor importance for explaining the variation in a country’s share of prepaid health care financing. The importance of the mentioned variables as determinants for prepaid health care financing also varies depending on the countries’ socio-economic development. From our analysis we conclude that more detailed information on indicators which reflect the distribution of individual characteristics (such as income, family size and structure and health risks) within a country’s population would be needed to gain deeper insight into the decisive determinants for prepaid health care financing.

Suggested Citation

  • Andrea M. Leiter & Engelbert Theurl, 2021. "Determinants of prepaid systems of healthcare financing: a worldwide country-level perspective," International Journal of Health Economics and Management, Springer, vol. 21(3), pages 317-344, September.
    • Handle: RePEc:kap:ijhcfe:v:21:y:2021:i:3:d:10.1007_s10754-021-09301-w
    DOI: 10.1007/s10754-021-09301-w
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    More about this item

    Keywords

    Health care financing; Prepaid health care financing systems; Out-of-pocket payments; Panel data analysis;
    All these keywords.

    JEL classification:

    • I13 - Health, Education, and Welfare - - Health - - - Health Insurance, Public and Private
    • I14 - Health, Education, and Welfare - - Health - - - Health and Inequality
    • H51 - Public Economics - - National Government Expenditures and Related Policies - - - Government Expenditures and Health
    • C33 - Mathematical and Quantitative Methods - - Multiple or Simultaneous Equation Models; Multiple Variables - - - Models with Panel Data; Spatio-temporal Models

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