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The determinants of health expenditures: evidence from US state-level data

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  • Zijun Wang

Abstract

Most macro studies of what determines health expenditures have used the same panel of OECD country-level data. Based on a more homogeneous panel data set of US states we constructed, this note applies the model selection procedure to identify the determinants of health expenditures at the state level. We find that the four key factors are gross state products, the proportion of the population over the age of 65, the degree of urbanization and the number of hospital beds. The cross-section income elasticity of health care is around 0.7, implying that health care is a necessity rather than a luxury good at the state level. The (relative) price of health care varies significantly across states but does not appear to have real effects on the amount of resources (measured in real dollars) a state devotes to health care.

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  • Zijun Wang, 2009. "The determinants of health expenditures: evidence from US state-level data," Applied Economics, Taylor & Francis Journals, vol. 41(4), pages 429-435.
    • Handle: RePEc:taf:applec:v:41:y:2009:i:4:p:429-435
    DOI: 10.1080/00036840701704527
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    1. Oecd, 2006. "Projecting OECD Health and Long-Term Care Expenditures: What Are the Main Drivers?," OECD Economics Department Working Papers 477, OECD Publishing.
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    1. Abdul Wahab, Abdul Azeez Oluwanisola & Kefeli, Zurina & Hashim, Nurhazirah, 2018. "Investigating The Dynamic Effect of Healthcare Expenditure and Education Expenditure On Economic Growth in Organisation of Islamic Countries (OIC)," MPRA Paper 90338, University Library of Munich, Germany, revised 19 Oct 2018.
    2. Chortareas, Georgios & Logothetis, Vassilis & Papandreou, Andreas, 2018. "Public Opinion, Elections, and Environmental Fiscal Policy," Cardiff Economics Working Papers E2018/9, Cardiff University, Cardiff Business School, Economics Section.
    3. Oliver Fritz & Peter Mayerhofer & Reinhard Haller & Gerhard Streicher & Florian Bachner & Herwig Ostermann, 2013. "Die regionalwirtschaftlichen Effekte der österreichischen Krankenanstalten," WIFO Studies, WIFO, number 46672, January.
    4. Bose, Srimoyee, 2015. "Determinants of Per Capita State-Level Health Expenditures in the United States: A Spatial Panel Analysis," Journal of Regional Analysis and Policy, Mid-Continent Regional Science Association, vol. 45(1).
    5. Samia Nasreen & Aviral Kumar Tiwari & Mehr‐un Nisa & Faryal Ishtiaq, 2024. "Evaluating the Role of GDP Per Capita, Air Pollution and Non‐Economic Factors in Determining Health Expenditure: Evidence from Asian Region Using Instrumental Variables Techniques," Economic Papers, The Economic Society of Australia, vol. 43(1), pages 63-90, March.
    6. Serap Taskaya & Mustafa Demirkiran, 2016. "The Causality between Healthcare Resources and Health Expenditures in Turkey. A Granger Causality Method," International Journal of Academic Research in Accounting, Finance and Management Sciences, Human Resource Management Academic Research Society, International Journal of Academic Research in Accounting, Finance and Management Sciences, vol. 6(2), pages 98-103, April.
    7. Błażej Łyszczarz, 2018. "Determinanty wydatków na zdrowie w gospodarstwach domowych w Polsce," Gospodarka Narodowa. The Polish Journal of Economics, Warsaw School of Economics, issue 1, pages 137-157.
    8. Fahad Alzahrani & Alan R. Collins & Elham Erfanian, 2019. "Drinking Water Quality Impacts on Health Care Expenditures in the United States," Working Papers Working Paper 2019-02, Regional Research Institute, West Virginia University.
    9. Lopreite, Milena & Misuraca, Michelangelo & Puliga, Michelangelo, 2023. "An analysis of the thematic evolution of ageing and healthcare expenditure using word embedding: A scoping review of policy implications," Socio-Economic Planning Sciences, Elsevier, vol. 87(PB).
    10. Rezwanul Hasan Rana & Khorshed Alam & Jeff Gow, 2020. "Health expenditure and gross domestic product: causality analysis by income level," International Journal of Health Economics and Management, Springer, vol. 20(1), pages 55-77, March.
    11. Hang Thu Nguyen-Phung & Hai Le, 2024. "Urbanization and Health Expenditure: An Empirical Investigation from Households in Vietnam," Economies, MDPI, vol. 12(6), pages 1-17, June.
    12. Vandersteegen, Tom & Marneffe, Wim & Cleemput, Irina & Vereeck, Lode, 2015. "The impact of no-fault compensation on health care expenditures: An empirical study of OECD countries," Health Policy, Elsevier, vol. 119(3), pages 367-374.
    13. Deepak Kumar BEHERA & Umakant DASH, 2017. "Impact of GDP and tax revenue on health care financing: An empirical investigation from Indian states," Theoretical and Applied Economics, Asociatia Generala a Economistilor din Romania / Editura Economica, vol. 0(2(611), S), pages 249-262, Summer.
    14. Nilgun Yavuz & Veli Yilanci & Zehra Ozturk, 2013. "Is health care a luxury or a necessity or both? Evidence from Turkey," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 14(1), pages 5-10, February.
    15. Masayoshi Hayashi & Akiko Oyama, 2014. "Factor Decomposition of Inter-prefectural Health Care Expenditure Disparities in Japan," CIRJE F-Series CIRJE-F-948, CIRJE, Faculty of Economics, University of Tokyo.
    16. Ben Brewer & Karen Smith Conway & Deniz Ozabaci & Robert S. Woodward, 2022. "US Health Care Expenditures, GDP and Health Policy Reforms: Evidence from End-of-Sample Structural Break Tests," Eastern Economic Journal, Palgrave Macmillan;Eastern Economic Association, vol. 48(4), pages 451-487, October.
    17. Jeannette Wicks-Lim & Jeffrey Thompson, 2010. "Combining Minimum Wage and Earned Income Tax Credit Policies to Guarantee a Decent Living Standard to All U.S. Workers," Published Studies peri_mw_eitc_oct2010, Political Economy Research Institute, University of Massachusetts at Amherst.
    18. Di Matteo, Livio & Cantarero-Prieto, David, 2018. "The Determinants of Public Health Expenditures: Comparing Canada and Spain," MPRA Paper 87800, University Library of Munich, Germany.
    19. Luca Grassetti & Laura Rizzi, 2019. "The determinants of individual health care expenditures in the Italian region of Friuli Venezia Giulia: evidence from a hierarchical spatial model estimation," Empirical Economics, Springer, vol. 56(3), pages 987-1009, March.
    20. Caravaggio, Nicola & Resce, Giuliano, 2023. "Enhancing Healthcare Cost Forecasting: A Machine Learning Model for Resource Allocation in Heterogeneous Regions," Economics & Statistics Discussion Papers esdp23090, University of Molise, Department of Economics.
    21. Clemente, Jesús & Lázaro-Alquézar, Angelina & Montañés, Antonio, 2019. "US state health expenditure convergence: A revisited analysis," Economic Modelling, Elsevier, vol. 83(C), pages 210-220.
    22. Vitor Castro, 2017. "Pure, White and Deadly… Expensive: A Bitter Sweetness in Health Care Expenditure," Health Economics, John Wiley & Sons, Ltd., vol. 26(12), pages 1644-1666, December.
    23. Genevieve E O'Connor, 2016. "Investigating the significance of insurance and income on health service utilization across generational cohorts," Journal of Financial Services Marketing, Palgrave Macmillan, vol. 21(1), pages 19-33, March.
    24. Muhammad Arshad Khan & Muhammad Iftikhar Ul Husnain, 2019. "Is health care a luxury or necessity good? Evidence from Asian countries," International Journal of Health Economics and Management, Springer, vol. 19(2), pages 213-233, June.
    25. Andrew J. Rettenmaier & Zijun Wang, 2012. "Regional variations in medical spending and utilization: a longitudinal analysis of US Medicare population," Health Economics, John Wiley & Sons, Ltd., vol. 21(2), pages 67-82, February.

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