Who Benefits from Government Health Spending and Why? A Global Assessment

Wagstaff, Adam ; Bilger, Marcel ; Buisman, Leander R. ; Bredenkamp, Caryn

World Bank Group, Washington, DC

关键词: ABBREVIATIONS;    AVERAGE COSTS;    BUSINESS DEVELOPMENT;    BUSINESS ENVIRONMENT;    CAPITATION;   

DOI  :  10.1596/1813-9450-7044
RP-ID  :  WPS7044

学科分类：社会科学、人文和艺术（综合）

来源: World Bank Open Knowledge Repository

【 摘 要 】

This paper uses a common householdsurvey instrument and a common set of imputation assumptionsto estimate the pro-poorness of government healthexpenditure across 69 countries at all levels of income. Onaverage, government health expenditure emerges assignificantly pro-rich, but there is heterogeneity acrosscountries: in the majority, government health expenditure isneither pro-rich nor pro-poor, while in a small minority itis pro-rich, and in an even smaller minority it is pro-poor.Government health expenditure on contracted privatefacilities emerges as significantly pro-rich for all typesof care, and in almost all Asian countries government healthexpenditure overall is significantly pro-rich. Thepro-poorness of government health expenditure at the countrylevel is significantly and positively correlated with grossdomestic product per capita and government healthexpenditure per capita, significantly and negativelycorrelated with the share of government facility revenuescoming from user fees, and significantly and positivelycorrelated with six measures of the quality of acountry's governance; it is not, however, correlatedwith the size of the private sector nor with the degree towhich the private sector delivers care disproportionately tothe better-off. Because poorly-governed countries areunderrepresented in the sample, government healthexpenditure is likely to be even more pro-rich in the worldas a whole than it is in the countries in this study.