The Relationship Between Health Outcomes and Health Expenditure in Europe by Using Compositional Data Analysis

Magdaléna Drastichová


Technical University of Ostrava, Czech Republic (Czechia)

Peter Filzmoser


Vienna University of Technology, Austria (Austria)

Abstract

The type of health system in each country and the resources devoted to it determine its outcomes. Relationships between ratios of expenditure to Gross Domestic Product (GDP) classified by provider and indicators reflecting health outcomes in 2015 are examined for 30 countries by means of a compositional data analysis and a regression analysis. The countries in the sample are the European Union (EU-28) countries plus Iceland and Norway. The outcome indicators used are life expectancy at birth (LE); healthy life years in absolute value at birth for females (HLYf) and for males (HLYm); and death rate due to chronic diseases (DR) (response variables). The results indicate that the higher the ratio of expenditure on retailers and other providers of medical goods in relation to other types of expenditure in the composition, the higher the DR indicator and the lower the LE indicator. The ratio of expenditure on residential long-term care facilities in the composition seems to have had a positive effect on both HLY indicators. The effect of expenditure ratios on providers of healthcare system administration and financing is not straightforward.     


Keywords:

healthcare expenditure, life expectancy, healthy life years, death rate due to chronic diseases, sustainability, efficiency, compositional data analysis

AITCHISON J. 1986, The Statistical Analysis of Compositional Data, Chapman & Hall, London.
DOI: https://doi.org/10.1007/978-94-009-4109-0   Google Scholar

BALTAGI B., MOSCONE F., 2010, Health Care Expenditure and Income in the OECD Reconsidered: Evidence from Panel Data, IZA Discussion Paper, paper #4851.
DOI: https://doi.org/10.2139/ssrn.1584182   Google Scholar

BLACKWOOD R., CURRIE C., 2009, 2016, Study design for assessing effectiveness, efficiency and acceptability of services including measures of structure, process, service quality, and outcome of health care, https://www.healthknowledge.org.uk/public-health-textbook/research-methods/1c-health-care-evaluation-health-care-assessment/study-design-assessing-effectiveness (18.09.2019).
  Google Scholar

BERGMAN Z., BERGMAN M. M., FERNANDES K., GROSSRIEDER D., SCHNEIDER L., 2018, The Contribution of UNESCO Chairs toward Achie-ving the UN Sustainable Development Goals, in: Sustainability, 10(12), https://doi.org/10.3390/su10124471.
DOI: https://doi.org/10.3390/su10124471   Google Scholar

CYLUS J. PAPANICOLAS I., SMITH P. C., 2016, Health system efficiency How to make measurement matter for policy and management, in: Health Policy Series, 46, 242 p.
  Google Scholar

DRASTICHOVA M., 2018a, The Theory and Measurement of Sustainable Development, 3rd ed.; SAEI, 52. VSBTU Ostrava: Ostrava, Czechia, 420 p.
  Google Scholar

DRASTICHOVA M., 2018b, Evaluation of Selected Indicators in the Social Dimension of Sustainable Development, in: Proceedings of the 12th International Scientific Conference INPROFORUM 2018 Innovations, Enterprises, Regions and Management, Jihočeská univerzita v Českých Budějovicích, České Budějovice, p. 182-190.
  Google Scholar

DRASTICHOVA M., FILZMOSER P., 2019, Assessment of Sustainable Development Using Cluster Analysis and Principal Component Analysis, in: Problemy Ekorozwoju/Problems of Sustainable Development, 14(2), p. 7-24.
  Google Scholar

ELOLA J., DAPONTE A., NAVARRO V., 1995, Health Indicators and the Organization of Health Care Systems in Western Europe, in: Am J Public Health, 85(10), p. 1397-1401.
DOI: https://doi.org/10.2105/AJPH.85.10.1397   Google Scholar

European Commission, Next steps for a sustainable European future. European action for sustainability, Communication from the Commission to the European Parliament, the Council, the European Economic and Social Committee and the Committee of the Regions, COM(2016) 739 final.
  Google Scholar

Eurostat, 2019a, Eurostat Database, https://ec.europa.eu/eurostat/data/database (10.09.2019).
  Google Scholar

Eurostat, 2019b, Health care expenditure (SHA 2011) (hlth_sha11) (2019b)., https://ec.europa.eu/eurostat/cache/metadata/en/hlth_sha11_esms.htm (18.09.2019).
  Google Scholar

FISEROVA E., HRON K., 2011, On interpretation of orthonormal coordinates for compositional data, in: Mathematical Geosciences 43(4), p. 455-468, https://doi.org/10.1007/s11004-011-9333-x.
DOI: https://doi.org/10.1007/s11004-011-9333-x   Google Scholar

FILZMOSER P., HRON K., TEMPL M., 2018, Applied Compositional Data Analysis. With Worked Examples, in: R. Springer Series in Statistics, Springer Nature Switzerland AG, Cham, 292 p.
DOI: https://doi.org/10.1007/978-3-319-96422-5   Google Scholar

GALLET C.A., DOUCOULIAGOS H., 2017, The impact of healthcare spending on health outcomes: A metaregression analysis, in: Social Science & Medicine,179, p. 9-17.
DOI: https://doi.org/10.1016/j.socscimed.2017.02.024   Google Scholar

GOLDACRE M., 1996, Health outcomes from a medical perspective, in: Health Outcomes: Biological, Social, and Economic Perspectives, ed. Macbeth H.M., Oxford University Press, Oxford.
DOI: https://doi.org/10.1093/oso/9780198548799.003.0003   Google Scholar

HRON K., FILZMOSER P., THOMPSON K., 2012, Linear regression with compositional explanatory variables, in: Journal of Applied Statistics, 39, p. 1115-1128.
DOI: https://doi.org/10.1080/02664763.2011.644268   Google Scholar

JABA E., BALANA C.B, ROBUA I.-B., 2014, The relationship between life expectancy at birth and health expenditures estimated by a cross-country and time-series analysis, in: Procedia Economics and Finance, 15, p. 108-114.
DOI: https://doi.org/10.1016/S2212-5671(14)00454-7   Google Scholar

LINDEN M., RAY D., 2017, Life expectancy effects of public and private health expenditures in OECD countries 1970-2012: Panel time series approach, in: Economic Analysis and Policy, 56, p. 101-113.
DOI: https://doi.org/10.1016/j.eap.2017.06.005   Google Scholar

LV Z., XU T., 2016, Does intelligence affect health care expenditure? Evidence from a cross-country analysis, in: Intelligence, 55, p. 86-89.
DOI: https://doi.org/10.1016/j.intell.2016.01.009   Google Scholar

MARONNA R.A., DOUGLAS R.D., YOHAI V.J., 2006, Robust Statistics: Theory and Methods, John Wiley & Sons, Ltd., Chichester.
DOI: https://doi.org/10.1002/0470010940   Google Scholar

MEGYESIOVA S., LIESKOVSKA V., 2018, Analysis of the Sustainable Development Indicators in the OECD Countries, in: Sustainability, 10, https://doi.org/10.3390/su10124554.
DOI: https://doi.org/10.3390/su10124554   Google Scholar

NIXON J., ULMANN P., 2006, The relationship between health care expenditure and health outcomes, in: The European Journal of Health Economics, 7(1), p. 7-18.
DOI: https://doi.org/10.1007/s10198-005-0336-8   Google Scholar

OR Z., 2000, Determinants of health outcomes in industrialised countries: a pooled cross-country, time-series analysis, in: OECD Economic Studies, 30(1), p. 53-77.
  Google Scholar

RAMESH M., MIRMIRANI S., 2007, An Assessment of OECD Health Care System Using Panel Data Analysis, in: Southwest Business & Economics Journal,16, p. 21-35.
  Google Scholar

SMITH P., 1990, The Use of Performance Indicators in the Public Sector, in: Journal of the Royal Statistical Society Series A, 153(1), p. 53-72, https://doi.org/10.2307/2983096.
DOI: https://doi.org/10.2307/2983096   Google Scholar

SUCHACEK J., WALANCIK M., WRÓBLEWSKI L., URMINSKY J., DRASTICHOVA M., SOTKOVSKY I., 2018, Management of municipal development of Euroregion Beskydy in Poland and Czechia, in: Polish Journal of Management Studies, 18(1), p. 365-378.
DOI: https://doi.org/10.17512/pjms.2018.18.1.27   Google Scholar

United Nations, European Commission, International Monetary Fund, OECD, World Bank, 2003, Handbook of National Accounting. Integrated Environmental and Economic Accounting 2003, in: Studies in Methods, Series F, 61(1). (ST/ESA/STAT/ SER.F/61/Rev.1).
  Google Scholar

WCED, 1987, Our common future. Oxford University Press, Oxford, New York.
  Google Scholar

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Published
2020-07-01

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Drastichová, M., & Filzmoser, P. (2020). The Relationship Between Health Outcomes and Health Expenditure in Europe by Using Compositional Data Analysis. Problemy Ekorozwoju, 15(2), 99–110. https://doi.org/10.35784/pe.2020.2.11

Authors

Magdaléna Drastichová 

Technical University of Ostrava, Czech Republic Czechia

Authors

Peter Filzmoser 

Vienna University of Technology, Austria Austria

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