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The health financing transition: A conceptual framework and empirical evidence

Author

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  • Fan, Victoria Y.
  • Savedoff, William D.
Abstract
Almost every country exhibits two important health financing trends: health spending per person rises and the share of out-of-pocket spending on health services declines. We describe these trends as a “health financing transition” to provide a conceptual framework for understanding health markets and public policy. Using data over 1995–2009 from 126 countries, we examine the various explanations for changes in health spending and its composition with regressions in levels and first differences. We estimate that the income elasticity of health spending is about 0.7, consistent with recent comparable studies. Our analysis also shows a significant trend in health spending – rising about 1 per cent annually – which is associated with a combination of changing technology and medical practices, cost pressures and institutions that finance and manage healthcare. The out-of-pocket share of total health spending is not related to income, but is influenced by a country's capacity to raise general revenues. These results support the existence of a health financing transition and characterize how public policy influences these trends.

Suggested Citation

  • Fan, Victoria Y. & Savedoff, William D., 2014. "The health financing transition: A conceptual framework and empirical evidence," Social Science & Medicine, Elsevier, vol. 105(C), pages 112-121.
    • Handle: RePEc:eee:socmed:v:105:y:2014:i:c:p:112-121
    DOI: 10.1016/j.socscimed.2014.01.014
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    13. Eriksen, Steffen & Wiese, Rasmus, 2019. "Policy induced increases in private healthcare financing provide short-term relief of total healthcare expenditure growth: Evidence from OECD countries," European Journal of Political Economy, Elsevier, vol. 59(C), pages 71-82.
    14. Bradley Chen & Victoria Y. Fan, 2015. "Strategic Provider Behavior Under Global Budget Payment with Price Adjustment in Taiwan," Health Economics, John Wiley & Sons, Ltd., vol. 24(11), pages 1422-1436, November.
    15. Thomas E. Getzen & Albert A. Okunade, 2017. "Symposium Introduction: Papers on ‘Modeling National Health Expenditures’," Health Economics, John Wiley & Sons, Ltd., vol. 26(7), pages 827-833, July.
    16. Barlow, Pepita, 2020. "Global disparities in health-systems financing: A cross-national analysis of the impact of tariff reductions and state capacity on public health expenditure in 65 low- and middle-income countries, 199," LSE Research Online Documents on Economics 104107, London School of Economics and Political Science, LSE Library.
    17. Fu, Hongqiao & Li, Ling & Yip, Winnie, 2018. "Intended and unintended impacts of price changes for drugs and medical services: Evidence from China," Social Science & Medicine, Elsevier, vol. 211(C), pages 114-122.
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    21. R. V. Naveenan & Chee Yoong Liew & Ploypailin Kijkasiwat, 2024. "Nexus Between Financial Inclusion, Digital Inclusion and Health Outcomes: Evidence from Developing Economies," Social Indicators Research: An International and Interdisciplinary Journal for Quality-of-Life Measurement, Springer, vol. 174(1), pages 367-408, August.
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