Department of Business Management, National Sun Yat-sen University, 70 Lienhai Rd., Kaohsiung 80424, Taiwan.
Department of Economics, Syracuse University, Syracuse, New York l3244, USA.
Health Policy. 2019 Jan;123(1):96-103. doi: 10.1016/j.healthpol.2018.11.004. Epub 2018 Nov 13.
Scholars have raised concerns that cutbacks on government health expenditure (GHE) during recessions may jeopardise population health. The present research investigates the extent to which population health outcomes are affected by responses of GHE to business cycles, i.e., cyclicality of GHE. We estimate GHE cyclicality by regressing detrended GHE on detrended gross domestic product (GDP). Our analysis of data for 1995 through 2014 from 135 developing countries shows that mean cyclicality is 0.61, or that a one percent deviation from the GDP trend is positively correlated with a 0.61 percent deviation from the GHE trend. Further, countries in which GHE is less procyclical appear to have shorter life expectancies and higher adult mortality rates. These results suggest that reducing procyclicality of GHE by protecting GHE in bad times may generate substantial health gains. Importantly, our results show that increasing the weight of social security funds in health budgets, and improving institutional quality, can be critical to breaking the procyclical pattern of GHE.
学者们担心，经济衰退期间政府卫生支出（GHE）的削减可能会危及民众健康。本研究探讨了 GHE 对商业周期的反应（即 GHE 的周期性）在多大程度上影响人口健康结果。我们通过将去趋势的 GHE 回归到去趋势的国内生产总值（GDP）来估计 GHE 的周期性。我们对 1995 年至 2014 年来自 135 个发展中国家的数据进行分析后发现，平均周期性为 0.61，即 GDP 趋势偏离一个百分点与 GHE 趋势偏离 0.61 个百分点呈正相关。此外，GHE 周期性较低的国家的预期寿命似乎较短，成年人死亡率较高。这些结果表明，通过在经济低迷时期保护 GHE 来降低 GHE 的周期性，可能会带来显著的健康收益。重要的是，我们的研究结果表明，增加卫生预算中社会保障资金的权重和改善制度质量，对于打破 GHE 的周期性模式至关重要。
