Pakdaman Mohsen, Geravandi Sara, Askari Roohollah, Askarishahi Mohsen, Afzali Hasan Reza
Health Policy and Management Research Center, Department of HealthCare Management, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
J Educ Health Promot. 2019 Jun 27;8:123. doi: 10.4103/jehp.jehp_453_18. eCollection 2019.
A sharp increase in expenditure is one of the challenges of the health system in Iran. Every macroeconomic variable affects health, and if it is disregarded, it will lead to higher macrobudgets. Physical and mental health as well as the use of health services change according to the macroeconomic conditions and business cycles (boom and recession). The present study aimed to determine the effect of macroeconomic indicators on health expenditure.
This study was descriptive analytical. The required data related to macroeconomic indicators and health expenditure in public and private sectors were collected during 1995-2014. The data were analyzed using the time series models in econometrics, Vector Auto Regression, and Granger causality technique.
The results of this study indicated that health expenditure has a positive bilateral relationship with gross domestic production (GDP), gross national production, national income, and national consumption. On the contrary, expenditure has a negative bilateral relationship with liquidity rate and inflation rate. In addition, budget deficit has a negative unilateral relationship with health expenditure while population rate has a positive unilateral relationship with health expenditure.
The results of this study indicated the increase of health expenditure in Iran that GDP is the most critical determining factor of health expenditure. In general, the total expenditure in the health sector in the world increases when the countries become richer. In line with the increase of resources, innovative financing methods and efficiency improvement are required for providing basic health services in low-income countries.
支出的急剧增加是伊朗卫生系统面临的挑战之一。每个宏观经济变量都会影响健康，如果忽视这一点，将导致更高的宏观预算。身心健康以及卫生服务的使用会根据宏观经济状况和商业周期（繁荣与衰退）而变化。本研究旨在确定宏观经济指标对卫生支出的影响。
本研究为描述性分析。收集了1995 - 2014年期间与宏观经济指标以及公共和私营部门卫生支出相关的所需数据。使用计量经济学中的时间序列模型、向量自回归和格兰杰因果技术对数据进行了分析。
本研究结果表明，卫生支出与国内生产总值（GDP）、国民生产总值、国民收入和国民消费呈正相关的双边关系。相反，支出与流动性比率和通货膨胀率呈负相关的双边关系。此外，预算赤字与卫生支出呈负单向关系，而人口增长率与卫生支出呈正单向关系。
本研究结果表明伊朗卫生支出增加，其中GDP是卫生支出最关键的决定因素。总体而言，当国家变得更富裕时，全球卫生部门的总支出会增加。与资源增加相一致，低收入国家在提供基本卫生服务方面需要创新的融资方法并提高效率。
