Faculty of Health, Medicine and Life Sciences, Department of Health Services Research, CAPHRI, Maastricht University Medical Center, Maastricht University, Maastricht, The Netherlands.
PLoS One. 2024 Mar 6;19(3):e0299359. doi: 10.1371/journal.pone.0299359. eCollection 2024.
Public health expenditure is one of the fastest-growing spending items in EU member states. As the population ages and wealth increases, governments allocate more resources to their health systems. In view of this, the aim of this study is to identify the key determinants of public health expenditure in the EU member states.
This study is based on macro-level EU panel data covering the period from 2000 to 2018. The association between explanatory variables and public health expenditure is analyzed by applying both static and dynamic econometric modeling.
Although GDP and out-of-pocket health expenditure are identified as the key drivers of public health expenditure, there are other variables, such as health system characteristics, with a statistically significant association with expenditure. Other variables, such as election year and the level of public debt, result to exert only a modest influence on the level of public health expenditure. Results also indicate that the aging of the population, political ideologies of governments and citizens' expectations, appear to be statistically insignificant.
Since increases in public health expenditure in EU member states are mainly triggered by GDP increases, it is expected that differences in PHE per capita across member states will persist and, consequently, making it more difficult to attain the health equity sustainable development goal. Thus, measures to reduce EU economic inequalities, will ultimately result in reducing disparities in public health expenditures across member states.
公共卫生支出是欧盟成员国增长最快的支出项目之一。随着人口老龄化和财富的增加，政府向其卫生系统分配更多的资源。鉴于此，本研究旨在确定欧盟成员国公共卫生支出的主要决定因素。
本研究基于涵盖 2000 年至 2018 年期间的宏观层面欧盟面板数据。通过应用静态和动态计量经济学模型，分析了解释变量与公共卫生支出之间的关联。
虽然国内生产总值和自费医疗支出被确定为公共卫生支出的关键驱动因素，但还有其他与支出具有统计显著关联的变量，如卫生系统特征。其他变量，如选举年和公共债务水平，仅对公共卫生支出水平产生适度影响。结果还表明，人口老龄化、政府和公民的政治意识形态以及期望似乎在统计上不显著。
由于欧盟成员国公共卫生支出的增加主要是由国内生产总值的增长引发的，预计成员国之间人均 PHE 的差异将持续存在，因此，实现健康公平可持续发展目标将更加困难。因此，减少欧盟经济不平等的措施最终将减少成员国之间公共卫生支出的差距。
