What drives public health care expenditure growth? Evidence from Swiss cantons, 1970–2012. Issue 9 (September 2016)

• Record Type: Journal Article
• Authors: Braendle, Thomas; Colombier, Carsten
• Is Part Of: Health policy. Volume 120:Issue 9(2016)
• Page Start: 1051
• Page End: 1060
• Publication Date: 2016-09
• Subjects: Health expenditures -- Government financing -- Public hospitals -- Statistical data analysis; Medical education -- Periodicals; Medical policy -- Periodicals; Delivery of Health Care -- Periodicals; Education, Medical -- Periodicals; Health Education -- Periodicals; Health Planning -- Periodicals; Public Policy -- Periodicals; Enseignement médical -- Périodiques; Politique sanitaire -- Périodiques; Medical education; Medical policy; Periodicals; Electronic journals; Electronic journals; 362.1
• DOI: 10.1016/j.healthpol.2016.07.009
• Languages: English
• ISSNs: 0168-8510

Abstract

Highlights: We estimate the impact of demand and supply-side determinants and political economy aspects on public health care expenditure growth. Novel dataset of cantonal healthcare expenditure (1970–2012) and use of dynamic panel estimators. GDP per capita, unemployment and share of foreigners are positively related to public healthcare expenditure growth. Public healthcare expenditure increases with the share of women in parliament. Fiscal rules do not limit public healthcare expenditure growth. Abstract: A better understanding of the determinants of public health care expenditures is key to designing effective health policies. We integrate demand and supply-side determinants and factors from political economy into an empirical analysis of the highly decentralized Swiss health care system and control for major health care finance reforms. We compile a novel data set of the cantonal health care expenditure in Switzerland, which currently amounts to about one fifth of total health care expenditure. We analyze the period 1970–2012 and use dynamic panel estimation methods. We find that per capita income, the unemployment rate and the share of foreigners are positively related to public health care expenditure growth. With regard to political economy aspects, public health care expenditures increase with the share of women elected to parliament. However, institutional restrictions for politicians, such as fiscal rules, do not appear to limit public health care expenditure growth.