Is technology still a major driver of health expenditure in the United States? Evidence from cointegration analysis with multiple structural breaks

The relationship between toxic air pollution, health expenditure, and economic growth in the European Union: fresh evidence from the PMG-ARDL model

Air pollution is a danger to economies throughout the European Union. Industry, population expansion, a building boom owing to housing and infrastructure development, increasing vehicle traffic, crowded streets, a lack of availability of clean fuel, and ineffective control programs are the primary causes. Toxic air is a double-edged sword for a country's health since it affects just a tiny fraction of Europe's population. The financial burden and healthcare expenses for people rise when health expenditures rise. The present research looks at how dangerous air levels, healthcare costs, and the expansion of the European Union's economy are all connected. The findings are based on data collected over 29 years and account for the abovementioned variables. The results of the unit root test have the significant probability values of all variables: health expenditures (HE), gross domestic product (GDP), nitrous oxides (NOX), and carbon dioxides (CO2) emissions at both level and first difference. We used the Johansen, Kao, and Pedroni cointegration tests to test the null hypothesis of no cointegration to see that sample variables had a long-term association. The PMG-ARDL test was used to get these findings. The results confirmed the significant probability values of dependent variables in long- and short-run results that GDP has a positive and significant effect on health expenditure, while NOX and CO2 emissions have a negative and significant impact on (HE), in the European Union. To verify the results, we applied the robustness test, fully modified OLS (FMOLD), and dynamic OLS (DOLS); the robustness test results validated the PMG-ARDL test results. Environmental pollution (CO2, NOX) has a significant and negative impact on healthcare expenditures and a significant effect on GDP (HE) in the EU region. The findings of this research have implications for a wide range of parties, including those who would examine the link between factors in a study meant to improve air quality, distribute health resources, or develop strategies for economic development.

The nexus among CO2 emission, health expenditure and economic development in the OECD countries: New insights from a cross-sectional ARDL model

To find a way to realize sustainable development, this paper applied a cross-sectional ARDL (CS-ARDL) method to explore the interaction between carbon emissions, economic development, and health care expenditure for OECD countries. Firstly, we conduct a cross-sectional test to check whether the data is confronted with this issue. Secondly, we conduct a panel unit root test and cointegration test to confirm whether the ARDL-based method is suitable for our data. Thirdly, we analyze the results and provide possible explanations. Lastly, we conduct a short-term causality test to detect the connection between different variables. The main conclusion of our study includes: 1) Health care is a necessity in OECD countries. 2) Environmental deterioration places a heavy burden on health care expenditure in OECD countries. 3) Health care expenditure of last year negatively affects health care expenditure. 4) There is a short-run causality relationship from CO2, economic development, and dependency rate of youth to health care expenditure in OECD countries. Related policy proposals are provided according to our analysis of the results.

Does energy productivity and public-private investment in energy achieve carbon neutrality target of China?

Carbon neutrality target is of great importance to all countries around the globe recently. Innovative methods are being evaluated to achieve the environmental sustainability. In this study, we aim to inspect the influence of public-private partnership in energy and energy efficiency on CO₂ emissions in China from 1991Q1 to 2017Q4. In doing so, we include other important determinants of CO₂ emissions also, such as environmental innovation, renewable energy, energy productivity and economic growth in our model. We employ the advanced cointegration methods that are developed recently. Moreover, spectral Breitung and Candelon (BC) causality test is used to find the causal effects of technological innovation, energy productivity, public-private partnership in energy, renewable energy consumption and GDP on CO₂ emissions. The results suggest that increase in income and public-private partnership enhance carbon emission in China. Conversely, an improvement in energy productivity, renewable energy and technological innovation exert negative influence over CO₂ emissions. There is a need to improve the efficiency of public-private partnership in energy projects in terms of carbon emission. Policymakers in China need to ensure an effective and timely transition towards renewable energy sources through environment related innovations and improved efficiency in all sources of energy.

On the Network Transmission Mechanisms of Disease-Specific Healthcare Expenditure Spillovers: Evidence from the Connectedness Network Analyses

Previous studies investigating factors influencing healthcare expenditure growth ignored the network transmission mechanisms of disease-specific healthcare expenditure spillovers and regarded the processes culminating in healthcare expenditure growth as a black box. In this study, we investigated factors influencing the network transmission mechanisms underlying the determinants of healthcare expenditure growth through the dynamic connectedness network and the robust least square regression analyses. Our results indicate that demographic transition and business cycles are key factors increasing interconnectedness of different disease-specific healthcare expenditures, and that promotion of primary care utilization would reduce total healthcare expenditure spillovers. In order to reduce diffusion of disease-specific healthcare expenditures, health promotion activities should focus on those clinical diagnosis-related groups of diseases classified as pure net transmitters of spillover, and preventive interventions targeting different diseases should be activated in different phrases of the business cycle.

Trends in and drivers of healthcare expenditure in the English NHS: a retrospective analysis

BACKGROUND

In England, rises in healthcare expenditure consistently outpace growth in both GDP and total public expenditure. To ensure the National Health Service (NHS) remains financially sustainable, relevant data on healthcare expenditure are needed to inform decisions about which services should be delivered, by whom and in which settings.

METHODS

We analyse routine data on NHS expenditure in England over 9 years (2008/09 to 2016/17). To quantify the relative contribution of the different care settings to overall healthcare expenditure, we analyse trends in 14 healthcare settings under three broad categories: Hospital Based Care (HBC), Diagnostics and Therapeutics (D&T) and Community Care (CC). We exclude primary care and community mental health services settings due to a lack of consistent data. We employ a set of indices to aggregate diverse outputs and to disentangle growth in healthcare expenditure that is driven by activity from that due to cost pressures. We identify potential drivers of the observed trends from published studies.

RESULTS

Over the 9-year study period, combined NHS expenditure on HBC, D&T and CC rose by 50.2%. Expenditure on HBC rose by 54.1%, corresponding to increases in both activity (29.2%) and cost (15.7%). Rises in expenditure in inpatient (38.5%), outpatient (57.2%), and A&E (59.5%) settings were driven predominately by higher activity. Emergency admissions rose for both short-stay (45.6%) and long-stay cases (26.2%). There was a switch away from inpatient elective care (which fell by 5.1%) and towards day case care (34.8% rise), likely reflecting financial incentives for same-day discharges. Growth in expenditure on D&T (155.2%) was driven by rises in the volume of high cost drugs (270.5%) and chemotherapy (110.2%). Community prescribing grew by 45.2%, with costs falling by 24.4%. Evidence on the relationship between new technologies and healthcare expenditure is mixed, but the fall in drug costs could reflect low generic prices, and the use of health technology assessment or commercial arrangements to inform pricing of new medicines.

CONCLUSIONS

Aggregate trends in HCE mask enormous variation across healthcare settings. Understanding variation in activity and cost across settings is an important initial step towards ensuring the long-term sustainability of the NHS.

Is health care infected by Baumol's cost disease? Test of a new model

Rising health care costs are a policy concern across the Organisation for Economic Co-operation and Development, and relatively little consensus exists concerning their causes. One explanation that has received revived attention is Baumol's cost disease (BCD). However, developing a theoretically appropriate test of BCD has been a challenge. In this paper, we construct a 2-sector model firmly based on Baumol's axioms. We then derive several testable propositions. In particular, the model predicts that (a) the share of total labor employed in the health care sector and (b) the relative price index of the health and non-health care sectors should both be positively related to economy-wide productivity. The model also predicts that (c) the share of labor in the health sector will be negatively related and (d) the ratio of prices in the health and non-health sectors unrelated, to the demand for non-health services. Using annual data from 28 Organisation for Economic Co-operation and Development countries over the years 1995-2016 and from 14 U.S. industry groups over the years 1947-2015, we find little evidence to support the predictions of BCD once we address spurious correlation due to coincident trending and other econometric issues.