Predictors of (in)efficiencies of Healthcare Expenditure Among the Leading Asian Economies – Comparison of OECD and Non-OECD Nations

Abstract

Purpose

The goal of this study was to assess the effectiveness of healthcare spending among the leading Asian economies.

Methods

We have selected a total of nine Asian nations, based on the strength of their economic output and long-term real GDP growth rates. The OECD members included Japan and the Republic of Korea, while the seven non-OECD nations were China, India, Indonesia, Malaysia, Pakistan, the Philippines, and Thailand. Healthcare systems efficiency was analyzed over the period 1996–2017. To assess the effectiveness of healthcare expenditure of each group of countries, the two-way fixed effects model (country- and year effects) was used.

Results

Quality of governance and current health expenditure determine healthcare system performance. Population density and urbanization are positively associated with a healthy life expectancy in the non-OECD Asian countries. In this group, unsafe water drinking has a statistically negative effect on healthy life expectancy. Interestingly, only per capita consumption of carbohydrates is significantly linked with healthy life expectancy. In these non-OECD Asian countries, unsafe water drinking and per capita carbon dioxide emissions increase infant mortality. There is a strong negative association between GDP per capita and infant mortality in both sub-samples, although its impact is far larger in the OECD group. In Japan and South Korea, unemployment is negatively associated with infant mortality.

Conclusion

Japan outperforms other countries from the sample in major healthcare performance indicators, while South Korea is ranked second. The only exception is per capita carbon dioxide emissions, which have maximal values in the Republic of Korea and Japan. Non-OECD nations’ outcomes were led by China, as the largest economy. This group was characterized with substantial improvement in efficiency of health spending since the middle of the 1990s. Yet, progress was noted with remarkable heterogeneity within the group.

Keywords:

• Asia
• health expenditure
• healthy life expectancy
• infant mortality
• nutrition
• population health outcomes

Ethical Statement

This study has been conducted with the anonymous, national-level aggregate data thus no patient interventions neither private data protection issues where involved. According to the Helsinki declaration, such study design does not require prior IRB/Ethical Committee consideration neither its approval.

Disclosure

Authors Mihajlo Jakovljevic and Takuma Sugahara express their funding acknowledgement to the Government-owned Japanese Society for promotion of science for awarding the Grant number ID S19161 out of which this project expenses were largely covered. Takuma Sugahara reports grants from Japan Society for the Promotion of Science (JSPS), during the conduct of the study. Yuriy Timofeyev acknowledges that the study was supported by a grant of the Russian Science Foundation (project No. 20-78-00023). The authors report no other potential conflicts of interest for this work.