Life expectancy and health expenditure evolution in Eastern Europe—DiD and DEA analysis

ABSTRACT

Background: Exploration of long-term health expenditure and longevity trends across three major sub-regions of Eastern Europe since 1989. Methods: 24 countries were classified as EU 2004, CIS, or SEE. European Health for All Database (HFA-DB) 1989–2012 data were processed using difference-in-difference (DiD) and data envelopment analysis (DEA). Results: The strongest expenditure growth was recorded in EU 2004 followed by SEE and the CIS. A surprisingly similar longevity increase was present in SEE and EU 2004. In 1989, countries that joined EU in 2004 were relatively inefficient in the number of life-years gained yet had a lower life expectancy than the SEE region and was only slightly higher than the CIS region (DEA). By 2012 the revenue spent was roughly linear to additional life-year expectancies. Conclusion: EU 2004 members were the best performers in terms of balanced longevity increase followed by health expenditure growth. The SEE economies’ longevity gains were lagging slightly behind at a far lower cost. An extrapolated CIS expenditure to longevity increase ratio has the fastest-growing long-term promise.

KEYWORDS:

• Socioeconomic transition
• life expectancy
• health expenditure
• long-term trends
• longevity
• CIS
• EU
• SEE

Financial & competing interests disclosure

The Ministry of Education Science and Technological Development of the Republic of Serbia has funded the underlying study behind the reported results through Grant OI 175014. Publication of results was not contingent to Ministry’s censorship or approval. There are no conflicts of interest.