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Author ORCID Identifier

Pub0000-0002-3337-213X

Article Classification

Sustainable Development

Abstract

This study focuses on the macroeconomic, environmental, and socioeconomic determinants that would bring an impact on the healthcare. The ASEAN countries' economic growth, carbon emissions, urban population, and energy consumption are hypothesized to be correlated with healthcare expenditure. This study aims to investigate the impact of each factor affecting healthcare expenditure in these six ASEAN countries. The study looks into six ASEAN countries, i.e. Indonesia, Philippines, Thailand, Malaysia, Singapore, and Brunei Darussalam for the period of 2010-2014. A panel data analysis was conducted to meet the objectives of this study. To test the stationarity of the data, panel unit root tests including Augmented Dickey-Fuller (ADF) test and Phillips-Perron (PP) test were conducted. Next, Poolability F-test, Hausman test and Breusch-Pagan Lagrange Multiplier test had been carried out in order to select the best estimation model out of the three models which are Pooled Ordinary Least Square (POLS), Fixed Effect Model (FEM) and Random Effect Model (REM). Both ADF test and PP test suggested that all the variables were in stationary at second differencing with trend and without trend at the significance level of 1%. The following results of Poolability F-test, Hausman test and Breusch-Pagan Lagrange Multiplier test revealed that REM is the best estimation model to be applied in this study. Based on the REM findings, there is a negative relationship between economic growth at 1% significant level and HE that does not reflect Wagner’s Law in the context of this study. The finding of an insignificant relationship between carbon emission and HE at 1% significant level also does not reflect the Social Capital Theory which suggests that poor environmental quality and subsequent health damages lead to higher government health spending. The conclusion of this study had inferred that both economic growth and urban population have a negative significant impact towards healthcare expenditure in countries where private healthcare services, especially those located in urban centres, play important roles in complementing public healthcare services in serving the population. Meanwhile, carbon emission and energy usage are found insignificant to healthcare expenditure.

References

Abbas, F., & Hiemenz, U. (2011). Determinants of Public health expenditures in Pakistan. Zentrum für Entwicklungsforschung/Center for Development Research (ZEF) No. 158, University of Bonn, 34, 1-25.

https://papers.ssrn.com/sol3/papers.cfm?abstract_id=1967070

Abbas, F., & Hiemenz, U. (2013). What determines public health expenditures in Pakistan? Role of income, urbanization and unemployment. Economic Change and Restructuring, 46(4), 341-362. https://doi.org/10.1007/s10644-012-9130-7

Ahmad, M., Akram, W., Ikram, M., Shah, A. A., Rehman, A., Chandio, A. A., & Jabeen, G. (2021). Estimating dynamic interactive linkages among urban agglomeration, economic performance, carbon emissions, and health expenditures across developmental disparities. Sustainable Production and Consumption, 26, 239-255.

https://doi.org/10.1016/j.spc.2020.10.006

Akbar, A., Rehman, A., Ullah, I., Zeeshan, M., & Afridi, F. E. A. (2020). Unraveling the Dynamic Nexus Between Trade Liberalization, Energy Consumption, CO2 Emissions, and Health Expenditure in Southeast Asian Countries. Risk Management and Healthcare Policy, 13, 1915-1927. https://doi.org/10.2147/RMHP.S272801

Alemu, A. M. (2012). Effects of Corruption on FDI Inflow in Asian Economies. Seoul Journal of Economics, 25(4), 387-412. https://ssrn.com/abstract=2182405

Allison, P. D. (2005). Fixed Effect Regression Methods for Longitudinal Data Using SAS. SAS Users Group International 31 (SUGI 31) Proceedings, San Francisco, California, March 26-29, 2006.

https://www.researchgate.net/publication/228767539_Fixed_Effects_Regression_Methods_in_SAS

Antonis, A., Constantinos, K., & Persefoni, T. (2013). Wagner’s law versus Keynesian hypothesis: evidence from pre-WWII Greece. Panoeconomicus, 60(4), 457-472.

http://dx.doi.org/10.2298/PAN1304457A

Anwar, J. (2016). Analysis of energy security, environmental emission and fuel import costs under energy import reduction targets: a case of Pakistan. Renewable and Sustainable Energy Review, 65, 1065-1078. https://doi.org/10.1016/j.rser.2016.07.037

Apergis, N., Gupta, R., Lao, C. K. M., & Mukherjee, Z. (2018). U.S. state-level carbon dioxide emissions: does it affect health care expenditure? Renewable and Sustainable Energy Reviews, 91, 521-530. https://doi.org/10.1016/j.rser.2018.03.035

Arroyo, F., & Miguel, L. J. (2019). The trends of the energy intensity and CO2 emissions related to final energy consumption in Ecuador: scenarios of national and worldwide strategies. Sustainability, 12(1), 20. https://doi.org/10.3390/su12010020

Atilgan, E., Kilic, D., & Ertugrul, H. M. (2017). The dynamic relationship between health expenditure and economic growth: is the health-led growth hypothesis valid for Turkey? The European Journal of Health Economics, 18(5), 567-574.

https://doi.org/10.1007/s10198-016-0810-5

Balan, F. (2016). Environmental quality and its human health effects: a casual analysis for the eu-25. International Journal of Applied Economics, 13(1), 57-71.

http://www2.southeastern.edu/orgs/ijae/index_files/IJAE%20MARCH%202016%20BALAN%20MARCH%2029%202016.pdf

Baltagi, B. (2005). Econometric analysis of panel data. John Wiley & Sons.

Barbieri, L. (2006). Panel unit root tests: a review. Working Paper. Serie Rossa: Economia – Quaderno N. 43 ottobre 2006. Università Cattolica del Sacro Cuore.

https://www.researchgate.net/publication/252756953_Panel_Unit_Root_Tests_A_Review

Barkat, K., Sbia, R., & Maouchi, Y. (2019). Empirical evidence on the long and short run determinants of health expenditure in the Arab world. The Quarterly Review of Economics and Finance, 73, 78-87. https://doi.org/10.1016/j.qref.2018.11.009

Bhattacharya, S., & Bhattacharya, C (2021). Sustainable human resource planning for hospitals in tier 2/3 cities: evidence from India. International Journal of Organizational Analysis. https://doi.org/10.1108/IJOA-07-2020-2289

Bloom, D. E., Kuhn, M., & Prettner, K. (2018). Health and economic growth. Econstor. https://www.econstor.eu/bitstream/10419/193233/1/dp11939.pdf

Bonnel, R. (2000). HIV/AIDS and economic growth: a global perspective*(1). The South African Journal of Economics, 68(5), 360-379. https://doi.org/10.1111/j.1813-6982.2000.tb01282.x

Bustreo, F. (2015). Financing the health sustainable development goal. World Health Organization. https://www.who.int/life-course/news/commentaries/financing-health-sustainable-goal/en/

Cetin, M. A., & Bakirtas, I. (2019). Does urbanization induce the health expenditures? A dynamic macro-panel analysis for developing countries. Dumlupinar University Journal of Social Sciences, 61, 208-222.

https://dergipark.org.tr/en/pub/dpusbe/issue/47035/569779

Chen, L., Zhuo, Y., Xu, Z., Xu, X., & Gao, X. (2019). Is carbon dioxide (CO2) emission an important factor affecting healthcare expenditure? Evidence from china, 2005-2016. International Journal Environmental Research and Public Health, 16(20), 3995. https://doi.org/10.3390/ijerph16203995

Dincer, H., & Yuksel, S. (2019). Identifying the causality relationship between health expenditure and economic growth: an application on e7 countries. Journal of Health Systems and Policies, 1(1), 5-23.

https://dergipark.org.tr/en/pub/jhesp/issue/39338/413742

Eisavi, M., Ghorbani, S., Moiedfar, A., & Holakoupour, M. (2019). Wagner’s Law Test on health expenditure in Iran. The Iranian Journal of Health Insurance, 2(3), 134-141. http://journal.ihio.gov.ir/article-1-99-en.html

Eryigit, S. B., Eryigit, K. Y., & Selen, U. (2012). The long-run linkages between education, health and defence expenditures and economic growth: evidence from Turkey. Defense and Peace Economics, 23(6), 559-574. https://doi.org/10.1080/10242694.2012.663577

Gövdeli, T. (2019). Health expenditure, economic growth, and co2 emissions: evidence from the OECD countries. Adıyaman Üniversitesi Sosyal Bilimler Enstitüsü Dergisi, 11(31), 488-516. https://doi.org/10.14520/adyusbd.477571

Greene, W. H. (1997). Econometric Analysis (3rd ed.). Macmillan Publishing Company.

Grigoli, F., & Kapsoli, J. (2013). Waste not, want not: the efficiency of health expenditure in emerging and developing economies. Review of Development Economics, 22(1), 384-403. https://doi.org/10.1111/rode.12346

Guida, C., & Carpentieri, G. (2021). Quality of life in the urban environment and primary health services for the elderly during the Covid-19 pandemic: An application to the city of Milan (Italy). Cities, 110, 103038. https://doi.org/10.1016/j.cities.2020.103038

Gujarati, D. N. (2004). Basic Econometrics. 4th Edition, McGraw-Hill Companies.

Gujarati, D. N., & Dawn, P. C. (2009). Basic Econometrics. New York: McGraw-Hill.

Haseeb, M., Kot, S., Hussain, H. I., & Jermsittiparsert, K. (2019). Impact of economic growth, environmental pollution, and energy consumption on heath expenditure and R&D expenditure of Asean countries. Energies; Basel, 12(19), 3598. https://doi.org/10.3390/en12193598

Jaén-García, M. (2018). Wagner’s Law: A Revision and a New Empirical Estimation. Hacienda Pública Española/Review of Public Economics, 224(1), 13-35.

https://doi.org/10.7866/HPE-RPE.18.1.1

Jebli, M. B., Youssef, S. B., & Ozturk, I. (2003). Testing environmental Kuznets curve hypothesis: The role of renewable and non-renewable energy consumption and trade in OECD countries. Ecological Indicators, 60(1), 824-831.

https://doi.org/10.1016/j.ecolind.2015.08.031

Jerett, M., Eyles, J., Dufournaud, C., & Birch, S. (2003). Environmental influences on healthcare expenditures: an explanatory analysis from Ontario, Canada. Journal of Epidemiology and Community Health, 57(5), 334-338.

https://doi.org/10.1136/jech.57.5.334

Jost, S. (2021). Linear correlation.

https://condor.depaul.edu/sjost/it223/documents/correlation.htm

Karlsson, S., & Lothgren, M. (2000). On the power and interpretation of panel unit root tests. Economics Letters, 66(3), 249-255. https://doi.org/10.1016/S0165-1765(99)00237-2

Kesavarajah, M. (2012). Wagner’s Law in Sri Lanka: An Econometric Analysis. International Scholarly Research Notices, Vol. 2012, Article ID 573826, 9 pages. https://doi.org/10.5402/2012/573826

Khandelwal, V. (2015). Impact of energy consumption, GDP & Fiscal deficit on public health expenditure in India: An ARDL bounds testing approach. Energy Procedia, 75, 2658-2664. https://doi.org/10.1016/j.egypro.2015.07.652

Kouassi, E., Akinkugbe, O., Kutlo, N. O., & Brou, J. M. B. (2017). Health expenditure and growth dynamics in the SADC region: evidence from non-stationary panel data with cross section dependence and unobserved heterogeneity. International Journal of Health Economics and Management, 18(1), 47-66. https://doi.org/10.1007/s10754-017-9223-y

Kroll, C., Warchold, A., & Pradhan, P. (2019). Sustainable Development Goals (SDGs): Are we successful in turning trade-offs into synergies? Palgrave Communications, 5, 140. https://doi.org/10.1057/s41599-019-0335-5

Lamartina, S., & Zaghini, A. (2011). Increasing Public Expenditure: Wagner’s Law in OECD Countries. German Economic Review, 12(2), 149–164. https://doi.org/10.1111/j.1468-0475.2010.00517.

Lee, W. C., Jiang, L., Phillips, C. D., & Ohsfeldt, R. L. (2014). Rural-Urban Differences in Health Care Expenditures: Empirical Data from US Households. Advances in Public Health, Vol. 2014, Article ID 435780. https://doi.org/10.1155/2014/435780

Liu, Y., & Noor, R. (2020). Energy efficiency in ASEAN: Trends and financing schemes. ADBI Working Paper 1196.

Machalek, R., & Martin, M. W. (2015). Sociobiology and sociology: a new synthesis. International Encyclopedia of the Social and Behavioral Sciences (Second Edition), 2015, 892-898. https://doi.org/10.1016/B978-0-08-097086-8.32010-4

Mattsson, A. D., Fors, S., & Kareholt, I. (2017). Different indicators of socioeconomic status and their relative importance as determinants of health in age. International Journal for Equity in Health, 16(173).

https://doi.org/10.1186/s12939-017-0670-3

Mujtaba, G., & Shahzad, S. J. H. (2021). Air pollutants, economic growth and public health: implications for sustainable development in OECD countries. Environmental Science and Pollution Research, 28(10), 12686-12698.

https://link.springer.com/article/10.1007/s11356-020-11212-1

Mulyanto, J., Kunst, A. E., & Kringos, D. S. (2019). Geographical inequalities in healthcare utilisation and the contribution of compositional factors: a multilevel analysis of 497 districts in Indonesia. Health and Place, 60, 102236.

https://doi.org/10.1016/j.healthplace.2019.102236

Narayan, P. K., & Narayan, S. (2008). Does environmental quality influence health expenditures? Empirical evidence from a panel of selected OECD countries. Ecological economics, 65(2), 367-374. https://doi.org/10.1016/j.ecolecon.2007.07.005

Pan, J., & Liu, G. (2012). The determinants of Chinese provincial government health expenditures: evidence from 2002-2006 data. Health Economics, 21(7), 757-777. https://doi.org/10.1002/hec.1742

Peña-Sánchez, A. R., Ruiz-Chico, J., & Jiménez-García, M. (2021). Dynamics of Public Spending on Health and Socio-Economic Development in the European Union: An Analysis from the Perspective of the Sustainable Development Goals. Healthcare, 9, 353. https://doi.org/10.3390/healthcare9030353

Peng, X., Tang, X., Chen, Y., & Zhang, J. (2021). Ranking the Healthcare Resource Factors for Public Satisfaction with Health System in China—Based on the Grey Relational Analysis Models. International Journal of Environmental Research and Public Health, 18, 995. https://doi.org/10.3390/ijerph18030995

Piabuo, S. M., & Tieguhong, J. C. (2017). Health expenditure and economic growth-a review of the literature and an analysis between the economic community for central African states (CEMAC) and selected African countries. Health economics review, 7(1), 23. https://doi.org/10.1186/s13561-017-0159-1

Raghupathi, V., & Raghupathi, W. (2020). Healthcare expenditure and economic performance: Insights from the United States Data. Frontiers in Public Health, 8, 156. https://doi.org/10.3389/fpubh.2020.00156

Rahman, M. M., Khanam, R., & Rahman, M. (2018). Health care expenditure and health outcome nexus: new evidence from the SAARC-ASEAN region. Globalization and Health, 14, 113. https://doi.org/10.1186/s12992-018-0430-1

Rasul, G., Nepal, A. K., Hussain, A., Maharjan, A., Joshi, S., Lama, A., Gurung, P., Ahmad, F., Mishra, A., & Sharma, E. (2021). Socio-Economic Implications of COVID-19 Pandemic in South Asia: Emerging Risks and Growing Challenges. Frontiers in Sociology, 6, 629693. https:/doi.org/10.3389/fsoc.2021.629693

Rezaei, S., Fallah, R., Karyani, A. K., Daroudi, R., Zandiyan, H., & Hajizadeh, M. (2016). Determinants of healthcare expenditures in Iran: evidence from a time series analysis. Medical Journal of the Islamic Republic of Iran, 30, 313.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4898847/

Sagarik, D. (2014). Public expenditures on health in Asean member countries: an analysis of trends and policy determinants. International Conference on Trends in Economics, Humanities and Management, 13-14. http://dx.doi.org/10.15242/ICEHM.ED0814067

Saida, Z., & Kais, S. (2018). Environmental pollution, health expenditure and economic growth and in the Sub-Saharan Africa countries: Panel ARDL approach. Sustainable Cities and Society, 41, 833-840. https://doi.org/10.1016/j.scs.2018.04.034

Samadi, A., & Rad, E. H. (2013). Determinants of healthcare expenditure in Economic Cooperation Organization (ECO) countries: evidence from panel cointegration tests. International Journal of Health Policy and Management, 1(1), 63-68.

https://doi.org/10.15171/ijhpm.2013.10

Shantikumar, S. (2016). Regression and correlation. HealthKnowledge. https://www.healthknowledge.org.uk/public-health-textbook/research-methods/1b-statistical-methods/regression-correlation

Taghizadeh-Hesary, F., & Taghizadeh-Hesary, F. (2020). The Impacts of Air Pollution on Health and Economy in Southeast Asia. Energies, 13, 1812.

https://doi.org/10.3390/en13071812

Tahir, M., Khan, I., & Shah, A. M. (2015). Foreign remittances, foreign direct investment, foreign imports and economic growth in Pakistan: a time series analysis. Arab Economics and Business Journal, 10, 82-89. https://doi.org/10.1016/j.aebj.2015.06.001

Tan, C. C., Lam, C. S. P., Matchar, D. B., Zee, Y. K., & Wong, J. E. L. (2021). Singapore's health-care system: key features, challenges, and shifts. The Lancet, 398(10305), 1091-1104. https://doi.org/10.1016/S0140-6736(21)00252-X

The World Bank Group. (2020). Data Bank.

https://databank.worldbank.org/reports.aspx?source=2&type=metadata&series=SP.URB.GROW

Ullah, I., Rehman, A., Khan, F. U., Shah, H. M., & Khan, F. (2019). Nexus between trade, co2 emissions, renewable energy, and health expenditure in Pakistan. The International Journal of Health Planning and Management, 35(4), 818-831.

https://doi.org/10.1002/hpm.2912

Wang, K. M. (2011) Health care expenditure and economic growth: Quantile panel-type analysis. Economic Modelling, 28(4), 1536-1549.

https://doi.org/10.1016/j.econmod.2011.02.008

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