Skip to main content
Erschienen in: Quality & Quantity 1/2018

30.01.2017

Distribution of the benefits from public health expenditures in Ghana

verfasst von: Micheal Kofi Boachie, K. Ramu

Erschienen in: Quality & Quantity | Ausgabe 1/2018

Einloggen

Aktivieren Sie unsere intelligente Suche um passende Fachinhalte oder Patente zu finden.

search-config
loading …

Abstract

Government intervention in the healthcare market is, partly, justified on grounds of equity and redistribution. The intervention usually comes in the form of expenditures—direct provision of care and subsidies—in many developing countries. Given the expected redistributive impact of public health expenditures, the aim of this paper was to establish the beneficiaries of public health spending in Ghana using utilisation data for outpatient care. We applied utilisation incidence analysis on outpatient healthcare utilisation data from the Study on Global AGEing and Adult Health, Ghana Wave 1 to conduct the analysis. The results show that ill-health was high in the rural areas, particularly among low income groups. While utilisation of public healthcare facilities for outpatient care was generally high, there was some disparities in utilisation. That is, utilisation of public health services, especially hospital care, was unfairly distributed among various income/wealth groups. Implications of these findings are that policymakers should continue to devise means to ensure equitable and even distribution of healthcare services, particularly hospital care, so that the poor and other vulnerable groups, whose plight call for government intervention, benefit.

Sie haben noch keine Lizenz? Dann Informieren Sie sich jetzt über unsere Produkte:

Springer Professional "Wirtschaft+Technik"

Online-Abonnement

Mit Springer Professional "Wirtschaft+Technik" erhalten Sie Zugriff auf:

  • über 102.000 Bücher
  • über 537 Zeitschriften

aus folgenden Fachgebieten:

  • Automobil + Motoren
  • Bauwesen + Immobilien
  • Business IT + Informatik
  • Elektrotechnik + Elektronik
  • Energie + Nachhaltigkeit
  • Finance + Banking
  • Management + Führung
  • Marketing + Vertrieb
  • Maschinenbau + Werkstoffe
  • Versicherung + Risiko

Jetzt Wissensvorsprung sichern!

Springer Professional "Wirtschaft"

Online-Abonnement

Mit Springer Professional "Wirtschaft" erhalten Sie Zugriff auf:

  • über 67.000 Bücher
  • über 340 Zeitschriften

aus folgenden Fachgebieten:

  • Bauwesen + Immobilien
  • Business IT + Informatik
  • Finance + Banking
  • Management + Führung
  • Marketing + Vertrieb
  • Versicherung + Risiko




Jetzt Wissensvorsprung sichern!

Fußnoten
1
Community-Based and Health Planning Services (CHPS) compounds are lower level public health facilities that provide outpatient primary healthcare services in rural areas. The facilities are below health centres and clinics. Emergency first aid services to patients are usually provided by CHPS compound before referral.
 
Literatur
Zurück zum Zitat Acharya, D., Vaidyanathan, G., Muraleedharan, V., Dheenadayalan, D., Dash, U.: Do the Poor Benefit from Public Spending on Healthcare in India? Results from Benefit (Utilization) Incidence Analysis in Tamil Nadu and Orissa. CREHS (2011) Acharya, D., Vaidyanathan, G., Muraleedharan, V., Dheenadayalan, D., Dash, U.: Do the Poor Benefit from Public Spending on Healthcare in India? Results from Benefit (Utilization) Incidence Analysis in Tamil Nadu and Orissa. CREHS (2011)
Zurück zum Zitat Akazili, J., Garshong, B., Aikins, M., Gyapong, J., McIntyre, D.: Progressivity of health care financing and incidence of service benefits in Ghana. Health Policy Plan. 27, 13–22 (2012). doi:10.1093/heapol/czs004 CrossRef Akazili, J., Garshong, B., Aikins, M., Gyapong, J., McIntyre, D.: Progressivity of health care financing and incidence of service benefits in Ghana. Health Policy Plan. 27, 13–22 (2012). doi:10.​1093/​heapol/​czs004 CrossRef
Zurück zum Zitat Arrow, K.: Uncertainty and the welfare economics of medical care. Am. Econ. Rev. 53, 941–973 (1963) Arrow, K.: Uncertainty and the welfare economics of medical care. Am. Econ. Rev. 53, 941–973 (1963)
Zurück zum Zitat Auster, R., Leveson, I., Sarachek, D.: The production of health, an exploratory study. J. Hum. Resour. 4(4), 411–436 (1969)CrossRef Auster, R., Leveson, I., Sarachek, D.: The production of health, an exploratory study. J. Hum. Resour. 4(4), 411–436 (1969)CrossRef
Zurück zum Zitat Berger, M.C., Messer, J.: Public financing of health expenditures, insurance, and health outcomes. Appl. Econ. 34(17), 2105–2113 (2002)CrossRef Berger, M.C., Messer, J.: Public financing of health expenditures, insurance, and health outcomes. Appl. Econ. 34(17), 2105–2113 (2002)CrossRef
Zurück zum Zitat Besley, T., Coate, S.: Public provision of private goods and the redistribution of income. Am. Econ. Rev. 81(4), 979–984 (1991) Besley, T., Coate, S.: Public provision of private goods and the redistribution of income. Am. Econ. Rev. 81(4), 979–984 (1991)
Zurück zum Zitat Bidani, M., Ravallion, M.: Decomposing Social Indicators Using Distributional Data. World Bank Working Paper 1487 (1995) Bidani, M., Ravallion, M.: Decomposing Social Indicators Using Distributional Data. World Bank Working Paper 1487 (1995)
Zurück zum Zitat Biritwum, R., Mensah, G., Yawson, A., Minicuci, N.: Study on global AGEing and adult health (SAGE) Wave 1: The Ghana National Report (2013) Biritwum, R., Mensah, G., Yawson, A., Minicuci, N.: Study on global AGEing and adult health (SAGE) Wave 1: The Ghana National Report (2013)
Zurück zum Zitat Bokhari, F.A., Gai, Y., Gottret, P.: Government health expenditures and health outcomes. Health Econ. 16(3), 257–273 (2007)CrossRef Bokhari, F.A., Gai, Y., Gottret, P.: Government health expenditures and health outcomes. Health Econ. 16(3), 257–273 (2007)CrossRef
Zurück zum Zitat Bose, M.: Access to in-patient healthcare in West Bengal: A benefit incidence analysis. International Institute for Population Sciences, Mumbai (2014) Bose, M.: Access to in-patient healthcare in West Bengal: A benefit incidence analysis. International Institute for Population Sciences, Mumbai (2014)
Zurück zum Zitat Canagarajah, S., Ye, X.: Public Health and Education Spending in Ghana 1992–1998: Issues of Equity and Efficiency. The World Bank, Washington, DC (2001) Canagarajah, S., Ye, X.: Public Health and Education Spending in Ghana 1992–1998: Issues of Equity and Efficiency. The World Bank, Washington, DC (2001)
Zurück zum Zitat Chakraborty, L., Singh, Y., Jacob, J.F.: Public Expenditure Benefit Incidence on Health: Selective Evidence from India. National Institute of Public Finance and Policy, New Delhi (2012) Chakraborty, L., Singh, Y., Jacob, J.F.: Public Expenditure Benefit Incidence on Health: Selective Evidence from India. National Institute of Public Finance and Policy, New Delhi (2012)
Zurück zum Zitat Chen, M., Fang, G., Wang, L., Wang, Z., Zhao, Y., Si, L.: Who benefits from government healthcare subsidies? An assessment of the equity of healthcare benefits distribution in China. PLoS ONE 10(3), e0119840 (2015). doi:10.1371/journal.pone.0119840 CrossRef Chen, M., Fang, G., Wang, L., Wang, Z., Zhao, Y., Si, L.: Who benefits from government healthcare subsidies? An assessment of the equity of healthcare benefits distribution in China. PLoS ONE 10(3), e0119840 (2015). doi:10.​1371/​journal.​pone.​0119840 CrossRef
Zurück zum Zitat Davoodi, H.R., Tiongson, E.R., Asawanuchit, S.S.: Benefit incidence of public education and health spending worldwide: evidence from a new database. Poverty Public Policy 2(2), 5–52 (2010)CrossRef Davoodi, H.R., Tiongson, E.R., Asawanuchit, S.S.: Benefit incidence of public education and health spending worldwide: evidence from a new database. Poverty Public Policy 2(2), 5–52 (2010)CrossRef
Zurück zum Zitat Davoodi, H.R., Tiongson, E.R., Asawanuchit, S.S.: How Useful are Benefit Incidence Analysis of Public Education and Health Spending? IMF Working Paper 03/22733, International Monetary Fund, Washington D.C. (2003) Davoodi, H.R., Tiongson, E.R., Asawanuchit, S.S.: How Useful are Benefit Incidence Analysis of Public Education and Health Spending? IMF Working Paper 03/22733, International Monetary Fund, Washington D.C. (2003)
Zurück zum Zitat Demery, L., Gaddias, I.: Social Spending, Poverty and Gender Equity in Kenya: A Benefit Incidence Analysis. Support to Public Finance Management Reforms, Kenya (2009) Demery, L., Gaddias, I.: Social Spending, Poverty and Gender Equity in Kenya: A Benefit Incidence Analysis. Support to Public Finance Management Reforms, Kenya (2009)
Zurück zum Zitat Demery, L.: Benefit Incidence: A Practitioner’s Guide. World Bank, Washington, D.C. (2000) Demery, L.: Benefit Incidence: A Practitioner’s Guide. World Bank, Washington, D.C. (2000)
Zurück zum Zitat Filmer, D., Pritchett, L.: The impact of public spending on health: does money matter? Soc. Sci. Med. 49(10), 1309–1323 (1999)CrossRef Filmer, D., Pritchett, L.: The impact of public spending on health: does money matter? Soc. Sci. Med. 49(10), 1309–1323 (1999)CrossRef
Zurück zum Zitat Ghana Statistical Service: Poverty profile in Ghana: 2005–2013. Ghana Statistical Service. Accra, Ghana (2014) Ghana Statistical Service: Poverty profile in Ghana: 2005–2013. Ghana Statistical Service. Accra, Ghana (2014)
Zurück zum Zitat Gillespie, W.I.: Effect of public expenditures on the distribution of income. In: Musgrave, R. (ed.) Essays in Fiscal Federalism. The Brookings Institution, Washington (1965) Gillespie, W.I.: Effect of public expenditures on the distribution of income. In: Musgrave, R. (ed.) Essays in Fiscal Federalism. The Brookings Institution, Washington (1965)
Zurück zum Zitat Gwatkin, D.R.: Health inequalities and the health for the poor: what do we know? What can we do? Bulletin of the WHO 78, 3–18 (2000) Gwatkin, D.R.: Health inequalities and the health for the poor: what do we know? What can we do? Bulletin of the WHO 78, 3–18 (2000)
Zurück zum Zitat Halasa, Y., Nassar, H., Zaky, H.: Benefit-incidence analysis of government spending on Ministry of Health outpatient services in Jordan. East Mediterr. Health J. 16, 467–473 (2010) Halasa, Y., Nassar, H., Zaky, H.: Benefit-incidence analysis of government spending on Ministry of Health outpatient services in Jordan. East Mediterr. Health J. 16, 467–473 (2010)
Zurück zum Zitat Jimenez, E.: Pricing Policy in the Social Sectors: Cost Recovery for Education and Health in Developing Countries. The Johns Hopkins University Press, Baltimore (1987) Jimenez, E.: Pricing Policy in the Social Sectors: Cost Recovery for Education and Health in Developing Countries. The Johns Hopkins University Press, Baltimore (1987)
Zurück zum Zitat Kim, T.K., Lane, S.R.: Government health expenditure and public health outcomes: a comparative study among 17 countries and implications for US Health care reform. Am. Int. J. Contemp. Res. 3(9), 8–13 (2013) Kim, T.K., Lane, S.R.: Government health expenditure and public health outcomes: a comparative study among 17 countries and implications for US Health care reform. Am. Int. J. Contemp. Res. 3(9), 8–13 (2013)
Zurück zum Zitat LeGrand, J.: The distribution of public expenditure: the case of health care. Economica 45, 125–142 (1978)CrossRef LeGrand, J.: The distribution of public expenditure: the case of health care. Economica 45, 125–142 (1978)CrossRef
Zurück zum Zitat Leu, R.E., Frey, R.L., Buhmann, B.: Taxes, expenditures, and income distribution in Switzerland. J. Soc. Policy 14, 341–360 (1985)CrossRef Leu, R.E., Frey, R.L., Buhmann, B.: Taxes, expenditures, and income distribution in Switzerland. J. Soc. Policy 14, 341–360 (1985)CrossRef
Zurück zum Zitat Mahal, A., Yazbeck, A.S., Peters, D.H., Ramanan, G.N.: The Poor and Health Service Use in India. Health, Nutrition and Population (HNP) Discussion Paper, World Bank (2001) Mahal, A., Yazbeck, A.S., Peters, D.H., Ramanan, G.N.: The Poor and Health Service Use in India. Health, Nutrition and Population (HNP) Discussion Paper, World Bank (2001)
Zurück zum Zitat Musgrove, P. (1996) Public and Private Roles in Health: Theory and Financing Patterns, HNP Discussion Paper No. 339, World Bank, Washington D.C Musgrove, P. (1996) Public and Private Roles in Health: Theory and Financing Patterns, HNP Discussion Paper No. 339, World Bank, Washington D.C
Zurück zum Zitat O’Donnell, O., Doorslaer, E.V., Wagstaff, A., Lindelow, M.: Analyzing Health Equity Using Household Survey Data: A Guide to Techniques & Their Implementation. The World Bank, Washington DC (2008) O’Donnell, O., Doorslaer, E.V., Wagstaff, A., Lindelow, M.: Analyzing Health Equity Using Household Survey Data: A Guide to Techniques & Their Implementation. The World Bank, Washington DC (2008)
Zurück zum Zitat O’Higgins, M., Ruggles, P.: The distribution of public expenditures among households in the United States. Rev. Income Wealth 27, 37–164 (1981a) O’Higgins, M., Ruggles, P.: The distribution of public expenditures among households in the United States. Rev. Income Wealth 27, 37–164 (1981a)
Zurück zum Zitat O’Higgins, M., Ruggles, P.: The distribution of public expenditures and taxes among households in the United Kingdom. Rev. Income Wealth 27, 298–326 (1981b)CrossRef O’Higgins, M., Ruggles, P.: The distribution of public expenditures and taxes among households in the United Kingdom. Rev. Income Wealth 27, 298–326 (1981b)CrossRef
Zurück zum Zitat Palmer, N.: Access and equity: evidence on the extent to which health services address the needs of the poor. In: Bennett, S., Gilson, L., Mills, A. (eds.) Health, Economic Development and Household Poverty, pp. 61–74. Routledge, London (2008) Palmer, N.: Access and equity: evidence on the extent to which health services address the needs of the poor. In: Bennett, S., Gilson, L., Mills, A. (eds.) Health, Economic Development and Household Poverty, pp. 61–74. Routledge, London (2008)
Zurück zum Zitat Sahn, D.E., Younger, S.D.: Expenditure incidence in Africa: microeconomic evidence. Fisc. Stud. 21(3), 329–347 (2000)CrossRef Sahn, D.E., Younger, S.D.: Expenditure incidence in Africa: microeconomic evidence. Fisc. Stud. 21(3), 329–347 (2000)CrossRef
Zurück zum Zitat Sen, A.: Why health equity? In: Anand, S., Peter, F., Sen, A. (eds.) Public Health, Ethics and Equity. Oxford University Press, Oxford (2006) Sen, A.: Why health equity? In: Anand, S., Peter, F., Sen, A. (eds.) Public Health, Ethics and Equity. Oxford University Press, Oxford (2006)
Zurück zum Zitat Srivastava, S., Bose, M., Anup, K., Sakthivel, S.: Benefit incidence analysis of institutional child delivery in India, 2004–2014: improving equity through the national health mission? BMJ Glob. Health 1, A4–A5 (2016). doi:10.1136/bmjgh2016EPHPabstracts.5 Srivastava, S., Bose, M., Anup, K., Sakthivel, S.: Benefit incidence analysis of institutional child delivery in India, 2004–2014: improving equity through the national health mission? BMJ Glob. Health 1, A4–A5 (2016). doi:10.​1136/​bmjgh2016EPHPabs​tracts.​5
Zurück zum Zitat Sundar, R: Household Survey of Health Care Utilisation and Expenditure, Working paper No. 53, NCAER: New Delhi (1995) Sundar, R: Household Survey of Health Care Utilisation and Expenditure, Working paper No. 53, NCAER: New Delhi (1995)
Zurück zum Zitat van den Boom, G.J.M, Nsowah-Nuamah, N.N.N., Overbosch, G.B.: Healthcare Provision and Self-medication in Ghana (2004) van den Boom, G.J.M, Nsowah-Nuamah, N.N.N., Overbosch, G.B.: Healthcare Provision and Self-medication in Ghana (2004)
Zurück zum Zitat Wagstaff, A.: Socio-economic inequalities in Child mortality: comparison across nine developing countries. Bull. WHO 78, 19–29 (2000) Wagstaff, A.: Socio-economic inequalities in Child mortality: comparison across nine developing countries. Bull. WHO 78, 19–29 (2000)
Zurück zum Zitat World Bank: World Development Report: Investing in Health. Oxford University Press, New York (1993) World Bank: World Development Report: Investing in Health. Oxford University Press, New York (1993)
Metadaten
Titel
Distribution of the benefits from public health expenditures in Ghana
verfasst von
Micheal Kofi Boachie
K. Ramu
Publikationsdatum
30.01.2017
Verlag
Springer Netherlands
Erschienen in
Quality & Quantity / Ausgabe 1/2018
Print ISSN: 0033-5177
Elektronische ISSN: 1573-7845
DOI
https://doi.org/10.1007/s11135-017-0475-x

Weitere Artikel der Ausgabe 1/2018

Quality & Quantity 1/2018 Zur Ausgabe