Sağlık Harcamalarının Belirleyicileri Üzerine Bir Uygulama: Çevre Kirliliği ve Yönetişimin Etkilerinin İncelenmesi

Bu çalışmada seçilmiş 27 OECD ülkesine ait 2000-2015 dönemi verileri dikkate alınarak sağlık harcamalarının belirleyicileri incelenmiştir. Bu süreçte bir bağımlı ve beş bağımsız değişken içeren dört ekonometrik model oluşturulmuştur. Bu modelleri tahmin etmek için panel veri analizi kullanılmıştır. Benzer çalışmalarda kullanılmış olan tipik belirleyicilere (gelir, ortalama yaşam beklentisi, genç ve yaşlı nüfusun çalışma çağındaki nüfusa oranı gibi) ek olarak modele iki değişken eklenmiştir: Birincisi çevre kirliliğidir (Sülfür Oksitler-SOx, Karbon Monoksit-CM, Nitrojen Oksitler-NOx ve Karbondioksit-CO2 olmak üzere dört farklı kirleticiyle yaklaşığı alınmıştır). İkincisiyse Uluslararası Ülke Risk Rehberi’nden elde edilmiş olan yönetişim indeksidir. Kullanılan dört kirleticiye göre oluşturulmuş olan dört modelin de sonuçlarına göre: Gelir, ortalama yaşam beklentisi, yönetişim indeksindeki iyileşmeler ve bağımlı nüfus oranı sağlık harcamalarını pozitif bir biçimde etkilemektedir. Ek olarak, SOx ve CO2 değişkenlerinin katsayıları anlamlı ve pozitifken; CM ve NOx değişkenlerinin katsayıları pozitif fakat anlamsızdır. Bu sonuçlara bağlı olarak bazı politika önerileri de sunulmuştur.

Anahtar Kelimeler:

Sağlık Harcamaları, Panel Veri Analizi, OECD Ülkeleri, Çevre Kirliliği, Yönetişim, Yönetişim

An Application on the Determinants of Health Expenditures: Investigating the Impacts of Environmental Pollution and Governance

This study investigates the determinants of health expenditures for the selected 27 OECD countries considering the period 2000-2015. Four econometric models, each of which includes one dependent and five independent variables, are constructed. Panel data analysis tools are employed. Besides using typical determinants of health expenditures (income, life expectancy and age dependency ratio), two more variables are additionally included: environmental pollution (which is separately proxied by four pollutants, namely Sulphur Oxides-SOx, Carbon Monoxide-CM, Nitrogen Oxides-NOx and Carbon Dioxides-CO2) and a governance indicator that is the rankings by the International Country Risk Guide (ICGR). In all four models, which correspond to each pollutant employed; income, life expectancy, improvements in governance and dependency ratio significantly and positively affect health expenditures. Moreover, while the coefficients of SOx and CO2 are significant and positive, the coefficients of CM and NOx are positive but insignificant. Some policy recommendations are put forward related to these results.

Keywords:

Health Expenditures, Panel Data Analysis, OECD Countries, Environmental Pollution, Governance,

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