Fiscal decentralization and China's regional infant mortality

Brock, Gregory J.; Jin, Yinghua; Zeng, Tong

doi:10.1016/j.jpolmod.2015.03.001

Cited by 14 publications

(6 citation statements)

References 36 publications

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“…9 Studies on the impact of FD on health status carried out in high-, low-, and middleincome countries suggest that the policy is associated with a reduction of infant mortality rate, the extent of which varies according to country settings and study designs. [10][11][12][13][14][15][16][17][18] However, investigations from China, [19][20][21] Uganda, 22 and Indonesia 23 reveal that FD may decrease healthcare resources, provision, and coverage, as well as negatively affect healthcare financing and quality of care. Similarly, evidence of the effects of FD on spatial disparities suggests that FD increases inequitable access to care between the urban and the rural population as well as between residents of rich and poor areas.…”

Section: Introductionmentioning

confidence: 99%

The Effects of Health Sector Fiscal Decentralisation on Availability, Accessibility, and Utilisation of Healthcare Services: A Panel Data Analysis

Rotulo

Paraskevopoulou

Kondilis

2021

Int J Health Policy Manag

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Background: Fiscal Decentralisation (FD) is a widely implemented decentralisation policy consisting of the allocation of pooling and spending responsibilities from the central government to lower levels of governance within a country. In 2001, The Italian National Health System (SSN) has introduced a strong element of FD, making regions responsible for their own pooling of resources and for their budgets. Despite the relevance, only few studies exist on health sector-FD in Italy, mostly looking at the effects of FD on infant mortality. Methods: This study performs a fixed-effects panel data analysis of Italian Regions and Autonomous provinces between the years 2001 and 2017, to investigate the effects of health sector-FD on availability, accessibility, and utilisation of healthcare services in Italy. Results: FD decreases availability of staff and hospital beds, decreases utilisation of care, measured by hospitalisation rates, and increases interregional patients' mobility for healthcare purposes, a finding suggesting increased disparities in access to healthcare. These effects seem to be stronger for public – rather than private – services, and are more prominent in poorer areas. Conclusion: This evidence suggest that FD has created a fragmented and unequal healthcare system, in which levels of availability, utilisation of, and accessibility to resources – as well as the extent of public sector’s retrenchment – coincide with the wealth of the area.

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Section: Introductionmentioning

confidence: 99%

The Effects of Health Sector Fiscal Decentralisation on Availability, Accessibility, and Utilisation of Healthcare Services: A Panel Data Analysis

Rotulo

Paraskevopoulou

Kondilis

2021

Int J Health Policy Manag

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“…Bhargava, Chowdhurry, and Singh (2005) also found the same results in India. In using stochastic frontier method, Brock, Yinghua and Zeng (2015) found that fiscal decentralization does not alleviates the problems of high IMR in China. However, in a more recent study, Ou et al (2016) findings reveal positive nexus between increase in health expenditures and low life expectancy in Taiwan.…”

Section: Literature Reviewmentioning

confidence: 99%

“…In terms of empirical evidence, numerous approaches were employed in literature. The first distinction in these approaches concerns the type of data used, where some studies employed aggregated macroeconomic data (see Ou et al 2016;Lawson and Spear, 2016;Brock, Yinghua, and Zeng, 2015;Handa, 2000;Bhargava, Chowdhury, and Singh, 2005). Several others employed household data (Elder, Godderis, and Haider, 2016;Demonbynes and Trommlerova, 2016;Grepin and Bharadwaj, 2015;Pfutze, 2014;Estevan and Baland, 2007).…”

Section: Literature Reviewmentioning

confidence: 99%

“…From the foregoing, recent empirical literature identified major determinants of population health outcomes; however, there might be problematic in attempting to adopt these findings wholesale in SSA countries; because majority of these empirics are based on data from either only developed economies (such studies includes, Ou et al 2016;Liu and Mora, 2016;Buckler et al 2016;Elder et al 2016;Lawson and Spear, 2016;Brock et al 2015;Tanaka, 2015;Maiti and Petrie, 2014;Cruces et al 2012) or pooled data from both emerging and developed nations (Linden et al 2017). Meanwhile, studies on developing countries were very scanty (these few studies includes, Demonbynes and Trommlerova, 2016; Grepin and Bharadwaj, 2015;and Fayissa and Gutema, 2005).…”

Section: Literature Reviewmentioning

confidence: 99%

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Health Outcomes in Sub-Saharan Africa Countries: An Analysis of Key Determinants

Popoola

2018

MHS

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The poor health outcomes (low longevity and high mortalities) in developing countries has been great concern for citizens and policy makers alike. Although, numerous studies have focus on socio-economic drivers (like education, age of mothers, income levels, and poverty) of health outcomes in developing nations; however, the same is not true for important exogenous determinants. Therefore, this study investigated the effects of access to clean drinkable water, sanitation, fertility rate, prevalence of HIV/AIDS, health financing, and child immunization on health outcomes in sub-Sahara African (SSA) region. To achieve this, the study explored Pooled OLS, Fixed and Random Effects covering 46 countries in the region from 2000 to 2015. The findings reveal that population health outcomes - as measured by infant and under-five mortalities rates are related negatively with increase public health financing, timely children immunization, quality drinkable water supply, but directly associated with higher fertility rate, and HIV prevalence. For life expectancy at birth, increase government health spending, timely children immunization, and quality drinkable water supply are positively predicted, while relate inversely with higher fertility rate, and HIV prevalence. The findings therefore suggest that for SSA countries to achieve the United Nations’ Sustainable Development Goal three of ensuring healthy lives before 2030; emphasis should on increasing public health financing, and provision of infrastructural facilities like clean water supply and sanitation. Again, greater attention should be on enhancing child immunization, reducing fertility rates and HIV prevalence in the region.

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“…Existing studies of the influences on medical health by fiscal decentralization mainly investigate the influence of fiscal decentralization on medical fund raising [16], infant mortality rates [30][31][32], government health expenditure [33,34], and local health expenditure efficiency [35]. Few studies have explored the influence of fiscal decentralization on the expenditure of the NCMS, which is what this paper attempt to investigate.…”

Section: Introductionmentioning

confidence: 99%

Fiscal Decentralization, Local Competitions and Sustainability of Medical Insurance Funds：Evidence from China

Qian

Cheng

Lu³

et al. 2019

Sustainability

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Local governments are responsible for the management of social medical insurance for urban and rural residents in China. Under the background of fiscal decentralization between the central government and local governments, the strengthening of supervision on medical insurance funds by local governments leads to a reduction in the expenditure of the medical insurance fund, which contributes to its sustainability. By employing the provincial level panel data during 2004–2014, we used a fixed effect model and a spatial autoregression model to investigate whether fiscal decentralization has had a negative influence on the expenditure of China’s new rural cooperative medical system (NCMS) fund. We found that fiscal decentralization has had a significant influence over its per capita expenditure. Our results also indicate that higher fiscal decentralization leads to higher financial aid in the NCMS provided by local governments. Additionally, the expenditure of the NCMS and the local financial aid are influenced by nearby governments. Our results suggest that appropriate fiscal decentralization, which helps to maintain the sustainability of social medical insurance funds, should be encouraged.

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Fiscal decentralization and China's regional infant mortality

Cited by 14 publications

References 36 publications

The Effects of Health Sector Fiscal Decentralisation on Availability, Accessibility, and Utilisation of Healthcare Services: A Panel Data Analysis

The Effects of Health Sector Fiscal Decentralisation on Availability, Accessibility, and Utilisation of Healthcare Services: A Panel Data Analysis

Health Outcomes in Sub-Saharan Africa Countries: An Analysis of Key Determinants

Fiscal Decentralization, Local Competitions and Sustainability of Medical Insurance Funds：Evidence from China

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