Health expenditures and causa mortis: an investigation on municipalities of the State of Paraná, Brazil

Detalhes bibliográficos
Autor(a) principal: Tallys Kalynka Feldens
Data de Publicação: 2022
Outros Autores: Kênia Barreiro de Souza
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Cadernos de Saúde Pública
Texto Completo: https://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/7904
Resumo: The Brazilian government shares the responsibility of financing public health among federal, state, and municipal levels. Health expenditures are thus uneven across the country and cannot contribute equally to health outcomes across disease categories. This study aims to identify how the health expenditures of municipalities affect the mortality rate in the state of Paraná by causa mortis. We considered years of life lost for each municipality, the chapters of the International Classification of Diseases (10th revision), and the elasticity of this measure in relation to public health expenditure. Considering the possibility of endogeneity, this study follows the instrumental variable approach in a panel of generalized method of moments - instrumental variable (GMM-IV) with fixed effects. Our results show that a 1% increase in health expenditure could decrease the average number of years lost specifically for some causes from 0.176% to 1.56% at the municipal level. These findings could elucidate policy perspective within state finance.
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spelling Health expenditures and causa mortis: an investigation on municipalities of the State of Paraná, BrazilHealthcare FinancingBudgetsYears of Life LostICD-10Health ResourcesThe Brazilian government shares the responsibility of financing public health among federal, state, and municipal levels. Health expenditures are thus uneven across the country and cannot contribute equally to health outcomes across disease categories. This study aims to identify how the health expenditures of municipalities affect the mortality rate in the state of Paraná by causa mortis. We considered years of life lost for each municipality, the chapters of the International Classification of Diseases (10th revision), and the elasticity of this measure in relation to public health expenditure. Considering the possibility of endogeneity, this study follows the instrumental variable approach in a panel of generalized method of moments - instrumental variable (GMM-IV) with fixed effects. Our results show that a 1% increase in health expenditure could decrease the average number of years lost specifically for some causes from 0.176% to 1.56% at the municipal level. These findings could elucidate policy perspective within state finance.La financiación de la salud pública es una responsabilidad compartida entre las tres esferas del gobierno brasileño, a nivel federal, estatal y municipal. En este sentido, los gastos son desiguales en el territorio, y no se puede esperar que contribuyan de forma homogénea a los resultados de salud en las distintas categorías de enfermedades. La función de este trabajo es identificar cómo los gastos de los municipios afectan a la tasa de mortalidad en el Estado de Paraná, por causa mortis. Se consideraron los años de vida perdidos para cada municipio, los capítulos de la Clasificación Internacional de Enfermedades (10ª revisión), y se estimó la elasticidad de esta medida en relación con el gasto sanitario público. Teniendo en cuenta la posibilidad de endogeneidad, este trabajo sigue el enfoque de variables instrumentales en un panel de los método generalizado de momentos (GMM-IV) con efectos fijos. Nuestros resultados muestran que un aumento del 1% en el gasto sanitario puede disminuir el número medio de años perdidos específicamente por algunas causas del 0,176% al 1,56%, a nivel municipal. Esto puede arrojar algo de luz sobre la perspectiva política dentro de las finanzas de los estados.O financiamento da saúde pública é uma responsabilidade compartilhada entre as três esferas governamentais brasileiras, i.e., a federal, estadual e municipal. Logo, gastos divergem pelo território e não se poderia esperar que contribuíssem de forma homogênea para os desfechos de saúde em todos os tipos de doença. Este artigo busca identificar como gastos municipais afetam a taxa de mortalidade no Estado do Paraná dado sua causa mortis. Consideramos anos de vida perdidos para cada município, os capítulos da Classificação Internacional de Doenças (10ª revisão) e estimamos a elasticidade dessa medida em relação aos gastos públicos em saúde. Considerando uma possível endogeneidade, este artigo segue a abordagem variável instrumental em um painel de método generalizado de momentos (GMM-IV) com efeitos fixos. Nossos resultados mostram que um aumento de 1% nos gastos municipais com saúde pode diminuir o número médio de anos perdidos entre 0,176% e 1,56% para algumas causas especificas de mortalidade. Nosso estudo pode lançar alguma luz sobre a perspectiva política das finanças dos estados.Reports in Public HealthCadernos de Saúde Pública2022-07-25info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersiontext/htmlapplication/pdfhttps://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/7904Reports in Public Health; Vol. 38 No. 7 (2022): JulyCadernos de Saúde Pública; v. 38 n. 7 (2022): Julho1678-44640102-311Xreponame:Cadernos de Saúde Públicainstname:Fundação Oswaldo Cruz (FIOCRUZ)instacron:FIOCRUZenghttps://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/7904/17690https://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/7904/17691Tallys Kalynka FeldensKênia Barreiro de Souzainfo:eu-repo/semantics/openAccess2024-03-06T15:30:15Zoai:ojs.teste-cadernos.ensp.fiocruz.br:article/7904Revistahttps://cadernos.ensp.fiocruz.br/ojs/index.php/csphttps://cadernos.ensp.fiocruz.br/ojs/index.php/csp/oaicadernos@ensp.fiocruz.br||cadernos@ensp.fiocruz.br1678-44640102-311Xopendoar:2024-03-06T13:09:03.957294Cadernos de Saúde Pública - Fundação Oswaldo Cruz (FIOCRUZ)true
dc.title.none.fl_str_mv Health expenditures and causa mortis: an investigation on municipalities of the State of Paraná, Brazil
title Health expenditures and causa mortis: an investigation on municipalities of the State of Paraná, Brazil
spellingShingle Health expenditures and causa mortis: an investigation on municipalities of the State of Paraná, Brazil
Tallys Kalynka Feldens
Healthcare Financing
Budgets
Years of Life Lost
ICD-10
Health Resources
title_short Health expenditures and causa mortis: an investigation on municipalities of the State of Paraná, Brazil
title_full Health expenditures and causa mortis: an investigation on municipalities of the State of Paraná, Brazil
title_fullStr Health expenditures and causa mortis: an investigation on municipalities of the State of Paraná, Brazil
title_full_unstemmed Health expenditures and causa mortis: an investigation on municipalities of the State of Paraná, Brazil
title_sort Health expenditures and causa mortis: an investigation on municipalities of the State of Paraná, Brazil
author Tallys Kalynka Feldens
author_facet Tallys Kalynka Feldens
Kênia Barreiro de Souza
author_role author
author2 Kênia Barreiro de Souza
author2_role author
dc.contributor.author.fl_str_mv Tallys Kalynka Feldens
Kênia Barreiro de Souza
dc.subject.por.fl_str_mv Healthcare Financing
Budgets
Years of Life Lost
ICD-10
Health Resources
topic Healthcare Financing
Budgets
Years of Life Lost
ICD-10
Health Resources
description The Brazilian government shares the responsibility of financing public health among federal, state, and municipal levels. Health expenditures are thus uneven across the country and cannot contribute equally to health outcomes across disease categories. This study aims to identify how the health expenditures of municipalities affect the mortality rate in the state of Paraná by causa mortis. We considered years of life lost for each municipality, the chapters of the International Classification of Diseases (10th revision), and the elasticity of this measure in relation to public health expenditure. Considering the possibility of endogeneity, this study follows the instrumental variable approach in a panel of generalized method of moments - instrumental variable (GMM-IV) with fixed effects. Our results show that a 1% increase in health expenditure could decrease the average number of years lost specifically for some causes from 0.176% to 1.56% at the municipal level. These findings could elucidate policy perspective within state finance.
publishDate 2022
dc.date.none.fl_str_mv 2022-07-25
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
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dc.identifier.uri.fl_str_mv https://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/7904
url https://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/7904
dc.language.iso.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv https://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/7904/17690
https://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/7904/17691
dc.rights.driver.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
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application/pdf
dc.publisher.none.fl_str_mv Reports in Public Health
Cadernos de Saúde Pública
publisher.none.fl_str_mv Reports in Public Health
Cadernos de Saúde Pública
dc.source.none.fl_str_mv Reports in Public Health; Vol. 38 No. 7 (2022): July
Cadernos de Saúde Pública; v. 38 n. 7 (2022): Julho
1678-4464
0102-311X
reponame:Cadernos de Saúde Pública
instname:Fundação Oswaldo Cruz (FIOCRUZ)
instacron:FIOCRUZ
instname_str Fundação Oswaldo Cruz (FIOCRUZ)
instacron_str FIOCRUZ
institution FIOCRUZ
reponame_str Cadernos de Saúde Pública
collection Cadernos de Saúde Pública
repository.name.fl_str_mv Cadernos de Saúde Pública - Fundação Oswaldo Cruz (FIOCRUZ)
repository.mail.fl_str_mv cadernos@ensp.fiocruz.br||cadernos@ensp.fiocruz.br
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