ArticleHealth economics2023
The effect of health financing systems on health system outcomes: A cross-country panel analysis.
Article in Health economics, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 34 papers, 1 of them a synthesis that pooled it.
What it found
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Who cites it
34 citing papers in PubMed, 1 synthesis or guideline pooled it.
- The impact of health insurance on maternal and reproductive health service utilization and financial protection in low- and lower middle-income countries: a systematic review of the evidence.BMC health services research · 2024Pooled it
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- The role of health financing system and pluralism in achieving sustainable development goal health outcomes in India: a multilevel analysis.International journal for equity in health · 2026Article
- Patient Satisfaction with Nursing Care Quality: Sociodemographic, Hospitalization, and Personality Factors.Nursing reports (Pavia, Italy) · 2026Article
- Financing Regimes and Case-Mix Complexity in Psychiatric Hospitals Beyond the Pandemic Shock-Insights from a Regional European Healthcare System.Healthcare (Basel, Switzerland) · 2026Article
- Market strategies used by private hospital providers to consolidate and increase power; a systematic scoping review and evaluative synthesis.Globalization and health · 2026Article
- Do Fossil Fuel Subsidies Crowd Out Health Expenditure? A Country-Level Longitudinal Analysis.Health economics · 2026Article
- State capacity and health system financing: a cross-country analysis.BMJ global health · 2026Article
- Healthcare in the United States: politics, policy, and potential global impact.Journal of thrombosis and thrombolysis · 2026Article
- Health financing inequality in fragmented health systems: evidence from Mexico, 2000-2023.International journal for equity in health · 2026Article
- Policy text analysis on inheritance and innovation of Mongolian medicine culture in China.Frontiers in public health · 2026Article
- Uncovering hidden patterns: How good governance and health outcomes are shaped by the public healthcare funding?Frontiers in public health · 2026Article
- Health financing strategies for achieving Universal Health Coverage in low- and middle-income countries: a narrative review.Frontiers in public health · 2026Review
- Health financing and systems in African small and island states: Unique challenges and opportunities in achieving universal health coverage.SSM - health systems · 2025Article
- The maternal and child mortality in the Middle East and North Africa between 2000 and 2020: the role of health financing.Global health research and policy · 2025Article
- Measurement of catastrophic health expenditures in households with essential hypertension and type 2 diabetes mellitus in cold regions of China.Health economics review · 2025Article
- Preventing chronic kidney disease and maintaining kidney health: conclusions from a Kidney Disease: Improving Global Outcomes (KDIGO) Controversies Conference.Kidney international · 2025Article
- It is time to increase Africa's governmental representation on the governing board of the global fund to fight AIDS, tuberculosis and malaria.BMJ global health · 2025Article
- Digital pulse: Social media reaction to South Africa's National Health Insurance implementation.African journal of primary health care & family medicine · 2025Article
Corrections and comments
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Authors and funding
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Several low- and middle-income countries are considering health financing system reforms to accelerate progress toward universal health coverage (UHC). However, empirical evidence of the effect of health financing systems on health system outcomes is scarce, partly because it is difficult to quantitatively capture the 'health financing system'. We assign country-year observations to one of three health financing systems (i.e., predominantly out-of-pocket, social health insurance (SHI) or government-financed), using clustering based on out-of-pocket, contributory SHI and non-contributory government expenditure, as a percentage of total health expenditures. We then estimate the effect of these different systems on health system outcomes, using fixed effects regressions. We find that transitions from OOP-dominant to government-financed systems improved most outcomes more than did transitions to SHI systems. Transitions to government financing increases life expectancy (+1.3 years, p < 0.05) and reduces under-5 mortality (-8.7%, p < 0.05) and catastrophic health expenditure incidence (-3.3 percentage points, p < 0.05). Results are robust to several sensitivity tests. It is more likely that increases in non-contributory government financing rather than SHI financing improve health system outcomes. Notable reasons include SHI's higher implementation costs and more limited coverage. These results may raise a warning for policymakers considering SHI reforms to reach UHC.
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