Assessing Public Expenditure on Health from a Fiscal Space Perspective

This document delineates a simple conceptual framework for assessing fiscal space for health and provides an illustrative roadmap for guiding such assessments. The roadmap draws on lessons learned from analyses of seven fiscal space case studies co...

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Bibliographic Details
Main Authors:	Tandon, Ajay, Cashin, Cheryl
Format:	Working Paper
Language:	English en_US
Published:	World Bank, Washington, DC 2013
Subjects:	ABSENTEEISM ACCESS TO HEALTH CARE ACCOUNTING ADMINISTRATIVE COSTS AGING ALLOCATIVE EFFICIENCY BUDGET CONSTRAINT BUDGETARY RESOURCES BURDEN OF DISEASE CAPACITY MEASURE CAPITA HEALTH EXPENDITURE CENTRAL FUNDS CENTRAL GOVERNMENT CHILD HEALTH COLLECTION OF CONTRIBUTIONS COMMUNICABLE DISEASE CONTROL COMMUNICABLE DISEASES COMMUNITY HEALTH COMPUTABLE GENERAL EQUILIBRIUM COST ESTIMATES COST OF CARE CROWDING DEBT DEBT INTEREST DEMAND FOR HEALTH DEMAND FOR HEALTH SERVICES DISASTERS DISEASE CONTROL DONOR FINANCING DONOR FUNDING ECONOMIC DOWNTURNS ECONOMIC GROWTH ECONOMIC GROWTH RATES EFFECTIVENESS OF GOVERNMENT EFFECTIVENESS OF GOVERNMENT EXPENDITURE EFFICIENCY GAINS EFFICIENCY IMPROVEMENTS EMPLOYMENT EPIDEMIOLOGY EQUILIBRIUM EQUITY CONSIDERATIONS EXERCISES EXPENDITURE LEVELS EXPENDITURES EXPENDITURES ON HEALTH EXTERNAL ASSISTANCE EXTERNALITIES FINANCIAL CRISES FINANCIAL MANAGEMENT FINANCIAL POSITION FINANCIAL PROTECTION FINANCIAL RISK FINANCIAL RISK PROTECTION FINANCING OF HEALTH CARE FISCAL CAPACITY FISCAL DEFICIT FISCAL DEFICITS FISCAL ENVELOPE FISCAL HEALTH FISCAL POLICY FISCAL TARGETS FISCAL TRANSFERS GOVERNMENT BUDGET GOVERNMENT BUDGET CONSTRAINT GOVERNMENT EXPENDITURE GOVERNMENT EXPENDITURES GOVERNMENT REVENUE GOVERNMENT REVENUES GOVERNMENT SPENDING GROWTH RATE HEALTH AFFAIRS HEALTH BUDGETS HEALTH CARE HEALTH CARE COVERAGE HEALTH CARE FINANCING HEALTH CARE SERVICES HEALTH CARE SYSTEM HEALTH EXPENDITURE HEALTH EXPENDITURE PER CAPITA HEALTH EXPENDITURE SHARE HEALTH EXPENDITURES HEALTH FACILITIES HEALTH FINANCING HEALTH FUNDING HEALTH INSURANCE HEALTH INSURANCE COVERAGE HEALTH INSURANCE PROGRAM HEALTH INSURANCE SCHEME HEALTH NEEDS HEALTH ORGANIZATION HEALTH OUTCOMES HEALTH PLANS HEALTH POLICY HEALTH PRICES HEALTH PROGRAM HEALTH PROMOTION HEALTH REFORM HEALTH RESEARCH HEALTH SECTOR HEALTH SERVICE HEALTH SERVICE DELIVERY HEALTH SERVICES HEALTH SHARE HEALTH SPENDING HEALTH SPENDING SHARE HEALTH STRATEGY HEALTH SYSTEM HEALTH SYSTEM STRENGTHENING HEALTH SYSTEMS HEALTH WORKERS HEALTH-CARE HEALTH-SECTOR HIV/AIDS HOSPITALS HUMAN DEVELOPMENT HUMAN RESOURCES ILLNESS IMMUNIZATION INCIDENCE ANALYSIS INCOME GROUPS INFANT MORTALITY INFANT MORTALITY RATE INFECTIOUS DISEASES INFORMAL SECTOR INFORMAL SECTOR WORKERS INSURANCE INSURANCE COVERAGE INSURANCE PREMIUMS INSURANCE SYSTEM INTEGRATION INTEREST PAYMENTS LABOR MARKETS LIFE EXPECTANCY LOW INCOME LOW-INCOME COUNTRIES MACROECONOMIC CONDITIONS MACROECONOMIC INDICATORS MACROECONOMIC POLICIES MACROECONOMIC POLICY MEDIUM-TERM EXPENDITURE MEDIUM-TERM EXPENDITURE FRAMEWORKS MIGRATION MORTALITY NATIONAL HEALTH NATIONAL HEALTH INSURANCE NATIONAL HEALTH INSURANCE FUND NATIONAL INCOME NUTRITION PEDIATRICS POCKET PAYMENTS POVERTY LEVEL POVERTY REDUCTION PRICE ELASTICITY PRICE OF HEALTH CARE PRIMARY CARE PRIVATE PROVIDERS PRIVATE SECTOR PRIVATE SECTORS PROGRAMS PROVISION OF INSURANCE PUBLIC BUDGET PUBLIC BUDGETS PUBLIC EXPENDITURE PUBLIC EXPENDITURE MANAGEMENT PUBLIC EXPENDITURE ON HEALTH PUBLIC FUNDING PUBLIC FUNDS PUBLIC HEALTH PUBLIC HEALTH CARE PUBLIC HEALTH CARE SYSTEM PUBLIC HEALTH INSURANCE PUBLIC HEALTH INSURANCE SCHEMES PUBLIC HEALTH SPENDING PUBLIC INFRASTRUCTURE PUBLIC RESOURCES PUBLIC SECTOR PUBLIC SPENDING QUALITY OF HEALTH QUALITY OF HEALTH CARE QUANTITATIVE ASSESSMENTS RECURRENT EXPENDITURES REPRODUCTIVE HEALTH RESOURCE ALLOCATIONS REVENUE SOURCES SHARE OF HEALTH SPENDING SMOKING SOCIAL HEALTH INSURANCE SOCIAL INSURANCE SOCIAL SECURITY SOCIAL SECURITY SYSTEM STATE BUDGET TAX REVENUES TAX SYSTEMS TOTAL SPENDING TUBERCULOSIS UNCERTAINTY UNIVERSAL HEALTH INSURANCE COVERAGE WASTE WORKERS
Online Access:	http://documents.worldbank.org/curated/en/2010/02/12614836/assesing-public-expenditure-health-fiscal-space-perspective http://hdl.handle.net/10986/13613

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Summary:	This document delineates a simple conceptual framework for assessing fiscal space for health and provides an illustrative roadmap for guiding such assessments. The roadmap draws on lessons learned from analyses of seven fiscal space case studies conducted over the past two years in Cambodia, India, Indonesia, Rwanda, Tonga, Uganda, and Ukraine. The document also includes a summary of the fiscal space assessments from these seven case studies. Any assessment of fiscal space typically entails an examination of whether and how a government could feasibly increase its expenditure in the short-to-medium term, and do so in a way that is consistent with a country's macroeconomic fundamentals. Although fiscal space generally refers to overall government expenditure, for a variety of reasons there has been growing demand for a framework for analyzing fiscal space specifically for the health sector. This document outlines ways in which generalized fiscal space assessments could be adapted to take a more health-sector specific perspective: what is the impact of broader macroeconomic factors on government expenditures for health? Are there sector-specific considerations that might expand the set of possible options for generating fiscal space for health? Are there country-specific examples of innovative strategies that have been successful in increasing fiscal space for health?

Assessing Public Expenditure on Health from a Fiscal Space Perspective

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