醫療支出之外溢效果 : GVAR模型分析

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题名:	醫療支出之外溢效果 : GVAR模型分析
其它题名:	The spillover effect of health expenditure : a global VAR analysis
作者:	賴彥融;Lai, Yan-Rong
贡献者:	淡江大學產業經濟學系碩士班胡登淵;Hu, Teng-Yuan
关键词:	醫療支出;外溢效果;共伴現象;全球向量自我回歸模型;Health expenditures;Spillover;co-movement;GVAR
日期:	2012
上传时间:	2013-04-13 10:52:33 (UTC+8)
摘要:	論文提要內容：全球醫療支出數十年來皆呈現成長的趨勢，無論從人均醫療支出占人均GDP的比例或是公共醫療支出占政府支出的比例都有明顯的成長，這樣的趨勢可能為世界各國政府帶來沉重的財政負擔，也可能為人民帶來財務與健康的衝擊。因此本文利用OECD Health Data 2010資料庫進行研究分析，運用近來Pesaran, Schuermann 與 Weiner (2004)和Dees, di Mauro, Pesaran 與 Smith (2007) 所發展的GVAR模型，納入同期相關性的考量，一方面降低可能發生的偏誤，另一方面透過此模型特有的設定，考量國內變量和透過商品貿易權重加權計算的國外變量以及考量全球氣候變遷可能帶來傳染病的影響加入全球異常溫度變量作為GVAR模型中特有的全球變量，估計探討人均總醫療支出成長率、人均公共醫療支出成長率和人均私人醫療支出成長率在各國之間是否透過貿易或其它不可觀察的因素而產生外溢效果以及美國、歐元區或全球考量不同人均醫療支出成長率對不同人均醫療支出成長率或人均GDP成長率、人均GDP成長率對不同人均醫療支出成長率之特定國家的衝擊反應函數和全球預期壽命對人均公共醫療支出成長率的衝擊反應函數。傳統醫療支出文獻並未研究醫療支出的外溢效果(Spillover)，有別於傳統文獻，本研究實證結果顯示：各國在考量不同人均醫療支出成長率的模型下確實存在外溢效果，尤其在人均公共醫療支出成長率模型下有較強的外溢效果，且相互依賴貿易的國家以及醫藥貿易進口比例較高的國家更加明顯。以美國、歐元區和全球的衝擊反應結果，我們了解到醫藥貿易出口大國/區人均醫療支出成長率的正向衝擊仍可能帶給其他先進國家正向的衝擊，但所得較低的國家可能相反，人均GDP成長率有負向的衝擊可能使大多數國家提高人均醫療支出成長率，但對於醫藥出口大國/區則可能呈現相反影響，考量當前美元的全球人均公共醫療支出成長率對全球預期壽命成長率的正向衝擊下，所得較低的國家有正向的影響，全球預期壽命成長率正向衝擊所得較低的國家人均GDP成長率有較大的負向影響，而實質美元則呈現不一定情況。跨國之間可能透過貿易影響個別國家的醫療支出與預期壽命。 Abstract: Global health expenditures have been showing a growing trend for decades. Both total Health expenditure per capita share of GDP and public Health expenditure share of government expenditure have a significant growth. This kind of trend may cause a heavy financial burden for governments around the world, and also bring financial and health impact to people. This study analyzes OECD Health Data 2010 database. It uses recent GVAR model developed by Pesaran, Schuermann and Weiner (2004) and Dees, di Mauro, Pesaran and Smith (2007), incorporating contemporaneous effects. This GVAR model on the one hand reduces the possibility of errors and on the other hand, through the model of setting, takes into account the internal variables (domestic variables) and, through merchandise trade weighted variables in foreign variables. Moreover, it considers the impact of global climate change bringing infectious diseases by incorporating the Annual Global Land Temperature Anomalies variables as the global variables. This thesis investigates whether spillover effects are significant for per capita total health expenditures growth rate, and per capita public health expenditures growth rate and per capita private health expenditures growth rate through trade or some unobserved factors It also demonstrates various impulse response functions, including U.S., and Euro or Global per capita health expenditures growth rate or per capita GDP growth rate shock to per capita health expenditures growth rate , and growth rates of per capita health expenditures shock to per capita GDP growth rates and per capita public health expenditures growth rate shock to global life expectancy at birth of Generalised impulse response function of a particular country. Traditional health expenses literature does not study the spillover effects of the health expenses, Unlike the traditional literature, The empirical results show: In consideration of the different growth rate of Health expenditure per capita that spillover effect does exist in countries, Spillover effect appears particularly strong in national public health care expenditure per capita growth rate model, and is more obvious in countries with high proportion of interdependence trading and pharmaceutical import. From the impact among US, Euro and Global of Generalised impulse response function, we understand that the positive shock of a major pharmaceutical export country''s per capita health expenditures growth rate may still bring a positive impact to other advanced countries, but a negative impact to countries with lower income, Negative shocks of per capita GDP growth rate may raise the growth rate of per capita health expenditure in most countries, but may appear opposite impacts to the major pharmaceutical export countries, when the current international US dollars into account the global public health expenditures per capita growth rate will bring a positive impact to growth rate of global life expectancy at birth ,and the positive impact to the lower income countries. The global life expectancy at birth growth rate will bring a positive impact to growth rate of per capita GDP, and the negative impact to the lower income countries. However, when we consider the real, results will appear ambiguous situation. The health expenditures and life expectancy at birth will be affected by the other country through trade.
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