2411-14062411-1406

10.17059/ekon.reg.2025-2-10

The Asymmetric Impact of Health Expenditure, Bottom Decile Income, and Trade Openness on BRICS Health Indicators

Асимметричное влияние расходов на здравоохранение, доходов нижнего дециля и открытости экономики на показатели здравоохранения в странах БРИКС

https://orcid.org/0000-0002-6783-0506

Mehta

Dhyani

Мехта

Дхиани

dhyani.mehta@sls.pdpu.ac.in

https://orcid.org/0000-0002-3102-6567

Derbeneva

Valentina V.

Дербенева

Валентина Валерьевна

v.v.derbeneva@urfu.ru

Pandit Deendayal Energy UniversityЭнергетический университет Пандита Диндаяла

Ural Federal University named after the first President of Russia B.N. YeltsinУральский федеральный университет имени первого Президента России Б. Н. Ельцина

212394411

2025

Мехта Дхиани , Дербенева Валентина Валерьевна

https://creativecommons.org/licenses/by/4.0/

https://www.economyofregions.org/ojs/index.php/er/article/view/997

https://www.economyofregions.org/ojs/index.php/er/article/download/997/426

Amid growing concerns about widening health inequities and the complex interaction of socioeconomic determinants, the problem of improving health outcomes in emerging economies—particularly within BRICS nations—has become ever more significant. This research delves into the impact of health expenditure, trade openness, and income distribution on health indicators such as infant mortality rate (IMR), life expectancy (LE), and crude death rate (CDR) in BRICS, including Brazil, Russia, India, China and South Africa. The study uses annual time series panel data from 2000 to 2023 and applies the cross-sectional asymmetric autoregressive distributed lag (CS-NARDL) model to examine these relationships. The findings reveal that an increase in health spending leads to reductions in mortality and death rates, while reduced spending has a more pronounced (negative) effect on health indicators. Moreover, the study highlights the organic improvement in health indicators observed in open economies, as they benefit from the exchange of advanced health technology and services. The results indicate that an increase in income among the poorest households in the lowest quartile of income distribution enhances their access to health services, thereby leading to improved health indicators. This study contributes to the existing literature on the impact of health expenditure and income distribution on health indicators. Governments should establish mechanisms to evaluate the effectiveness of healthcare spending on health outcomes, enabling them to improve their healthcare policies and programs.

В условиях неравномерного доступа к медицинским услугам и воздействия различных социально-экономических факторов проблема повышения эффективности систем здравоохранения в странах с развивающейся экономикой, в частности в странах БРИКС, приобретает особую значимость. Настоящее исследование посвящено анализу того, как государственные расходы на здравоохранение, открытость экономики и распределение доходов влияют на ключевые показатели здоровья населения — уровень младенческой смертности (IMR), ожидаемую продолжительность жизни (LE) и общий коэффициент смертности (CDR) в Бразилии, России, Индии, Китае и Южной Африке. В качестве эмпирической базы использованы панельные данные за 2000–2023 гг. Для оценки асимметричных эффектов применяется модель кросс-секционного асимметричного авторегрессионного распределённого лага (CS-NARDL). Показано, что увеличение расходов на здравоохранение способствует снижению показателей смертности, тогда как их сокращение оказывает более выраженное негативное влияние на состояние здоровья населения. Кроме того, выявлено, что в более открытых экономиках наблюдается естественное улучшение показателей здравоохранения, обусловленное доступом к передовым медицинским технологиям и услугам. Повышение доходов среди наименее обеспеченных групп населения (нижний дециль) также способствует улучшению доступа к медицинской помощи и, соответственно, улучшению здоровья. Таким образом, данное исследование расширяет наши представления о влиянии расходов на здравоохранение и распределении доходов на здоровье населения в странах БРИКС. Подчеркивается необходимость внедрения механизмов мониторинга и оценки эффективности государственных расходов в данной сфере, что позволит повысить эффективность политики здравоохранения и приблизиться к целям устойчивого развития.

health indicatorshealth expenditureIMRlife expectancycrude death ratetrade openness

показатели здравоохранениягосударственные расходы на здравоохранениеуровень младенческой смертностиожидаемая продолжительность жизниобщий коэффициент смертностиоткрытость торговли

We would like to extend our appreciation to the editor, anonymous reviewers and all those who contributed for the success of this research work.

Авторы выражают свою признательность редактору, анонимным рецензентам, а также всем, кто помог в проведении данного исследования.

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