What drives variations in public health and social services expenditures? the association between political fragmentation and local expenditure patterns

Yonsu Kim () and Jae Hong Kim
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Yonsu Kim: University of Nevada, Las Vegas
Jae Hong Kim: University of California, Irvine

The European Journal of Health Economics, 2022, vol. 23, issue 5, No 3, 789 pages

Abstract: Abstract The US spends two times more than the OECD average in health expenditure but has a much smaller portion of public health spending to total health expenditure than other OECD countries. While it has been suggested that public health and social services spending is crucial to promoting health outcomes, less is known about what drives variations in public health expenditure across regions. This study aims to examine whether political fragmentation in local governance is associated with variations in public health and social services expenditures. Using the US Census of Governments, we constructed a panel dataset of political fragmentation and local government spending patterns (1997–2012) for 792 US counties (population > 60,882, top 25%) and employed Least Squares Dummy Variable (LSDV) and Generalized Estimating Equations (GEE) models. We found that per capita public health spending tended to be smaller in areas where the degree of political fragmentation was higher (Coef: – 0.034; p

Keywords: Political fragmentation; Health expenditure; Social services expenditures; Leviathan hypothesis; Public finance (search for similar items in EconPapers)
Date: 2022
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DOI: 10.1007/s10198-021-01394-x

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