Phase and wave dependent analysis of health expenditure efficiency: A sample of OECD evidence

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Boduroglu E., ATICI K. B., Omay T.

Frontiers in Public Health, vol.11, 2023 (SCI-Expanded) identifier identifier identifier

  • Publication Type: Article / Article
  • Volume: 11
  • Publication Date: 2023
  • Doi Number: 10.3389/fpubh.2023.1125975
  • Journal Name: Frontiers in Public Health
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Social Sciences Citation Index (SSCI), Scopus, EMBASE, MEDLINE, Directory of Open Access Journals
  • Keywords: COVID-19 daily cases, OECD, health expenditure efficiency, wave and phase dependency, cumulative Fourier transform, unit root testing
  • Hacettepe University Affiliated: Yes


Introduction: Health expenditures are a factor that reflects the government's public health policy and contributes to the protection of national health. Therefore, this study focuses on measuring the effectiveness of health expenditures in order to evaluate and improve the public health system and policy during the pandemic period. Method: In order to examine the effectiveness of health expenditures, the behaviors of the pandemic process were analyzed in two stages. The number of daily cases is analyzed in the first stage by dividing it into waves and phases according to the transmission coefficient (R). For this classification, the discrete cumulative Fourier function estimation is used. In the second stage, the unit root test method was used to estimate the stationarity of the number of cases in order to examine whether the countries made effective health expenditures according to waves and phases. The series being stationary indicates that the cases are predictable and that health expenditure is efficient. Data consists of daily cases from February 2020 to November 2021 for 5 OECD countries. Conclusion: The general results are shown that cases cannot be predicted, especially in the first stage of the pandemic. In the relaxation phase and at the beginning of the second wave, the countries that were seriously affected by the epidemic started to control the number of cas es by taking adequate measures, thus increasing the efficiency of their health systems. The common feature of all the countries we examined is that phase 1, which represents the beginning of the waves, is not stationary. After the waves fade, it can be concluded that the stationary number of health cases cannot be sustainable in preventing new waves' formation. It is seen that countries cannot make effective health expenditures for each wave and stage. According to these findings, the periods in which countries made effective health expenditures during the pandemic are shown. Discussion: The study aims to help countries make effective short- and long-term decisions about pandemics. The research provides a view of the effectiveness of health expenditures on the number of cases per day in 5 OECD countries during the COVID-19 Pandemic.