title: Medicine and democracy: The importance of institutional quality in the relationship between health expenditure and health outcomes in the MENA region.
abstract: Evidence suggests that the effect of health expenditure on health outcomes is highly context-specific and may be driven by other factors. We construct a panel dataset of 18 countries from the Middle East and North Africa region for the period 1995-2012. Panel data models are used to estimate the macro-level determinants of health outcomes. The core finding of the paper is that increasing health expenditure leads to health outcomes improvements only to the extent that the quality of institutions within a country is sufficiently high. The sensitivity of the results is assessed using various measures of health outcomes as well as institutional variables. Overall, it appears that increasing health care expenditure in the MENA region is a necessary but not sufficient condition for health outcomes improvements.
authors.affiliation: Aix-Marseille University, INSERM, IRD, SESSTIM, 23 rue Stanislas Torrents, 13006 Marseille, France; Aix-Marseille University (Aix-Marseille School of Economics), CNRS & EHESS, 23 rue Stanislas Torrents, 13006 Marseille, France. Electronic address: marwan-al-qays.bousmah@univ-amu.fr.
authors.forename: Marwân-Al-Qays
authors.initials: MA
authors.lastname: Bousmah
authors.affiliation: Aix-Marseille University (Aix-Marseille School of Economics), CNRS & EHESS, 23 rue Stanislas Torrents, 13006 Marseille, France; ORS PACA, Observatoire Régional de la Santé, Provence Alpes Côte d'Azur, 23 rue Stanislas Torrents, 13006 Marseille, France. Electronic address: bruno.ventelou@inserm.fr.
authors.forename: Bruno
authors.initials: B
authors.lastname: Ventelou
authors.affiliation: Aix-Marseille University, INSERM, IRD, SESSTIM, 23 rue Stanislas Torrents, 13006 Marseille, France; Aix-Marseille University (Aix-Marseille School of Economics), CNRS & EHESS, 23 rue Stanislas Torrents, 13006 Marseille, France. Electronic address: mohammad.abu-zaineh@inserm.fr.
authors.forename: Mohammad
authors.initials: M
authors.lastname: Abu-Zaineh
mesh_terms: D000352:Africa, Northern; D003709:Democracy; D005102:Health Expenditures; D006268:Health Facilities / Q000592:standards*; D006801:Humans; D008511:Medicine; D008877:Middle East; D017063:Outcome Assessment, Health Care; D011787:Quality of Health Care
keywords: Health expenditure; Health outcomes; Institutional quality; MENA region