Health Expenditure Trends in East Asian and Pacific Countries, 1995-2010

Abstract

Specific Aims: To classify East Asian and Pacific countries into homogenous groups based on potential determinants of their healthcare expenditures and public health care. Methods: We used data from the 1995 to 2010 World Health Organization (WHO) database. Cluster analysis techniques were applied to identify clusters of East Asian and Pacific countries using variables identified as potential determinants of healthcare expenditures and public health care. Differences between clusters of countries were validated using Analysis of Variance (ANOVA). Average annual growth rate (AAGR) was calculated to study the change in trends across countries over time. Main Results: Nineteen countries with complete data were included. Of those, we identified four distinct clusters. Cluster 1 consisted of Cambodia, Laos, Mongolia, Solomon Islands, Timor-Leste and Vanuatu. Cluster 2 represented China, Myanmar, and Vietnam. Cluster 3 consisted of Fiji, Indonesia, South Korea, Malaysia and Thailand. Cluster 4 represented Micronesia, Papua New Guinea, Philippines, Samoa and Tonga. Health Expenditure per capita AAGR (P=0.002), infant mortality rate AAGR (P=0.018), life expectancy at birth AAGR (p=0.003), population ages 65 and above AAGR (P=0.004) and death rate (P<0.001) were found to be significantly different among the clusters. Clusters were similar based on birth rate (P=0.425) and public health expenditure (P=0.231), though there were trends of differences. Conclusion: East Asian and Pacific countries were similar based on birth rate and public health expenditure, but were different based on health expenditure per capita, infant mortality rate, life expectancy at birth, population ages 65 and above and death rate. Exploration of clusters among countries may increase the chances of success for health policies and innovations at lower costs of targeted implementation at a global level.