Association of Health and Social Spending With Health Outcomes in OECD Countries.

Abstract

Objectives: To examine the associations of health and social spending with health outcomes, including Disability-Adjusted Life Years (DALY), Years of Life Lost (YLL), Years Lived with Disability (YLD), death, and life expectancy at birth among Organization for Economic Cooperation and Development (OECD) member countries from 2000 to 2019.

Study setting and design: We conducted a retrospective longitudinal study.

Data sources and analytical sample: Our sample included 36 OECD member countries as of 2019 using data from the Global Burden of Disease Study 2021, the OECD, and the World Bank.

Principal findings: Fixed-effect analysis revealed significant associations of health and social spending with health outcomes, but the patterns varied. Specifically, a one-percentage-point increase in health spending was associated with a 1.43% (95% CI: -1.86, -1.01) decrease in the death rate per 100,000 population and a 0.68% (0.56, 0.79) increase in YLD per 100,000 population. In contrast, a one-percentage-point increase in social spending was associated with a 0.29% (-0.45, -0.12) reduction in DALYs, primarily driven by a 0.30% (-0.37, -0.23) decrease in YLDs and a 0.07% (0.03, 0.12) increase in life expectancy. No significant associations were found for the remaining outcomes. These associations remained robust when incorporating one- and two-year lagged effects.

Conclusions: These findings highlight the distinct mechanisms through which health and social spending impact health outcomes. Health spending predominantly influenced mortality, while social spending was more closely associated with improvements in quality-of-life measures. Policymakers should consider these complementary effects when designing interventions to optimize health outcomes.