本研究利用González et al.(2005)提出縱橫平滑轉換模型探討公共健康支出占總健康支出在特定門檻值下，健康人力資本變數(預期壽命、65歲以上人口占總人口比例及公共健康支出占GDP比例)對經濟成長的影響。以縱橫資料(Panel Data)形式，從1995年至2014年間，並以OECD成員28個國家、東協以及過渡經濟體地區做為研究觀察主體。
實證結果顯示:OECD成員28個國家、過渡經濟體、東協地區政府在公共健康支出的投入，使預期壽命對GDP大部分呈現正效果。OECD(28國)在公共健康支出超過門檻值時，65歲以上人口占總人口比例對GDP的影響轉為負效果。過渡經濟體、東協地區對GDP的影響為正效果OECD(28國)公共健康支出高於門檻值時，公共健康支出占GDP比例的投入對GDP由正轉為負效果。在過渡經濟體，增加公共健康支出占GDP比例對GDP為正向影響。東協地區在公共健康支出占GDP比例投入在第二個門檻值時，對GDP由正轉為負效果。此外，預防性健康支出占GDP比例大於0.1798%時，對GDP增加的效果會下降，然而治療性支出占GDP比例對GDP影響由負轉正。

SUMMARY

This paper uses 28 OECD countries(OECD28),11 Transition Economic countries (TE), and the Association of Southeast Asian Nations (ASEAN) over the period 1995-2014 to analyze the relationship between health human capital and GDP. The ratio of public health expenditure to total health expenditure is regarded as the transition variable in panel smooth transition regression (PSTR) model. Health human capital includes life expectancy), the ratio of public health expenditure to GDP, and the ratio of population over 65 to the whole population.

Result: The threshold values of the ratio of public health expenditure to GDP are respectively estimated as 81.0864%, 88.2535%, and 55.4616%- 85.990% in OECD 28、ASEAN and TE. Regardless of the threshold values, longer life expectancy effect GDP positive significantly in OECD 28, ASEAN and TE. The ratio of the population over 65 to the whole population decreases with GDP in OECD28 but increases with GDP in ASEAN and TE when the ratio of public health expenditure to the whole health expenditure is greater than the threshold value .The ratio of public health expenditure to GDP decreases with GDP in OECD28 and ASEAN but increases with GDP in TE when the ratio of public health expenditure to the whole health expenditure is greater than the threshold value.

This research also calculates the income elasticities of health expenditure, public health expenditure and treatment expenditure for 22 OECD countries and indicates that all such expenditure are necessity goods.

Research findings present that the PSTR model can provide an important reference for public health policy and on the devotion of public health plays an important role on economic performance.

Key words: panel smooth transition regression model, public health expenditure,
threshold value, income elasticity

INTRODUCTION

The increasing trend of health expenditure, especially the public health expenditure. is a global issue in the past three decades. Using the ratio of public health expenditure to total health expenditure as the transition variable in panel smooth transition regression (PSTR) model, this paper investigates the relationships between life expectancy, the ratio of public health expenditure to GDP,), the ratio of population over 65 to the whole population -and GDP from 28 OECD countries(OECD28), 11 Transition Economic countries (TE) and Association of Southeast Asian Nations (ASEAN) developed by Gonzalez et al.(2005).

Our approach has two main advantages. First, PSTR model can deal with non-linearity of the dependent variable and cross-section heterogeneity. Second, according to Hurlin (2007), PSTR model is a regime-switching model and allows for the extreme value of a transition function and the transition from one regime to another is smooth.

MATERIALS AND METHODS

This paper uses three panel of 28 OECD countries(OECD28), 11 Transition Economic
countries (TE), and Association of Southeast Asian Nations (ASEAN) over the period 1995-2014 to investigate the health human capital-GDP nexum.

In a PSTR model, there are two concerns: the choice of the threshold variable and the determination of the number of regime switching. This research adopts three-step procedure in a PSTR model. First, this research examines the linearity versus the PSTR model. Then, if linearity is not accepted, this research determines the number of transition functions. Finally, this research removes individual-specific means and applies nonlinear least squares to estimate the parameters of the transformed model.

RESULTS AND DISCUSSION

The empirical results show that when the ratio of public health expenditure to the whole health expenditure is smaller than the threshold, 81.0864%, life expectancy, public health expenditure, and the ratio of the population above 65 to the whole population increase with GDP; when this ratio is greater than the threshold, the ratio of the population above 65 to the whole population and the public health expenditure decrease with GDP in OED 28. When the ratio of public health expenditure to the whole health expenditure is smaller than the threshold, 88.2535%, life expectancy, public health expenditure, and the ratio of the population above 65 to the whole population increase with GDP; when this ratio is greater than the threshold, the ratio of the population above 65 to the whole population and the public health expenditure also increase with GDP but the life expectancy does not affect GDP in TE

When the ratio of public health expenditure to the whole health expenditure is smaller than the threshold, 55.4616%, public health expenditure as well as the ratio of the population above 65 to the whole population increase with but life expectancy decreases with GDP; when this ratio is greater than the threshold, the ratio of the population above 65 to the whole population and the life expectancy increase with GDP but the ratio of public health expenditure to total health expenditure negatively affect GDP in ASEAN The calculated income elasticities of total health expenditure, public health expenditure, and treatment health expenditure indicate that these expenditure are necessity goods for 22 OECD countries.

CONCLUSION

Existing literature uses linear models and cross-sectional data to estimate the relationship between health expenditure and economic performance and might ignore the nonlinear path of health spending with gross domestic product as well as the heterogeneity among cross-sectional objects. Estimation results could be biased.

This study uses the panel smooth transition regression model (PSTR) to analyze the relationship between health human capital and GDP. The ratio of public health expenditure to total health expenditures regarded as the transition variable. Research findings present that the PSTR model can provide an important reference for public health policy. The devotion of public health expenditure plays an important role on stimulating economic performance.

The calculated income elasticities of total health expenditure, public health expenditure, and treatment health expenditure indicate that these expenditure are necessity goods for 22 OECD countries. Public health expenditure and treatment health expenditure are both important for the population’s health and economic status.

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