Investigating the relationship of government revenue and expenditure on economic growth using a generalized method of moments: Does state-level panel ensure sustainable growth?

The current research project investigates the correlation between economic growth, government spending, and public revenue in seventeen Indian states spanning the years 1990 to 2020. An analysis of the relationship between key fiscal policy variables and economic growth was conducted utilising a panel data approach, the Generalised Method of Moments (GMM), and fully modified Ordinary Least Squares (FMOLS & DOLS) estimation. In our investigation, we assessed the impacts of non-tax revenue, development plan expenditure, tax revenue, and development non-plan expenditure on (i) the net state domestic product (NSDP) and (ii) the NSDP per capita. The findings indicate that the selected fiscal variables are significantly related. The results indicate that expeditious expansion of the fiscal sector is obligatory to stimulate economic growth in India and advance the actual development of the economies of these states.

Public expenditure on health care and the incidence of non-communicable diseases (NCDs) in China from 2008 to 2018.

OBJECTIVES: This study investigates whether differences in individual-level and provincial-level health funding could explain or mitigate health inequalities among older people in terms of non-communicable diseases within a population served by fragmented health insurance schemes. STUDY DESIGN: A national repeated cross-sectional analysis was done of the 2008, 2011, 2014, and 2018 Chinese Longitudinal Healthy Longevity Surveys. These provided a total of 44,623 persons aged 60 and over. MAIN OUTCOME MEASURES: Respondents were asked whether they had been diagnosed with any types of non-communicable diseases by doctors. A dichotomous outcome variable was constructed to indicate whether older people had any diagnosed non-communicable diseases. RESULTS: Compared with uninsured older persons, those who were enrolled in social health insurance schemes designed for civil servants as cadres, urban employees and urban residents were more likely to report a higher incidence of non-communicable diseases. There were no significant differences in the prevalence of non-communicable diseases between uninsured older people and those in the New Rural Cooperative Medical Scheme. Although the incidence of non-communicable diseases among older persons increased over the study period, greater health expenditure was significantly associated with a lower risk of non-communicable diseases. The interaction results between individual social health insurance schemes and public health expenditure indicate that disparities in the incidence of non-communicable diseases among different health insurance schemes diminish as public health expenditure increases. Older individuals with Public Free Medical Services benefited the most in provinces with higher public health expenditure compared with other health insurance schemes. CONCLUSIONS: Given the evidence of the beneficial effects of universal health coverage on non-communicable diseases among older persons, these results should encourage policy makers to increase public health funding and to raise the overall benefit packages for social health insurance schemes.

[PUBLIC EXPENDITURE ON MENTAL HEALTH IN ISRAEL: CALCULATION, ANALYSIS AND INTERNATIONAL COMPARISON].

INTRODUCTION: This is the first health economics study to calculate and analyze public expenditure on mental health in Israel from 2019 through 2021. Financing of the NIS 4 billion expenses is divided equally between the health funds and direct financing from the state budget.

Old age takes its toll: Long-run projections of health-related public expenditure in Luxembourg.

This paper simulates long-term trends in Luxembourg's public expenditure on healthcare and on long-term care. We combine population projections with micro-simulations of individuals' health status that account for their demographic, socio-economic characteristics and their childhood circumstances. Model equations estimated on data from the SHARE survey and from several branches of Social Security provide a rich framework to study policy-relevant applications. We simulate public expenditure on healthcare and long-term care under different scenarios to evaluate the separate contributions of population ageing, costs of producing health-related services, and the distribution of health status across age cohorts. Results suggest that rising per capita expenditure on healthcare will mostly result from production costs, while rising expenditure on long-term care will mostly reflect population ageing.

Effects of public expenditures on environmental pollution: evidence from G-7 countries.

In this study, the effect of public expenditures and, their sub-components on environmental pollution is discussed in G-7 countries. Two different periods were used in the study. These are the period 1997-2020 for general public expenditure, and the period 2008-2020 for public expenditure sub-components. For cointegration, Westerlund cointegration test was used, and according to the analysis result there is a cointegration relationship between general government expenditure and environmental pollution. Panel Fourier Toda-Yamamoto causality test was used to determine the causality relationship between public expenditures and environmental pollution and the result indicates that there is bidirectional causality between public expenditures and CO2 on a panel basis. For models estimation, System the Generalized Method of Moments (GMM) method was used. The findings of the study indicate that general public expenditures decrease environmental pollution. Considering at the results of the sub-components of public expenditures, housing and community amenities, social protection, health expenditure, economic affairs, recreation, culture & religion expenditures have a negative effect on environmental pollution. Other control variables generally  have a statistically significant effect on environmental pollution. Energy consumption and population density increase environmental pollution but environmental policy stringency index, renewable energy and GDP per capita reduce environmental pollution.

What is the impact of national public expenditure and its allocation on neonatal and child mortality? A machine learning analysis.

BACKGROUND: Understanding the impact of national public expenditure and its allocation on child mortality may help governments move towards target 3.2 proposed in the 2030 Agenda. The objective of this study was to estimate the impacts of governmental expenditures, total, on health, and on other sectors, on neonatal mortality and mortality of children aged between 28 days and five years. METHODS: This study has an ecological design with a population of 147 countries, with data between 2012 and 2019. Two steps were used: first, the Generalized Propensity Score of public spending was calculated; afterward, the Generalized Propensity Score was used to estimate the expenditures' association with mortality rates. The primary outcomes were neonatal mortality rates (NeoRt) and mortality rates in children between 28 days and 5 years (NeoU5Rt). RESULTS: The 1% variation in Int$ Purchasing Power Parity (Int$ PPP) per capita in total public expenditures, expenditure in health, and in other sectors were associated with a variation of -0.635 (95% CI -1.176, -0.095), -2.17 (95% CI -3.051, -1.289) -0.632 (95% CI -1.169, -0.095) in NeoRt, respectively The same variation in public expenditures in sectors other than health, was associates with a variation of -1.772 (95% CI -6.219, -1.459) on NeoU5Rt. The results regarding the impact of total and health public spending on NeoU5Rt were not consistent. CONCLUSION: Public investments impact mortality in children under 5 years of age. Likely, the allocation of expenditures between the health sector and the other social sectors will have different impacts on mortality between the NeoRt and the NeoU5Rt.

Effect of Public Expenditure on Economic Growth in the Case of Ethiopia.

This study's primary goal was to explain how Ethiopia's economic growth affected government spending. The time series data utilized in the study were gathered between 1980 and 2018. The time series data were subjected to the Johansen cointegration test and the vector error correction model (VECM) in order to evaluate the short- and long-term correlations between public spending and economic growth in Ethiopia. According to the study, both long- and short-term economic growths are positively and significantly impacted by government spending on education. Long-term economic growth is negatively impacted by government expenditure on agriculture, while short-term effects are negatively impacted and considerable. In the long run, investment spending has a positive but negligible impact on economic growth; however, in the short run, it has a negative but large effect. Defense spending by the government has a positive and negligible effect on economic growth over the short and long terms. Both in the short and long terms, spending on health has a favorable and considerable impact on economic growth. According to the study, government spending on the education sector would help to foster the conditions that could result in higher labor force participation rates and, consequently, higher rates of economic growth. Aiming to establish a healthy and productive society that promotes economic progress, policy should focus on complementary measures to scale-up initiatives in the health sector.

Analysis and intervention of heatwave related economic loss: Comprehensive insights from supply, demand, and public expenditure into the relationship between the influencing factors.

Increasing extreme temperatures are producing a serious impact on the economies of cities. However, the importance of social factors is typically neglected by the existing research. In this work, we first establish a supply-demand-public expenditure (SDP) framework for assessing and forecasting heat-related economic loss. Compared with the previous framework, SDP possesses a more comprehensive index system and functions that apply to all types of cities. We selected different economic development and geographical locations (Nanjing, Suzhou, and Yancheng) as case studies to verify the wide applicability of the SDP framework. A qualitative analysis and quantitative prediction of heatwaves and socioeconomic factors on losses were conducted for different cities. The results showed that different loss types displayed obvious regional heterogeneity among the cities. The labor value loss was the most significant type, and health loss was the most vulnerable type. In addition, public expenditure played a neglected critical regulatory role. Apart from these, the current level of public expenditure for heat prevention and control remains insufficient. Based on an assessment of the effects of interventions, policymakers need to make more efforts to increase the proportion of heat-related public spending and ensure stable socio-economic development by utilizing pathways with positive intervention potentials.

Expenditure of biological drugs for rheumatoid arthritis treatment in the Brazilian public health system

ABSTRACT OBJECTIVE This work aims to analyze the quantity and expenses related to biological drugs used for the treatment of rheumatoid arthritis (RA) in outpatient public care within the Brazilian Unified Health System (SUS). METHODS It is a cross-sectional descriptive study based on secondary data from a historical series, referring to the purchase, volume, and the number of patients treated with different biological drugs (infliximabe, etanercept, adalimumab, rituximab, abatacept, tocilizumab, golimumab, and certolizumab pegol) for RA treatment in outpatient care from 2012 to 2017. The data were extracted from the SUS Outpatient Information System database-SIA/SUS and included ten drugs used for RA treatment. The study assessed the quantity and expenditure of these drugs, the number of RA patients treated, and the expenditure by RA subtypes. The National Broad Consumer Price Index was used to adjust the expenditures for December 2017. RESULTS The Ministry of Health allocated approximately $500 million to provide about 2 million units of biological drugs for RA patients from 2012 to 2017. The supply of adalimumab 40 mg and etanercept 50 mg accounted for 68.3% of the total expenditure. The subtypes "other rheumatoid arthritis with rheumatoid factor" (ICD-10 M05.8), "rheumatoid arthritis without rheumatoid factor" (ICD-10 M06.0), and "Felty's syndrome" (M05. 0) represented 84.5% of the total expenditures. The proportion of patients treated with biological drugs increased by 33.0%. There was a significant 83.0% increase in the number of patients using biological drugs compared to the overall number of RA patients treated during the study period. CONCLUSIONS The results obtained allow us to draw a more recent profile of expenditure on RA treatment and indicate trends in the use of biological drugs for this condition, generating data that can support management decisions in public health policies.

Cost-related variables in the public purchase of dental materials for endodontic application: 10-year analysis

Aim: This study analyzed public procurements for different endodontic materials used in the Brazilian public health system and evaluated the variables related to their cost. Methods: A time-series study was performed by screening materials for endodontic application in the public Brazilian Databank of Healthcare Prices from 2010 to 2019. Data were categorized according to material composition and clinical application. The collated variables were used in a multiple linear regression model to predict the impact of unit price in procurement processes. Results: A total of 5,973 procurement processes (1,524,693 items) were evaluated. Calcium hydroxides were found in 79% of the observations (4,669 processes). Prices drop each year by US$1.87 while MTAs and epoxy resins are increasingly purchased at higher prices (US$50.87; US$67.69, respectively). The microregion, the procurement modality, and the type of institution had no influence on unit prices in the adjusted model (p > 0.05). Conclusions: Calcium hydroxide-based materials were the cheapest and most frequently purchased endodontic materials in the public health care system. Novel formulations are being implemented into clinical practice over time and their cost may be a barrier to the broad application of materials such as MTAs, despite their effectiveness

Does increasing public expenditure on sports promote regional sustainable development: Evidence from China.

In the post-COVID era, how to improve the level of regional sustainable development has attracted much attention. And the vigorous development of the sports economy may be closely related to the regional sustainable development. This paper explores the impact and mechanism analysis of government sports public expenditure on regional sustainable development from the perspective of sports economic development. The study found that China's sustainable development presents obvious ladder-like characteristics and highlights the regional imbalance and inadequacy of regional green and coordinated development. And the government's increase in public expenditure on sports can significantly promote regional sustainable development and improve the level of regional green and coordinated development. With the continuous improvement of the regional economic development, the effect of sports public expenditure continues to increase. It can be seen from this that implementing the strategy of strengthening the country through sports under the government's guidance is an essential guarantee for the public health and quality of life and the sustainable development of the economy and society. Additionally, the development level of market finance is also an important driving factor for the government's public expenditure on sports to improve the level of sustainable development in the region. From the mechanism analysis, the government activates the local residents' consumption level by increasing the public expenditure on sports, thus promoting regional sustainable development.

Public Expenditure and Green Total Factor Productivity: Evidence from Chinese Prefecture-Level Cities.

Whilst effective public expenditure policies are essential for transforming the traditional factor-driven economy into a green and innovation-driven economy, the impacts of public expenditure's size and composition on green economic development have not been comprehensively investigated. This paper attempts to fill this research gap. Based on the data of Chinese prefecture-level cities from 2010 to 2018, we first measure green total factor productivity (GTFP), the proxy variable for green development, and briefly analyze its spatial-temporal trends. Then, using the dynamic panel models, dynamic panel mediation models, and dynamic panel threshold models, we evaluate how public expenditure affects GTFP. The main findings are fourfold: (1) there is a significant inverted U-shaped relationship between the expenditure size and GTFP. (2) The expansion of social expenditures and science and technology (S&T) and environmental protection expenditures play an important role in stimulating green growth, while economic expenditures and administrative expenditures have adverse effects. (3) Public expenditure mainly promotes green development through four channels: human capital accumulation, technological innovation, environmental quality improvement, and labor productivity increase. (4) The expenditure composition influences the turning point of the inverted U-shaped relationship. Based on these findings, we propose some targeted policy suggestions to promote green development.

A política de esporte e lazer em Goiás: análise do financiamento e gasto de 2003 a 2018 / The sports and leisure policy in Goiás: analysis of financing and spending from 2003 to 2018 / La política de deporte y ocio en Goiás: análisis de financiación y gasto de 2003 a 2018

Esta investigação científica teve por objetivo analisar o financiamento e gasto com a política pública de esporte e lazer realizada pelo governo do estado de Goiás ao longo de 2003 a 2018. A pesquisa tem caráter quanti-qualitativo, é um estudo descritivo e se apoiou em pes-quisa documental, realizada na legislação de esporte e lazer do estado de Goiás, nos Planos Plurianuais e nos gastos governamentais. Conclui-se que a maior parte do financiamento do setor se deu sob a gestão do órgão responsável pela política de esporte e lazer, o gasto com este ocupou um lugar marginal no orçamento público do estado e a maior parte do gasto foi direcionado para Infraestrutura ­ sobretudo, de grandes instalações de esporte e lazer ­ e Pessoal (AU).

This scientific investigation aimed to analyze the funding and spending on public policy for sport and leisure carried out by the government of the state of Goiás from 2003 to 2018. The research has a quanti-qualitative character, is a descriptive study and was based on documental research, carried out in the sport and leisure legislation of the state of Goiás, in the Pluriannual Plans and in government expenditures. Most of the sector's financing was under the management of the body responsible for sports and leisure policy, spending on this occupied a marginal place in the state's public budget and most of the spending was directed to Infrastructure ­ above all, for large companies. sport and leisure facilities ­ and Staff (AU).

Esta investigación científica tuvo como objetivo analizar la financiación y el gasto en políticas públicas de deporte y ocio llevadas a cabo por el gobierno del estado de Goiás de 2003 a 2018. La investigación tiene un carácter cuanti-cualitativo, es un estudio descriptivo y se basó en una investigación documental, realizada en la legislación de deporte y ocio del estado de Goiás, en los Planes Plurianuales y en el gasto público. La mayor parte de la financiación del sector se realizó bajo la gestión del organismo responsable de la política deportiva y de ocio, el gasto en este ocupó un lugar marginal en el presupuesto público del estado y la mayor parte del gasto se dirigió a Infraestructuras ­ sobre todo, grandes instalaciones deportivas y de ocio ­ y Personal.(AU).

Public Health Expenditures and Clinical and Social Complexity of Tuberculosis Cases-Alameda County, California, July-December 2017.

CONTEXT: Alameda County, California, is a high tuberculosis (TB) burden county that reported a TB incidence rate of 8.1 per 100 000 during 2017. It is the only high TB burden California county that does not have a public health-funded TB clinic. OBJECTIVE: To describe TB public health expenditures and clinical and social complexities of TB case-patients. DESIGN, SETTING, AND PARTICIPANTS: Public health surveillance of confirmed and possible TB case-patients reported to Alameda County Public Health Department during July 1, 2017, to December 31, 2017. Social complexity status was categorized for all case-patients using surveillance data; clinical complexity status, either by surveillance definition or by the Charlson Comorbidity Index (CCI), was categorized only for confirmed TB case-patients. MAIN OUTCOME MEASURES: Total public health and per patient expenditures were stratified by insurance status. Cohen's kappa assessed concordance between clinical complexity definitions. All comparisons were conducted using Fisher's exact or Kruskal-Wallis tests. RESULTS: Of 81 case-patients reported, 68 (84%) had confirmed TB, 29 (36%) were socially complex, and 15 (19%) were uninsured. Total public health expenditures were $487 194, and 18% of expenditures were in nonlabor domains, 57% of which were for TB treatment, diagnostics, and insurance, with insured patients also incurring such expenditures. Median per patient expenditures were significantly higher for uninsured and government-insured patients than for privately insured patients ($7007 and $5045 vs $3704; P = .03). Among confirmed TB case-patients, 72% were clinically complex by surveillance definition and 53% by the CCI; concordance between definitions was poor (κ = 0.25; 95% confidence interval, 0.03-0.46). CONCLUSIONS: Total public health expenditures approached $500 000. Most case-patients were clinically complex, and about 20% were uninsured. While expenditures were higher for uninsured case-patients, insured case-patients still incurred TB treatment, diagnostic, and insurance-related expenditures. State and local health departments may be able to use our expenditure estimates by insurance status and description of clinically complex TB case-patients to inform efforts to allocate and secure adequate funding.

Asymmetric effect of FDI and public expenditure on population health: new evidence from Pakistan based on non-linear ARDL.

The core purpose of the study is to examine the asymmetric effect of foreign direct investment (FDI) and population health (measured by life expectancy index). The study takes time series data for 1980-2020. The non-linear autoregressive distributed lag (NARDL) bound testing to cointegration approach is applied to scrutinize an asymmetric association among foreign direct investment, government expenditures, trade openness, public debt, and population health. The study also used an asymmetric causality test to investigate the causal association between the measured variables. The findings affirm that cointegration exists between the variables in the occurrence of asymmetries. The asymmetric causality outcomes confirm that only positive changes in FDI have bidirectional causality to life expectancy while negative shocks have unidirectional that runs from FDI to life expectancy. The government expenditure and foreign direct investment also provided evidence of social sector health welfare in Pakistan. The output shows that increasing government expenditure can cause an increase in life expectancy while decreasing government expenditure can cause a decrease in life expectancy. The study found that investment in health care medical services is paramount to better results as far as government assistance (welfare) gains. The outcomes of the study have given numerous policy suggestions to boost life expectancy in the general public of Pakistan.

Decline in Public Spending on Biopharmaceutics in Brazil

Abstract Biopharmaceuticals, mainly monoclonal antibodies, and fusion proteins are drugs that have gained notoriety in the treatment of various chronic and inflammatory diseases and have high prices. The study aimed to verify which monoclonal antibodies and fusion proteins were most incorporated into the Unified Health System (SUS), which therapeutic indication most benefited from them and to analyze public spending on these biopharmaceuticals from January 2012 to September 2019. This study performed a qualitative and quantitative analysis of biopharmaceuticals incorporated by SUS. The data were collected on the websites of CONITEC and the Health Price Bank. The results demonstrated that subcutaneous adalimumab was most frequently incorporated, and the most requested therapeutic indication was rheumatoid arthritis. Public spending on biopharmaceuticals exceeded R$ 28 billion (more than US$ 140 billion). However, a downward trend was confirmed (-266.7%) in the period evaluated. Despite the increase in demand and public spending on biologics in general, in Brazil and worldwide, the results of this research show that there was a drop in public spending on the biopharmaceuticals studied in the last seven years.

Uma avaliação empírica do tamanho ótimo dos municípios / An Empirical Assessment of the Optimal Size of Municipalities / Una evaluación empírica del tamaño ideal de los municipios

Esta pesquisa tem o objetivo de realizar uma investigação empírica sobre o tamanho ótimo dos municípios, isto é, a quantidade de habitantes que propicia o menor nível de despesas em relação ao PIB municipal, de modo que se obtenha escala econômica para otimização da aplicação dos recursos públicos. Este estudo analisa uma amostra de dados de 4.835 municípios com população inferior a 50.000 habitantes, que representam 89% do total de municípios brasileiros. A base de dados reúne informações de receitas e despesas municipais, extraídas do Finanças do Brasil - Dados Contábeis dos Municípios - Finbra 2010 e dados socioeconômicos do Censo Demográfico do IBGE 2010 e do PIB dos municípios do IBGE 2010. Os resultados empíricos indicam que o tamanho ótimo de população para um município brasileiro equivale aproximadamente a 31.667 habitantes por cidade, com base em métodos econométricos como mínimos quadrados ordinários com desvio padrão robusto. Esse porte populacional proporciona ganhos de escala na administração pública e confere maior autonomia local em relação ao governo central para ofertar bens públicos de qualidade.

This research aims to carry out an empirical investigation on the optimal size of the municipalities, that is, the number of inhabitants that offers the lowest level of expenditure in relation to the municipal GDP, obtaining an economic scale to provide the best level of public resources. This study analyzes a sample of data from 4.835 municipalities with a population of less than 50,000 inhabitants, which represent 89% of the total Brazilian municipalities. The database gathers information on municipal revenues and expenses extracted from Finance of Brazil - Accounting Data of Municipalities - FINBRA 2010, socioeconomic data from the 2010 IBGE Demographic Census and the municipalities GDP from the 2010 IBGE. The outcomes showed that the optimal population size for a Brazilian municipality is equivalent to 31.667 inhabitants per city, based on Ordinary Least Squares (OLS) with robust standards errors. This population size provides gains of scale in public administration and improves local autonomy in relation to the central government in order to offer quality public goods.

Esta investigación tiene como objetivo realizar una investigación empírica sobre el tamaño óptimo de los municipios, es decir, sobre el número de habitantes que proporciona el menor nivel de gasto en relación al producto bruto interno (PIB) municipal, de manera de obtener la escala económica para la optimización de la aplicación de recursos públicos. Para ello analiza una muestra de datos de 4835 municipios con una población de menos de cincuenta mil habitantes, lo que representa el 89 % de todos los municipios brasileños. La base de datos recopila información sobre ingresos y gastos municipales, extraídos de Finanzas de Brasil-Datos contables municipales-FINBRA 2010, datos socioeconómicos del censo demográfico del IBGE de 2010 y datos del PIB de los municipios en 2010. Los resultados empíricos informaron que el tamaño ideal de la población de un municipio brasileño es equivalente a aproximadamente 31.667 habitantes por ciudad, según métodos econométricos, como enteros cuadrados ordinarios con desviación estándar robusta. Este tamaño de población ofrece ganancias de escala en la administración pública y otorga mayor autonomía local en relación con el gobierno central para ofrecer bienes públicos de calidad.

Public expenditure composition and fiscal decentralization in Brazilian local governments: an analysis through unconditional quantile regression with longitudinal data / Composición del gasto público y descentralización fiscal en los gobiernos locales brasileños: un análisis por regresión cuantílica incondicional con datos longitudinales / Composição do gasto público e descentralização fiscal em governos locais brasileiros: uma análise por regressão quantílica incondicional com dados longitudinais

Abstract This paper investigates the effect of increasing fiscal decentralization on the composition of public expenditures of Brazilian local governments. The research is innovative, demonstrating that the heterogeneity of expenditure scale influences the correlation between fiscal decentralization and public expenditure of local governments. The sample consisted of unbalanced panel data of 5,565 municipalities for 17 years from 2000 to 2016. The analysis used unconditional quantile regression with panel data. The main findings were: (i) fiscal decentralization affects public expenditure in Brazilian local governments. However, this effect depends on local expenditure scale and fiscal decentralization strategy. For example, the median coefficient was negative in personnel expenditures, and the effect was positive for the third quartile of local governments, when fiscal decentralization was measured by the tax revenue over total revenue. On the other hand, the effects were also positive for median and third quartile regarding intergovernmental transfers per capita like proxy of fiscal decentralization; (ii) the measures (proxies) of fiscal decentralization are correlated with the composition of public expenditure; (iii) in median terms, fiscal decentralization has greater effects on investment expenditures than on current and personnel expenditures; and (iv) in median terms, the tax revenue participation promotes an increase in administrative and planning expenditures instead of expenditures in social functions. Fiscal decentralization measured by intergovernmental transfer per capita has more positive effects on social functions than on legislative and administrative functions.

Resumen Este artículo tuvo como objetivo investigar el efecto de una mayor descentralización fiscal en la composición del gasto público de los gobiernos locales brasileños. La investigación innovó al demostrar que la heterogeneidad de la escala del gasto influye en la correlación entre la descentralización fiscal y la composición del gasto público de los gobiernos locales. La muestra estuvo constituida por un panel de datos desbalanceados con 5.565 municipios durante 17 años, correspondientes al período 2000-2016. El análisis se realizó mediante regresión cuantílica incondicional. Los principales resultados fueron: (i) la descentralización fiscal afecta el gasto público de los gobiernos locales brasileños, sin embargo, el tipo de efecto depende de la escala del gasto local y de la estrategia de descentralización fiscal. Por ejemplo, en los gastos de personal, para la mediana, el coeficiente fue negativo y el efecto fue positivo para el tercer cuartil de los gobiernos locales, cuando la descentralización fiscal se midió por los ingresos tributarios sobre los ingresos totales. Por otro lado, los efectos también fueron positivos para la mediana y el tercer cuartil considerando las transferencias intergubernamentales per cápita como proxy de la descentralización fiscal; (ii) las medidas (proxies) de la descentralización fiscal se correlacionan con la composición del gasto público; (iii) la descentralización fiscal afecta más el gasto de inversión que los gastos de personal y los gastos corrientes en términos medianos; y (iv) en términos medianos, la participación de los ingresos tributarios promueve un aumento del gasto en funciones de gestión y planificación en lugar de gastos en funciones sociales; por otro lado, la descentralización fiscal medida por transferencias intergubernamentales per cápita afecta positivamente más funciones sociales que legislativas y administrativas.

Resumo Este artigo teve por objetivo investigar o efeito do aumento da descentralização fiscal na composição do gasto público dos governos locais brasileiros. A pesquisa inovou ao demonstrar que a heterogeneidade da escala do gasto influencia na correlação entre a descentralização fiscal e a composição do gasto público dos governos locais. A amostra foi composta por um painel de dados desbalanceado com 5.565 municípios durante 17 anos, correspondente ao período de 2000 a 2016. A análise foi realizada por meio da regressão quantílica incondicional. Os principais resultados foram: (i) a descentralização fiscal afeta nos gastos públicos dos governos locais brasileiros, contudo o tipo de efeito depende da escala do gasto local e da estratégia de descentralização fiscal. Por exemplo, nos gastos com pessoal, para a mediana, o coeficiente foi negativo e o efeito foi positivo para o terceiro quartil dos governos locais, quando a descentralização fiscal foi mensurada pela receita tributária sobre a receita total. Por outro lado, os efeitos foram também positivos para mediana e terceiro quartil considerando as transferências intergovernamentais per capita como proxy da descentralização fiscal; (ii) as mensurações (proxies) da descentralização fiscal são correlacionadas com a composição do gasto público; (iii) a descentralização fiscal afeta mais o gasto com investimentos que os gastos de pessoal e correntes em termos medianos; e (iv) em termos medianos, a participação da receita tributária promove o aumento do gasto em funções de administração e planejamento ao invés de gastos em funções sociais; por outro lado, a descentralização fiscal medida pelas transferências intergovernamentais per capita afeta positivamente mais funções sociais que funções legislativa e administrativa.

State Spending on Public Benefit Programs and Child Maltreatment.

BACKGROUND: To determine the association between states' total spending on benefit programs and child maltreatment outcomes. METHODS: This was an ecological study of all US states during federal fiscal years 2010-2017. The primary predictor was states' total annual spending on local, state, and federal benefit programs per person living ≤100% federal poverty limit, which was the sum of (1) cash, housing, and in-kind assistance, (2) housing infrastructure, (3) child care assistance, (4) refundable Earned Income Tax Credit, and (5) Medical Assistance Programs. The main outcomes were rates of maltreatment reporting, substantiations, foster care placements, and fatalities after adjustment for relevant confounders. Generalized estimating equations adjusted for federal spending and estimated adjusted incidence rate ratios (IRRs) and 95% confidence intervals (CIs). RESULTS: States' total spending was inversely associated with all maltreatment outcomes. For each additional $1000 states spent on benefit programs per person living in poverty, there was an associated -4.3% (adjusted IRR: 0.9573 [95% CI: 0.9486 to 0.9661]) difference in reporting, -4.0% (adjusted IRR: 0.903 [95% CI: 0.9534 to 0.9672]) difference in substantiations, -2.1% (adjusted IRR: 0.9795 [95% CI: 0.9759 to 0.9832]) difference in foster care placements, and -7.7% (adjusted IRR: 0.9229 [95% CI: 0.9128 to 0.9330]) difference in fatalities. In 2017, extrapolating $1000 of additional spending for each person living in poverty ($46.5 billion nationally, or 13.3% increase) might have resulted in 181 850 fewer reports, 28 575 fewer substantiations, 4168 fewer foster care placements, and 130 fewer fatalities. CONCLUSIONS: State spending on benefit programs was associated with reductions in child maltreatment, which might offset some benefit program costs.

Public expenditure on hospitalizations for COVID-19 treatment in 2020, in Brazil.

OBJECTIVE: Describe the expenditure resulting from hospitalizations for clinical treatment of users diagnosed with COVID-19 in the Unified Health System (SUS) between February and December 2020. METHODS: This is a descriptive study based on data from the Hospital Information System about government expenditure on hospitalizations for clinical treatment of users diagnosed with COVID-19 and causes included in the ICD-10 chapters. We obtained the number of hospitalizations, average length of stay, lethality rate, and total expenditure considering hospital services, professional services and average expenditure per hospitalization. RESULTS: In the period evaluated, SUS registered 462,149 hospitalizations, 4.9% of them for COVID-19 treatment. Total expenditure exceeded R$ 2.2 billion, with 85% allocated to hospital services and 15% to professional services. Expenditure for treating COVID-19 was distributed differently between the country's regions. The Southeast region had the highest number of hospitalizations, highest total amount spent, highest average length of stay in days, and highest lethality rate; the South region, in turn, recorded the highest percentage of spending on non-profit hospitals (58%) and corporate hospitals (15%). CONCLUSIONS: Hospitalizations for clinical treatment of coronavirus infection were more costly compared to those for treatment of acute respiratory failure and pneumonia or influenza. Our results show the disparities in hospitalization expenditure for similar procedures between the regions of Brazil, underlining the vulnerability and the need for strategies to reduce the differences in access, use, and distribution of SUS resources, ensuring equanimity, and considering the unfair inequalities between the country's regions.