Analyses of the relationship between total health care expenditures and various factors via multiple time series methods: The Turkish case

The aim of this study is to determine the factors that have an impact on total health expenditures in short and long terms. For this study, the measles vaccination rate, the amount of CO2 emissions released into the atmosphere, the number of doctors and nurses were determined as independent variables and total health expenditure was determined as dependent variable. Between 1990 and 2018, time series analysis was carried out with data on these variables obtained from the Ministry of Health, Turkish Statistical Institute, World Bank and Organization for Economic Development and Cooperation. In the statistical analyses, first the stagnation tests of the variables were performed, and then, respectively, short and long-term relations were determined with the ARDL Bound Test and their causality was examined with the Toda-Yamamato Causality Analysis. As a result of the study, according to the ARDL Bound Test; In the long term, total health expenditure was increased by the amount of CO2, while the increase in the number of nurses was found to decrease. According to the findings, it was determined that the number of doctors and the rate of measles vaccination had no meaningful effect on total health expenditure in the long term. In the short term, with total health expenditures; a negative relationship was found between the measles vaccination rate and the number of doctors, and a positive relationship between CO2 and the number of nurses. In the results of the Toda-Yamamato Causality Analysis, from the number of doctors and nurses to the measles vaccination rate; It has been concluded that there is a causality from CO2 towards the number of doctors and the number of nurses. Due to the fact that they have implications for reducing total health expenditures; In the short term, the number of doctors and the measles vaccination rate should be increased, while the number of nurses should be increased in the long term. In addition, development planning to reduce the amount of CO2 emissions released into the atmosphere will not prevent the country from growing economically while reducing the effects of CO2 on health. Keywords: ARDL bound test, health expenditures, time series analysis, Toda-Yamamato causality analysis