The moderating effect of supranational organizations on the impact of health investments on health status: The case of the European Union

To understand the health status of a society, it is necessary to focus not only on the indicators related to the health care but also on the economic, social, and institutional dynamics underlying these indicators. Investments in health systems constitute the basic condition for maintaining a healthy life at both individual and societal levels. The effectiveness of these investments is closely related not only to the amount of resources allocated by countries but also to how these resources are utilized and within which institutional framework they are implemented. The norms and policies guided by supranational organizations play a decisive role in the development of countries' health systems and the improvement of health indicators. In this context, the European Union (EU) stands out as one of the most powerful supranational structures that encourages member states to act in line with the principles of equality, accessibility, quality, and sustainability within their health systems. This study investigates the impact of per capita health expenditure (SH) and the number of hospital beds per 1,000 people (YS) on two major health indicators—infant mortality rate (BÖH) and life expectancy at birth (DBYS)—while examining the moderating role of EU membership in these relationships. Health expenditure and hospital bed capacity are considered critical determinants of health outcomes, whereas EU membership is expected to influence these relationships by introducing common standards, regulations, and policy frameworks across member states. In the study, panel data analysis techniques were employed. Interaction terms between independent variables (SH and YS) and the moderator (EU membership) were introduced into the models to assess the moderating effects. The results demonstrate that higher per capita health expenditure significantly reduces infant mortality and EU membership moderates the relationship between SH and BÖH. However, no moderating effect of EU membership was found for the relationship between YS and BÖH. Similarly, the effects of SH and YS on DBYS were not moderated by EU membership. These findings highlight the importance of health expenditure in reducing infant mortality and underline the supportive role of EU membership in strengthening this relationship. Nevertheless, the absence of moderating effects for life expectancy suggests that DBYS is influenced by a broader set of factors beyond healthcare financing and infrastructure, including education, environmental conditions, and social policies. In conclusion, the study contributes to the health economics literature by providing evidence that EU membership amplifies the beneficial impact of health spending on infant survival but does not significantly alter the determinants of overall life expectancy. The findings offer valuable insights for policymakers, particularly in developing countries aiming to improve maternal and child health outcomes.