Document Type : Original Article


1 Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran

2 Department of Health Economics, School of Health Management and Information Sciences, Iran University of Medical Sciences


CONTEXT: There are numerous factors which affect the health status in different ways, including
financing mechanisms, health‑care expenditures, socioeconomic characteristics, and health‑care
resources. One of the most important factors which contribute to the health status of a population
is health‑care resource which includes number of beds or health‑care professionals for instance.
AIMS: The objectives of this study were as follows: to examine the regression of the life expectancy
and health‑care inputs and also to investigate the regression of death rate and health‑care inputs.
SETTINGS AND DESIGN: This study was a panel dataset analysis of OECD countries.
MATERIALS AND METHODS: A generalized method of moment (GMM) regression models with
country‑level health outcomes (death rate and life expectancy) as dependent variables were estimated.
A panel dataset with n = 26 (the number of countries) and T = 12 (the number of time periods) was
used. The GMM regression model was used to estimate the effect of health‑care resources on
health outcomes.
RESULTS: Findings showed that there are strong reverse correlations between immunization rate and
number of physicians with crude rate of death (−2.64 [P < 001] and −76.50 [P < 001], respectively).
There were also positive correlations between immunization rate and number of physicians with
life expectancy at birth (0.01 [P < 001] and 1.03 [P < 001], respectively). Moreover, there were
negative correlations between inpatient rate and beds with life expectancy (−0.00003 [P < 001]
and −0.12 [P < 001], respectively).
CONCLUSIONS: It is essential for policymakers to consider the optimal level of health resource to
achieve better health outcomes. Oversupply of hospital beds and specialist doctors could lead to
induced demand and put the patients at risk of unnecessary procedures.


1. Qin X, Hsieh CR. Economic growth and the geographic
maldistribution of health care resources: Evidence from China,
1949‑2010. China Econ Rev 2014;31:228‑46.
2. Speybroeck N, Kinfu Y, Dal Poz MR, Evans DB. Reassessing the
Relationship Between Human Resources for Health, Intervention
Coverage and Health Outcomes. Geneva: World Health
Organization; 2006.
3. Monsef A, Mehrjardi AS. Determinants of life expectancy: A panel
data approach. Asian Econ Financ Rev 2015;5:1251‑7.
4. Halicioglu F. Modeling life expectancy in Turkey. Econ Model
5. Farahani M, Subramanian SV, Canning D. The effect of changes
in health sector resources on infant mortality in the short‑run and
the long‑run: A longitudinal econometric analysis. Soc Sci Med
6. Anand S, Bärnighausen T. Human resources and health outcomes:
Cross‑country econometric study. Lancet 2004;364:1603‑9.
7. Or Z, Wang J, Jamison D. International differences in the impact
of doctors on health: A multilevel analysis of OECD countries.
J Health Econ 2005;24:531‑60.
8. Extracts OS. Organization for Economic Co‑Operation and
Development. Access Mode; 2010. Available from: http://www.
9. Bousmah MA, Ventelou B, Abu‑Zaineh M. Medicine and
democracy: The importance of institutional quality in the
relationship between health expenditure and health outcomes
in the MENA region. Health Policy 2016;120:928‑35.
10. McGovern ME, Canning D. Vaccination and all‑cause child
mortality from 1985 to 2011: Global evidence from the
demographic and health surveys. Am J Epidemiol 2015;182:791‑8.
11. Aaby P, Martins CL, Garly ML, Balé C, Andersen A, Rodrigues A,
et al. Non‑specific effects of standard measles vaccine at 4.5 and
9 months of age on childhood mortality: Randomised controlled
trial. BMJ 2010;341:c6495.
12. Liebert H, Mäder B. Marginal Effects of Physician Coverage
on Infant and Disease Mortality. HEDG, c/o Department of
Economics, University of York; 2016.
13. Pando, Cynthia, “The Influence of Number of Physicians on Infant
Mortality Across Nations” (2016). Volume 24‑2016. 35. http://‑lehighreview‑vol‑24/35.
14. Shinjo D, Aramaki T. Geographic distribution of healthcare
resources, healthcare service provision, and patient flow in Japan:
A cross sectional study. Soc Sci Med 2012;75:1954‑63.
15. Anand S, Bärnighausen T. Health workers and vaccination
coverage in developing countries: An econometric analysis.
Lancet 2007;369:1277‑85.
16. Shetty A, Shetty S. The impact of doctors per capita on the
mortality rate in Asia. Int J Med Pharm Sci. 2014 May; 4(09).