What question did this study set out to answer?

To evaluate the relationship between government healthcare financing, social protection expenditure, household out-of-pocket burdens, and macro-fiscal sustainability across Central Asian countries.

August 14, 2026EconomiesOpen Access

The Relationship Between Healthcare Financing and Social Protection in Ensuring Equity and Fiscal Sustainability

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Authors

AKAiymgul KapenovaL. N. Gumilyov Eurasian National University RIRuslana ICHSHANOVANational Center for Biotechnology ZIZagira ISKAKOVAL. N. Gumilyov Eurasian National University

Discussion

Member takes

Implication

Panel analysis shows public health and social protection spending reduce out-of-pocket costs in Central Asia, highlighting fiscal sustainability trade-offs.

Key Points

To evaluate the relationship between government healthcare financing, social protection expenditure, household out-of-pocket burdens, and macro-fiscal sustainability across Central Asian countries.
Analyzed a country–year panel of five Central Asian nations (Kazakhstan, Kyrgyzstan, Tajikistan, Turkmenistan, and Uzbekistan) from 2015 to 2024 (N = 5).
Applied fixed-effects regression models as the primary benchmark alongside two-step System Generalized Method of Moments (GMM) sensitivity analyses.
Tracked household burden through out-of-pocket expenditure shares of current health expenditure and macro-fiscal pressure via changes in general government debt.
Domestic general government health expenditure was negatively associated with out-of-pocket spending share (fixed-effects coefficient: −3.810; System GMM: −4.102).
Social protection expenditure was negatively associated with the out-of-pocket spending share (fixed-effects coefficient: −1.245; System GMM: −1.830).
Combined public social and health expenditure was positively associated with the government debt-to-GDP ratio, with substantial cross-country variation in closing the 5% of GDP public health spending gap.

Cite This Study

Kapenova et al. (2026) studied this question.

synapsesocial.com/papers/6a7ec71db70b84ec8b913316 https://doi.org/10.3390/economies14080337

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August 14, 2026EconomiesOpen Access

The Relationship Between Healthcare Financing and Social Protection in Ensuring Equity and Fiscal Sustainability

View Full Paper

Ask AI

Bookmark

Authors

AKAiymgul KapenovaL. N. Gumilyov Eurasian National University RIRuslana ICHSHANOVANational Center for Biotechnology ZIZagira ISKAKOVAL. N. Gumilyov Eurasian National University

Discussion

Member takes

Implication

Panel analysis shows public health and social protection spending reduce out-of-pocket costs in Central Asia, highlighting fiscal sustainability trade-offs.

Key Points

To evaluate the relationship between government healthcare financing, social protection expenditure, household out-of-pocket burdens, and macro-fiscal sustainability across Central Asian countries.
Analyzed a country–year panel of five Central Asian nations (Kazakhstan, Kyrgyzstan, Tajikistan, Turkmenistan, and Uzbekistan) from 2015 to 2024 (N = 5).
Applied fixed-effects regression models as the primary benchmark alongside two-step System Generalized Method of Moments (GMM) sensitivity analyses.
Tracked household burden through out-of-pocket expenditure shares of current health expenditure and macro-fiscal pressure via changes in general government debt.
Domestic general government health expenditure was negatively associated with out-of-pocket spending share (fixed-effects coefficient: −3.810; System GMM: −4.102).
Social protection expenditure was negatively associated with the out-of-pocket spending share (fixed-effects coefficient: −1.245; System GMM: −1.830).
Combined public social and health expenditure was positively associated with the government debt-to-GDP ratio, with substantial cross-country variation in closing the 5% of GDP public health spending gap.

Cite This Study

Kapenova et al. (2026) studied this question.

synapsesocial.com/papers/6a7ec71db70b84ec8b913316 https://doi.org/10.3390/economies14080337

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