MUNICIPAL CENTRALITY AND INTERDEPENDENCE OF PUBLIC HEALTH EXPENDITURE: Evidence for Brazil, Northeast and Rio Grande do Norte
Spatial dependence; centrality; health spending; municipalities.
The present research investigates the determinants of public health expenditure, from the point of view of horizontal and vertical spatial interdependence among Brazilian municipalities, with cutouts to the northeast and the state of Rio Grande do Norte. The objective is to investigate how the pattern of the expenditures of neighboring municipalities affect the pattern of expenditures of a given municipality. The data were collected in IBGE / DATASUS and in the System of Public Budgets in Health (SIOPS). In order to approach the results, Moran’s I and Gi of Getis and Ord (1992) tests are used to identify the spatial correlations and the Balmont process (2003). Spatial equations are used in the econometric analysis of the determinants of public expenditure, using the Spatial Lag Model (SAR) and Spatial Error Model (SEM). As main results, it can be observed that the municipality centrality provides an improvement in the informational level of public health expenditure modeling and that the per capita expenditure of the central municipalities with hospital and outpatient care is higher than the non-central expenditure in all the cutouts studied. On the other hand, the findings conclude that per capita expenditure with basic care is lower in central municipalities, which is explained by economies of scale. Finally, the study points out that the consideration of the central municipalities in the econometric models produces a reduction in the horizontal interdependence between the Brazilian municipalities.