HOUSEHOLD EXPENDITURE DURING A PANDEMIC: COVID-19 AND THE CASE OF BULGARIA

This article examines the expenditures of Bulgarian households during the COVID-19 pandemic. It specifies the theoretical and methodological features of the concepts of the household total and monetary expenditures and outlines their structure and specific characteristics. It also proves that the amount of total consumer expenditure is greater than the amount of monetary consumer expenditure. The structure and dynamics of the total expenditure average per household and per person are analyzed, deriving the factors that affect the trends in the change of the studied categories. The object of study is household total expenditure, and the subject involves the supposed role of COVID-19 as a factor that affects the state and dynamics of household total expenditure and/or its structure in Bulgaria. The conclusion is that there is a negative pandemic impact, but it should not be overestimated and/or dramatized. © 2022, Dimitar A Tsenov Academy of Economics. All rights reserved.

Uncovering the Dynamics of Consumption-Based Household Water Footprint in Response to Pandemic: The Hysteresis Effect of Disruption

The socioeconomic disruption of COVID-19 has strong implications for water management. However, it remains unclear how water use related to urban and rural household consumption responded to the outbreak. Taking 15 provincial regions in China for a case study, we quantified the variations of consumption-based household water footprint induced by the first outbreak of the pandemic and tracked the responsive changes of interregional virtual water flows and control relationships. We found in many regions, the most drastic change occurred only a quarter after the major outbreak, when the average water footprint of urban and rural households decreased by 13% and 9%, respectively. This indicates the presence of a hysteretic effect of disruption to household expenditures. With the subsequent recovery of household consumption, the water footprints in many regions rebounded and even surpassed the historical values. Guangdong had a fast rebound in its net virtual water inflow related to urban households because of the fast recovery of its manufacturing and services activities. The pandemic-related water footprint dynamics suggest not only the necessity of timely managing supply chains to prevent shortage of water and water-intensive products, but also the importance of fostering consumption adjustments for conserving water in a post-pandemic era. © 2023 The Authors. Earth's Future published by Wiley Periodicals LLC on behalf of American Geophysical Union.

Revenues and Expenditures for Public Elementary and Secondary Education: FY 21. Finance Tables. NCES 2023-301

This set of tables introduces new data for national and state-level public elementary and secondary revenues and expenditures for fiscal year (FY) 2021. Specifically, these tables include the following school finance data: (1) revenue and expenditure totals;(2) revenues by source;(3) expenditures by function and object;(4) current expenditures;(5) revenues and current expenditures per pupil;(6) expenditures from Title I funds;and (7) revenues and expenditures from COVID-19 Federal Assistance Funds. The tables chosen for this report demonstrate the range of information available when using the National Public Education Financial Survey (NPEFS). [For "Revenues and Expenditures for Public Elementary and Secondary Education: FY 20. Finance Tables. NCES 2022-301," see ED619372.]

Special Issue: Recent learnings and development in healthcare financing: A global perspective. (Special Issue: Recent learnings and development in healthcare financing: A global perspective.)

This special issue contains 11 s that discuss recent learnings and developments in healthcare financing from a global perspective. The s cover a range of topics such as the impact of mental illness on poverty and catastrophic health expenditure in India, financing challenges in the American healthcare industry, comparative analysis of health system financing in India and Saudi Arabia, and the contribution of the Ghana National Health Insurance Scheme to inequality in healthcare utilisation. Other s explore the influence of socio-economic status on health financing choices in Jambi Province, households' willingness to pay for community-based health insurance in Bangladesh, and changes in household expenditures during the first wave of COVID-19 in India. The issue also includes discussions on managing the provider-purchaser split in India and reconsidering patient value to create better healthcare.

Facial ageing . . . and other stories

When high quality photographs of the faces of 2700 middle aged and older participants in a longitudinal study were assessed by a panel without knowledge of their chronological age and medical history, people whose perceived age was lower than their chronological age were less likely to have osteoporosis, chronic obstructive pulmonary disease, hearing loss, or cataracts. Energy expenditure and incident type 2 diabetes Data from 90 000 participants in the UK Biobank study who wore an accelerometer for seven days reveal a linear relation between the amount of energy expended during physical activity and the subsequent incidence of type 2 diabetes—even after adjusting for body mass index. A study using data for 1.5 million prescriptions of PPIs in UK general practice found an increased risk of diagnosis of an inflammatory bowel disease in the first two years after treatment started.

The impact of universal health coverage and COVID-19 pandemic on out-of-pocket expenses in Thailand: an analysis of household survey from 1994 to 2021.

OBJECTIVES: After Thailand achieved Universal Health Coverage (UHC) in 2002, the extent of financial risk protection has not been assessed in the long term, especially after the COVID-19 pandemic. Therefore, this study aims to revisit the impact of UHC on out-of-pocket expenses (OOPE) for health and to descriptively explore the impact of COVID-19 on OOPE. METHODS: This study was a secondary data analysis and used data from the Socio-Economic Survey from 1994 to 2021 in Thailand. The effect of UHC on the percentage of OOPE in total health expenditures (THE) from 1994 to 2019 was investigated with an interrupted time-series analysis. Descriptive analyses of OOPE in absolute value during the COVID-19 were conducted. RESULTS: The percentage of OOPE in THE significantly decreased both before (ß -2.02%; 95% CI: -2.70% to - 1.33%) and during (ß 1.41%; 95% CI: 0.70% to 2.11%) the UHC period. During the pandemic, total household OOPE for medical equipment was found to have rapidly increased from 643 million THB in 2019 to 9.4 billion THB in 2020. CONCLUSIONS: The trend of providing financial risk protection (measured by OOPE/THE) in Thailand continues until 2019. Providing medical equipment in sufficient and equally accessible manners should be prioritized during the future pandemic.

The role of heritage sites and other influential factors in domestic tourism inflow to Australian states: a gravity model approach

Domestic tourism plays a crucial role in the Australian economy, generating revenue, creating employment opportunities, fostering cultural identity, and facilitating tourism growth and development. The remote regions of Australia are particularly reliant on domestic inbound tourism to stimulate their local economies. This study investigates the influence of heritage sites and various factors on domestic tourism inflows to eight states in the Australia between 1998-2021. The gravity method and random effect model are employed for the empirical analysis. The results indicate that the macro determinants, including population of origin state, gross state product per capita, infrastructural development, shared border between states, and the number of heritage sites, have significant and positive impact on domestic tourism inflow. Conversely, the consumer price index, distance, and pandemic outbreak have a negative influence on domestic tourism inflow. These findings hold important practical implications. Given Australia's geographical remoteness, promoting domestic tourism becomes imperative to boost the tourism industry and local economies. Therefore, it is recommended that authorities prioritize domestic tourism flows and invest in infrastructure, preserve heritage sites, stabilize prices, implement effective marketing strategies, and respond swiftly to public emergencies such as the Covid-19 pandemic.

The economic contribution of the cultural sector in Brazil: an input-output approach with different income groups

Brazil is characterized by strong income inequality, which is naturally reflected in the consumption of goods and services. Such disparities in access are also reproduced in the artistic and cultural activities sector. Thus, understanding the cultural sector as key to the development of society, the present article evaluates the intersectoral impact of the artistic and cultural activities sector on other sectors of the Brazilian economy. First, this analysis identifies the effects of COVID-19, which allows us to determine how the sector is affected by such a shock in terms of output, employment and income. Subsequently, the relevance of the cultural sector is evaluated by identifying different family income groups with the 2015 input-output matrix published by the Brazilian Institute of Geography and Statistics (IBGE) and information from the Family Budget Survey (POF). The main results indicate that the COVID-19 pandemic, specifically, its effect on the cultural sector, reduced the production of cultural activities by 31.8%, equating to a loss of 237,701 jobs. This result indicates the relevance of the cultural sector for the Brazilian economy. In addition, we show that low income families, a group representing more than 70% of households, are responsible for only 28% of all Brazilian household consumption in the cultural sector. However, families in the highest income bracket, i.e. less than 3% of households, account for 22% of this sector. This result underscores the importance of developing public policies to stimulate consumption among low income groups, given that in addition to the cultural sector's economic benefits, there are intangible benefits of cultural activity for society.

The impact of military expenditures on out of pocket healthcare payments: international evidence based on a dynamic panel data analysis

PurposeThe empirical analysis dealt in this paper emphasizes on the impact of military expenditures on out of pocket (OOP) healthcare payments. A sizeable body of defence economics literature has investigated the trade-off between military and public health expenditure, by testing the crowding-out or growth-stimulating hypothesis;does military expenditure scaling up crowd-out or promote governmental resources for social and welfare programs, including also state health financing?Design/methodology/approachIn this study, panel data from 2000 to 2018 for 129 countries is used to examine the impact of military expenditure on OOP healthcare payments. The dataset of countries is categorized into four income-groups based on World Bank's income-group classification. Dynamic panel data methodology is applied to meet study objectives.FindingsThe findings of this study indicate that military expenditure positively affects OOP payments in all the selected groups of countries, strongly supporting in this way the crowding-out hypothesis whereby increased military expenditure reduces the public financing on health. Study econometric results are robust since different and alternative changes in specifications and samples are applied in our analysis.Practical implicationsUnder the economic downturn backdrop for several economies in the previous decade and on the foreground of a potential limited governmental fiscal space related to the Covid-19 pandemic adverse economic effects, this study provides evidence that policy-makers have to adjust their government policy initiatives and prioritize Universal Health Coverage objectives. Consequently, the findings of this study reflect the necessity of governments as far as possible to moderate military expenditures and increase public financing on health in order to strengthen health care systems efficiency against households OOP spending for necessary healthcare utilization.Originality/valueDespite the fact that a sizeable body of defence economics literature has extensively examined the impact of military spending on total and public health expenditures, nevertheless to the best of our knowledge there is no empirical evidence of any direct effect of national defence spending on the main private financing component of health systems globally;the OOP healthcare payments.

Comparative impact of COVID-19 and common diseases on poverty in Cameroon and sustainable response strategies

In the context of a developing country like Cameroon characterized by the scarcity of financial resources and the appearance of Covid-19, this article shows that this pandemic was not more important than the pre-existing health problems to the point of giving it more importance in funding compared to strengthening the health system. The theoretical elasticity model of the poverty rate to growth is used to estimate the impact of Covid-19 and the incidence of impoverishing health expenditure is used for the impact of common diseases. It is estimated through direct health payments that common diseases push about 340,865 people into extreme poverty annually. The Covid-19, through the loss of growth generated between 4.8 and 6.6 points according to the optimistic or pessimistic scenarios, would impoverish between 224,193 and 398,565 people: impact on the number of poor ranging from 0.7 to 1.2 times that of all common diseases, i.e., equivalent on average, but sensitive to the speed of spread of the virus and the duration of the crisis while the impact of common diseases is structural and linked to the poorly performing health system. The solutions proposed are endogenous and linked to the impact mechanisms.

Preference Shifts During Health Shocks: Foreign Tourists' Expenditure-Price Elasticity Throughout the Pandemic

This study evaluates the changes in the expenditure-price elasticities of foreign tourists in the summer periods of 2019, 2020, and 2021. We first develop a theoretical characterization that combines microeconomic, loss aversion, price inequality and precautionary savings theories. Next, exploiting microdata for more than 34,000 foreign tourists visiting Spain, we estimate OLS and quantile regressions to empirically examine the expenditure elasticities with respect to the prices of transport services, leisure activities and bars and restaurants at the destination (17 regions). We find that (i) the expenditure-price elasticity of transportation (leisure activities) increases (decreases) during the pandemic, whereas that of bars and restaurants remains unchanged, (ii) foreign tourists are comparatively less expenditure-price elastic at high expenditure levels in transportation and bars and restaurants, and (iii) expenditure-price elasticities are highly heterogeneous depending on the origin country. Managerial and theoretical implications of the findings for firms' pricing strategies are discussed.

Indirect Calorimetry Critical in Identifying Early Hypometabolism and Late-Stage Hypermetabolism in Post-surgical Patients

Background: Indirect calorimetry (IC) is the gold-standard procedure for measuring resting energy expenditure (REE) in hospitalized patients. Predictive energy equations commonly use static variables and rarely account for changes in REE throughout hospitalization. We hypothesize that predictive equations are typically inaccurate in surgical intensive care unit (ICU) patients. More specifically, we hypothesize that predictive equations often overpredict measured resting energy expenditure (mREE) in early-stage critical illness and underpredict needs later in surgical ICU stay, leading to over-/under-feeding and associated complications. Method(s): This prospective observational trial enrolled surgical ICU patients who underwent emergent or urgent operations for abdominal trauma, perforated viscus, or ischemic bowel within 72 hours of their surgical procedure. Metabolic assessments were performed using the COSMED Q-NRG + Metabolic Monitor ventilator, mask, and canopy at regular intervals during and post ICU admission until hospital discharge. Measurements were categorized by post-surgical intervention ICU admission days 0-3, 4-7, 8-14, 15-21, and 22-28. Patients with multiple measurements taken during the same time interval were averaged. mREE reported in calories (kcal) per kilogram (kg) of admission body weight per day were compared in obese (BMI > 30 kg/m2) and non-obese (BMI < 30 kg/m2) subgroups. Compared to IC, the Mifflin St Jeor (MSJ) equation determined predicted REE using ICU admission anthropometrics. Data are reported as mean+/-standard error of the mean (SEM) and median (interquartile range), and a two-sided p-value of <0.05 was determined significant. Result(s): In total, 18 surgical ICU patients who contributed 47 IC measurements were included in the analysis (Table 1). Most measures were obtained within the first 7 days of post-surgical ICU admission (72%). mREE peaked between days 8-14 in obese and non-obese subgroups (20.6 vs 28.5 kcal/kg;p = 0.02) and was lowest during 0-3 days of post-surgical ICU admission in both groups. Across all 5-time intervals, average kcal/ kg ranged from 14.7-20.6 among obese patients and from 20.1-28.5 in non-obese counterparts (Table 2). Non-obese patients had higher mREE per kg of body weight than obese patients at all time points (Figure 1). MSJ over-predicted mREE during the first 7 days post ICU admission in non-obese patients and within the first 3 days in obese patients and underpredicted mREE in both groups thereafter. Conclusion(s): Equations such as MSJ over- and under-predict mREE in post-operative surgical ICU patients depending on the days elapsed since post-surgical ICU admission. ASPEN's current guideline recommendation of 12-25 kcal/kg may also underfeed post-surgical populations while 25 kcal/kg may not support hypermetabolism among non-obese patients seen in week 2 following post-surgical ICU admission. Alternatively, MSJ multiplied by a 1.2 activity factor may account for hypermetabolism during this time. Notably, non-obese patients experienced greater hypermetabolism than obese patients during week 2 which is consistent with our previously published data in mechanically ventilated COVID- 19 patients. Additionally, the striking dichotomy between the mREE of obese and non-obese patients at all post-surgical time points should be considered in the clinical care of patients. Ultimately, IC remains the gold-standard means of measuring REE and is a critical tool to capture the dynamic nature of energy requirements in post-surgical populations as weight-based and predictive equations continually fall short. (Table Presented).

Comparing food consumption during the COVID-19 pandemic: analysis of household income and expenditure survey data in Iran.

BACKGROUND: On March 11, 2020, the WHO declared the outbreak of the infectious disease COVID-19 as a pandemic. The health strategies of nations lead to possible changes in lifestyle and increase poor eating habits. Hence, the purpose of this study is to compare food consumption during COVID-19 pandemic in Iran. METHODS: This cross-sectional study used secondary data from the Households Income and Expenditure Survey (HIES) conducted annually by the Statistical Centre of Iran. Food cost data of HIES included the amount of all food items in household food baskets during the last month. Then, they were classified into six food groups to evaluate their energy intake. The consequence of food consumption was analyzed as a function of socioeconomic status (SES) variables and residence pre- and post-COVID-19 pandemic. RESULTS: In total, 75,885 households (83.5% male) were included in the study. Among the population of urban and rural areas as well as in different SES categories, people tended to increase the consumption of meat (P < 0.05) and fresh foods, especially vegetable groups (P < 0.001) and decrease the consumption of fruit (P < 0.001), fat and sweets groups (P < 0.05) and also in energy intake (P < 0.05). Macronutrient changes were different in the category of SES, urban and rural. CONCLUSION: Our study indicated that the COVID-19 pandemic had different effects on food groups, energy and macronutrients consumption, which could be due to possible changes in food patterns as a result of the pandemic.

EDUCATIONAL AND INNOVATIVE ELEMENTS OF HUMAN CAPITAL AND THEIR IMPACT ON ECONOMIC GROWTH

Human capital is an important factor for economic growth and the development of socio-economic systems. However, the appropriate expression of the value of human capital, the mechanism and its impact on economic development are still under discussion. It is hypothesised that there is a relationship between human capital and economic growth. To test this hypothesis, data on the group of Visegrad (V4) countries for the period 2000–2019 was analysed. The study examines the presence of a causal link between some attributes of human capital and economic growth and the conditions, under which its positive effects can be expected based on statistical methods. It also deals with the role and the applicability of some of its characteristics to express the impact of human capital on economic growth. The model revealed a positive, statistically significant relationship between gross domestic product per capita and the innovative capacity of human capital and the qualifications of employees. The impact of tools for human capital creation and development extends over a longer period and is reduced by the simultaneous action of other labour market factors. Currently, economies are affected by the Covid-19 pandemic. Corresponding changes are also noticeable in the way work is done, with more weight on the home office. It will be interesting to examine how this transformation will affect economic growth. The changes in the position of employees and the care of companies for human capital are also a good topic for further research that can be conducted every few years. © Daňová M., Širá E. Text. 2023.

The effect of COVID-19 on food sales.

Both COVID-19 pandemic-related restrictions and recessionary employment loss severely impacted US food sales during 2020. This article estimates the historical relationship between food expenditures and employment at the county level. Using these estimates, we simulate the impact of the loss of employment on food sales and find that, on average, employment loss increased food-at-home (FAH) sales by 1.3% and decreased food-away-from-home (FAFH) sales by 0.5% in 2020. We argue differences to the actual 4.8% increase in FAH sales and 19.5% decrease in FAFH sales in 2020 likely stem from the more drastic COVID-19 pandemic-related restrictions and behavioral changes.

COVID-19 Aftermath: Direction Towards Universal Health Coverage in Low-Income Countries Comment on "Health Coverage and Financial Protection in Uganda: A Political Economy Perspective".

Progressive realization of universal health coverage (UHC) requires health systems capacity to provide quality service and financial risk protection which supports access to services without financial hardship. Government health spending in low-income countries (LICs) has been low and heavily relied on external donor resources and out-of-pocket payment. This has resulted in high prevalence of catastrophic health spending or foregone care by those who cannot afford. Under fiscal constraints posed by pandemic, reforms in LICs should focus on efficiency through health resource waste reduction. Targeting the poor even with low level of health spending can make a significant health gain. Investment in primary healthcare and health workforce is the foundation for realizing UHC which cannot be postponed. Innovative tax on health hazardous products, conditional debt relief can increase fiscal space for health; while international collaboration to accelerate coronavirus disease 2019 (COVID-19) vaccine coverage can bring LICs out of acute phase of pandemic.

Determinants of life expectancy at birth: a longitudinal study on OECD countries.

This paper analyses the influence of several determinants on life expectancy at birth in 36 OECD countries over the 1999-2018 period. We utilized a cross-country fixed-effects multiple regression analysis with year and country dummies and used dynamic models, backward stepwise selection, and Arellano-Bond estimators to treat potential endogeneity issues. The results show the influence of per capita health-care expenditure, incidence of out-of-pocket expenditure, physician density, hospital bed density, social spending, GDP level, participation ratio to labour, prevalence of chronic respiratory diseases, temperature, and total size of the population on life expectancy at birth. In line with previous studies, this analysis confirms the relevance of both health care expenditure and health care system (physicians and hospital beds in our analysis) in influencing a country's population life expectancy. It also outlines the importance of other factors related to population behaviour and social spending jointly considered on this outcome. Policy makers should carefully consider these mutual influences when allocating public funds, particularly after the COVID-19 pandemic period.

An overview of state subsidies in Italian agriculture in the period 2000-2019

This paper provides a descriptive analysis of the trends and the main components of public support for agriculture in Italy over the two decades (2000-2019) preceding the outbreak of the Covid-19 pandemic. For this analysis, the wealth of highly informative data contained in the CREA database "Agricultural expenditure of the Regions" was used. This is the most up-todate and consistently available source of information on public spending in agriculture, with regional details that distinguish it from other official statistical sources. Overall public support for the agriculture sector in the period under consideration decreased by over EUR 4 billion (from EUR 15,613 billion in 2000 to just below EUR 12 billion in 2019). The share of support in agricultural added value has also decreased: from 55% in 2000 to about 34% in 2019. Looking at the individual categories of support (EU CAP 1st and 2nd pillar funds, tax and social security reliefs, State transfers and regional funds) included in the analysis, it is clear that this decrease was due to the halving of tax and social security reliefs (from 26.6% to 15.8%), and the significant reduction in the support provided by the budgets of the Regions and Autonomous Provinces (from over 4 billion euros in 2000 to 1,7 billion euros in 2019). To this must be added a reduction in government contributions (from 4.3% to 4.1%). As a result, EU support was consequently stable in the first decade and increased in the last ten years (from 43.1% in 2000 to 63.9% in 2019). This analysis highlights the various support models derived from each Region's particular production and politicaladministrative situations. © 2022 Franco Angeli Edizioni. All rights reserved.

COVID-19 and consumer behavior: food stockpiling in the U.S. market

The emergence of the COVID-19 pandemic has brought radical changes in consumer spending patterns. One aspect of this change is food stockpiling detected in several countries. Using a univariate probit model, this paper relies on the COVID-19 Impact Survey (2020) for American households to assess the likelihood of consumers stockpiling food in response to the stringent lockdown measures imposed by the government's pandemic regulations. Our findings reveal a set of significant correlations between marital status, age, race, occupation, household structure, and the propensity of stockpiling food during the pandemic. Furthermore, the results show that residents in urban areas are more likely to engage in food stockpiling compared with residents in rural and suburban areas. The paper also examines the nexus between residence areas, lockdown measures, and the probability of stockpiling food. This research reveals a significant association between psychological factors and the likelihood of stockpiling food in response to the COVID-19 pandemic [EconLit Citations: D12, H12, I18, P25].