Why health policies should be transnational: A case for East Asia Pacific countries

Article type: Research Article

Authors: Ambade, Preshit Nemdas^a | Katragadda, Chinmayee^{b; 1} | Sun, Diana^{b; 1} | Bootman, J. Lyle^{c; 1} | Abraham, Ivo^{c; d; *}

Affiliations: [a] Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, USA | [b] Center for Health Outcomes and PharmacoEconomic Research, University of Arizona, Tucson, AZ, USA | [c] Department of Pharmacy Practice & Science, Center for Health Outcomes & Pharmacoeconomic Research, College of Pharmacy, University of Arizona, Tucson, AZ, USA | [d] Department of Family and Community Medicine, College of Medicine, University of Arizona, Tucson, AZ, USA

Correspondence: [*] Address for correspondence: Ivo Abraham, PhD, RN, Professor, Department of Pharmacy Practice, College of Pharmacy; Professor and Vice Chair for Research (interim), Department of Family and Community Medicine, College of Medicine - Tucson; University of Arizona, Drachman Hall B306H, 1295N. Martin Ave., P.O. Box 210202, Tucson, Arizona 85721, USA. Tel.: +1 5206264425; E-mail: abraham@pharmacy.arizona.edu.

Note: [1] Author Note: C. Katragadda, D. Sun, and J. Lyle Bootman contributed to this work while at the University of Arizona. They are now, respectively, at the University of Rochester, Genentech Inc., and Tabula Rasa Healthcare Inc.

Abstract:  This paper argues that health policies should transcend national boundaries yet should not reach the supranational level. Along with multinational global health efforts, such cross-national health policies are essential to leverage joint efforts by countries learning from their peers that experience similar health system challenges. In our analysis, we used World Bank Health, Nutrition, and Population (HNP) data from 1995 to 2014 for East Asia Pacific (EAP) countries to explore health system comparability across member nations. We applied a hierarchical cluster analysis using Ward’s method and a squared Euclidean distance approach to classify 24 EAP countries into four relatively stable clusters based on their (dis)similarities over nine selected health expenditure and health system performance related indicators. One-way analysis of variance (ANOVA) was used to assess the discreteness of the formed clusters. Each cluster had unique characteristics based on the included indicators and health system performance of the member countries. We present transnational health policy recommendations for the EAP region based on both our use of robust methodology and the resulting comparative clusters.

Keywords: East Asia Pacific countries, EAP, hierarchical cluster analysis, transnational health policies, health system research, world bank health nutrition and population statistics database

DOI: 10.3233/JRS-199001

Journal: International Journal of Risk & Safety in Medicine, vol. 30, no. 2, pp. 101-125, 2019