Vikalpa: The Journal for Decision Makers

Scholars in health economics have been studying the relationship between healthcare expenditure and health outcomes for the last half-century. Researchers emphasized the increase of public health expenditure towards providing primary healthcare based on the logic that health expenditure has a direct effect on the health outcomes of the people. However, such studies have a lot of inconsistencies. Given the background, the present study has three research objectives. First, to investigate the effect of healthcare spending on multiple health outcomes in SAARC nations after controlling for country-specific health infrastructures and economic conditions. Second, to undertake a differential analysis of the effect of public and private healthcare spending (both aggregate and out of pocket) on specific health outcomes. Third, to explore the presence (if any) of the differential effect of health expenditure and health infrastructure variables on specific health outcome variables, including mortality and morbidity indicators. Based on a 20-year (1993–2012) panel data from seven SAARC countries, health expenditure was found to influence improved health outcomes in SAARC nations. In addition, the differential effect of public, private and out-of-pocket (OOP) health expenditure was observed on different health outcomes. Thus, OOP expenditures was found to be the major influencer of life expectancy, death rate and TB instances, while public expenditure was found to be influential for improving infant mortality rate (IMR). The present study supports the notion that disaggregated effects of health expenditure (by including the effect of public, private and OOP expenditures) are needed to get a complete understanding of the health expenditure–health outcome linkage. In addition, the findings emphasize on the role of proximal predictors of health outcomes (alongside expenditure variables in the same model) as important inclusion in the health expenditure-health outcome investigation.

Sustainability in the e-commerce business has created an overwhelming interest among practitioners and researchers. The different business models adopted by the e-retailers in India lack sustainable aspects, hindering them from generating sustainable revenues. To accomplish such goals, e-retailers need to focus on sustainable factors such as trust, innovation, timely delivery of goods, usability, internet speed and customer support service. In view of this, the article is aimed to create an instrument that captures sustainable online retailing by developing, measuring and empirically validating a scale. The validity of the scale was established by adopting a proper psychometric scale development procedure. The study found that after applying various judgmental and statistical criteria to the initial scale of 26 items, 17 items were retained with the removal of nine items sequentially at different steps. The dropped items could not meet the set thresholds of different criterion. Results of the study suggested that trust and internet speed in the present context are key determinants of sustainable e-retailing. The study focused on the online retail sector only. Methodological developments in other areas might lead to different results if the chosen criteria were to be repeated there. Both judgmental and statistical procedures need to be used with proper consensus. The practical implications of the study involve five constructs that e-marketers and practitioners could adopt to provide better customer experience resulting in higher customer satisfaction. The authors demonstrated a detailed procedure for scale purification. This procedure will help researchers in this area and in adjacent disciplines build greater consistency regarding applying methodological steps in scale purification. It will also assist reviewers and editors with tools to identify methodological errors while making review decisions. Such a scale will help in bringing standardization of the research carried out in sustainable online retailing.