Why have patterns of healthcare spending varied during the Great Recession? Using cross-national, harmonized data for 27 EU countries from 1995 to 2011, we evaluated political, economic, and health system deter-minants of recent changes to healthcare expenditure. Data from Euro Stat, the IMF, and World Bank (2013 editions) were evaluated using multivariate random-and fixed-effects models, correcting for pre-existing time-trends. Reductions in government health expenditure were not significantly associated with magnitude of economic recessions. Nor did ideology of governing parties have an effect. In contrast, each $100 reduction in tax revenue was associated with a$2. 72 drop in health spending. IMF borrowers were significantly more likely to reduce healthcare budgets than non-IMF borrowers, even after correcting for potential confounding by indication. Exposure to lending from international financial institutions, tax revenue falls, and decisions to implement cuts correlate more closely than underlying eco-nomic conditions or orientation of political parties with healthcare expenditure change in EU member states.

China ; Disease ; Humans ; Public Health Surveillance ; methods