Page 146 - GHES-3-3

Global Health Economics and
Sustainability
A comparative analysis

Figure 1. State-wise COVID-19 confirmed, cured, and death cases as on January 27, 2023
Note: Data source: mygov.in; figure created in MS Excel.

Figure 2. Pre-COVID-19 and COVID-19 period average actual health expenditure (% of state budget)
Note: Data source: State budget documents; figure created in MS Excel.

spending during COVID-19, with a 1.42 basis point of actual to budgeted expenditure, with an AE/BE ratio
increase. of 1. The ratio deviated from 1 marginally during the pre-
COVID-19 period for these two states. During the pre-
The second column of Table 2 presents the actual-to- COVID-19 period, Arunachal Pradesh had the highest
budget estimated (AE/BE) health expenditure ratio for the deviation of 75 points. During COVID-19, Sikkim, Kerala,
pre-COVID-19 period. This ratio should be around one for and West Bengal had the worst fiscal performance in the
a state with maximum fiscal discipline. Any deviation on upward direction, with AE/BE ratios of 1.27, 1.24, and 1.24,
either side indicates that the budgeted estimate is unreliable respectively. With an AE/BE ratio of 0.76, Nagaland was
and that the actual realization would differ significantly. the worst performer in terms of resource underutilization.
This approach is a rudimentary method of determining Mizoram (1.01), Punjab (1.02), and Uttar Pradesh were the
fiscal competence. top-performing states (1.04).

During pre-COVID-19, Gujarat and Maharashtra were The Theil U-statistic for Indian states is shown
the only states with perfect fiscal balance and discipline in the last three columns of the pre-COVID-19 and

Volume 3 Issue 3 (2025) 138 https://doi.org/10.36922/ghes.2920