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Spurious regression problems in the determinants of health care expenditure: a comment on Hitiris (1997)

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  • Jennifer Roberts

Abstract

In a recent article in this journal Hitiris used panel data for ten EC countries to analyse the determinants of aggregate health care expenditure. This comment shows that the model was plagued by a spurious regression problem. The data are reexamined using standard unit root and cointegration testing procedures, as well as new tests for unit roots in panels and for long-run relationships when the orders of integration of the underlying regressors are not known. There is overwhelming evidence for non-stationarity of the variables, and no conclusive evidence regarding the existence of equilibrium relationships. The apparent significance of the dependency rate and the rate of inflation in the Hitiris model were simply due to the influence of common stochastic trends. New results confirm the overriding importance of income in determining aggregate health care spending, but suggest a shortrun income elasticity significantly less than one. The results also uncover a number of problems in modelling the determinants of health care expenditure and warn against drawing firm conclusions from aggregate level models in an area where theory provides little guidance.

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  • Jennifer Roberts, 2000. "Spurious regression problems in the determinants of health care expenditure: a comment on Hitiris (1997)," Applied Economics Letters, Taylor & Francis Journals, vol. 7(5), pages 279-283.
    • Handle: RePEc:taf:apeclt:v:7:y:2000:i:5:p:279-283
    DOI: 10.1080/135048500351393
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    1. Pesaran, M. H. & Shin, Y. & Smith, R. J., 1996. "Testing for the 'Existence of a Long-run Relationship'," Cambridge Working Papers in Economics 9622, Faculty of Economics, University of Cambridge.
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    Cited by:

    1. Erika Laranjeira & Helena Szrek, 2016. "Going beyond life expectancy in assessments of health systems’ performance: life expectancy adjusted by perceived health status," International Journal of Health Economics and Management, Springer, vol. 16(2), pages 133-161, June.
    2. Silvia Fedeli, 2012. "The impact of GDP on health care expenditure: the case of Italy (1982-2009)," Working Papers in Public Economics 153, University of Rome La Sapienza, Department of Economics and Law.
    3. Di Matteo, Livio & Cantarero-Prieto, David, 2018. "The Determinants of Public Health Expenditures: Comparing Canada and Spain," MPRA Paper 87800, University Library of Munich, Germany.
    4. Fabio Pammolli & Francesco Porcelli & Francesco Vidoli & Monica Auteri & Guido Borà, 2017. "La spesa sanitaria delle Regioni in Italia - Saniregio2017," Working Papers CERM 01-2017, Competitività, Regole, Mercati (CERM).
    5. Jochen Hartwig & Jan-Egbert Sturm, 2012. "An outlier-robust extreme bounds analysis of the determinants of health-care expenditure growth," KOF Working papers 12-307, KOF Swiss Economic Institute, ETH Zurich.
    6. Roel van Elk & Esther Mot & P.H. Franses, 2009. "Modelling health care expenditures; overview of the literature and evidence from a panel time series model," CPB Discussion Paper 121, CPB Netherlands Bureau for Economic Policy Analysis.
    7. Caravaggio, Nicola & Resce, Giuliano, 2023. "Enhancing Healthcare Cost Forecasting: A Machine Learning Model for Resource Allocation in Heterogeneous Regions," Economics & Statistics Discussion Papers esdp23090, University of Molise, Department of Economics.
    8. Murat Gündüz, 2020. "Healthcare expenditure and carbon footprint in the USA: evidence from hidden cointegration approach," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 21(5), pages 801-811, July.
    9. Di Matteo, Livio, 2005. "The macro determinants of health expenditure in the United States and Canada: assessing the impact of income, age distribution and time," Health Policy, Elsevier, vol. 71(1), pages 23-42, January.
    10. Joan Costa-Font & Marin Gemmill & Gloria Rubert, 2008. "Re-visiting the Health Care Luxury Good Hypothesis: Aggregation, Precision, and Publication Biases?," Working Papers in Economics 197, Universitat de Barcelona. Espai de Recerca en Economia.
    11. Roel van Elk & Esther Mot & P.H. Franses, 2009. "Modelling health care expenditures; overview of the literature and evidence from a panel time series model," CPB Discussion Paper 121.rdf, CPB Netherlands Bureau for Economic Policy Analysis.
    12. McCoskey, Suzanne K. & Selden, Thomas M., 1998. "Health care expenditures and GDP: panel data unit root test results," Journal of Health Economics, Elsevier, vol. 17(3), pages 369-376, June.
    13. Clemente, Jesus & Marcuello, Carmen & Montanes, Antonio & Pueyo, Fernando, 2004. "On the international stability of health care expenditure functions: are government and private functions similar?," Journal of Health Economics, Elsevier, vol. 23(3), pages 589-613, May.
    14. Esther Stroe-Kunold & Joachim Werner, 2009. "A drunk and her dog: a spurious relation? Cointegration tests as instruments to detect spurious correlations between integrated time series," Quality & Quantity: International Journal of Methodology, Springer, vol. 43(6), pages 913-940, November.
    15. Alejandro F. Rodríguez & M. Nieves Valdés, 2019. "Health care expenditures and GDP in Latin American and OECD countries: a comparison using a panel cointegration approach," International Journal of Health Economics and Management, Springer, vol. 19(2), pages 115-153, June.
    16. Jay Pan & Gordon G. Liu, 2012. "The Determinants Of Chinese Provincial Government Health Expenditures: Evidence From 2002–2006 Data," Health Economics, John Wiley & Sons, Ltd., vol. 21(7), pages 757-777, July.
    17. Joan Costa‐Font & Marin Gemmill & Gloria Rubert, 2011. "Biases in the healthcare luxury good hypothesis?: a meta‐regression analysis," Journal of the Royal Statistical Society Series A, Royal Statistical Society, vol. 174(1), pages 95-107, January.
    18. Amiri, Arshia & Ventelou, Bruno, 2012. "Granger causality between total expenditure on health and GDP in OECD: Evidence from the Toda–Yamamoto approach," Economics Letters, Elsevier, vol. 116(3), pages 541-544.
    19. Muhammad Arshad Khan & Muhammad Iftikhar Ul Husnain, 2019. "Is health care a luxury or necessity good? Evidence from Asian countries," International Journal of Health Economics and Management, Springer, vol. 19(2), pages 213-233, June.
    20. Giorgia Marini, 2016. "A note on the power of panel cointegration tests – An application to health care expenditure and gdp," Public Finance Research Papers 21, Istituto di Economia e Finanza, DSGE, Sapienza University of Rome.
    21. Silvia Fedeli, 2015. "The Impact of GDP on Health Care Expenditure: The Case of Italy (1982–2009)," Social Indicators Research: An International and Interdisciplinary Journal for Quality-of-Life Measurement, Springer, vol. 122(2), pages 347-370, June.
    22. Jochen Hartwig & Jan-Egbert Sturm, 2014. "Robust determinants of health care expenditure growth," Applied Economics, Taylor & Francis Journals, vol. 46(36), pages 4455-4474, December.
    23. Paresh Kumar Narayan, 2010. "Modelling health and output at business cycle horizons for the USA," Health Economics, John Wiley & Sons, Ltd., vol. 19(7), pages 872-880, July.

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