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Spurious correlation in estimation of the health production function: A note


  • Sule Akkoyunlu

    () (Swiss Form for Migration and Population)

  • Frank R. Lichtenberg

    () (Columbia University)

  • Boriss Siliverstovs

    () (KOF Swiss Economic Institute)

  • Peter Zweifel

    () (University of Zurich)


In this paper, we address the issue of spurious correlation in the production of health in a systematic way. Spurious correlation entails the risk of linking health status to medical (and nonmedical) inputs when no links exist. This note first presents the bounds testing procedure as a method to detect and avoid spurious correlation. It then applies it to a recent contribution by Lichtenberg (2004), which relates longevity in the United States to pharmaceutical innovation and public health care expenditure. The results of the bounds testing procedure show longevity to be related to these two factors. Therefore, the estimates reported by Lichtenberg (2004) cannot be said to be result of spurious correlation, to the contrary, they very likely reflect an effective relationship, at least for the United States.

Suggested Citation

  • Sule Akkoyunlu & Frank R. Lichtenberg & Boriss Siliverstovs & Peter Zweifel, 2010. "Spurious correlation in estimation of the health production function: A note," Economics Bulletin, AccessEcon, vol. 30(3), pages 2505-2514.
  • Handle: RePEc:ebl:ecbull:eb-10-00138

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    References listed on IDEAS

    1. Zeynep Or, 2001. "Exploring the Effects of Health Care on Mortality Across OECD Countries," OECD Labour Market and Social Policy Occasional Papers 46, OECD Publishing.
    2. Pierre-Yves Crémieux & Marie-Claude Meilleur & Pierre Ouellette & Patrick Petit & Martin Zelder & Ken Potvin, 2005. "Public and private pharmaceutical spending as determinants of health outcomes in Canada," Health Economics, John Wiley & Sons, Ltd., vol. 14(2), pages 107-116.
    3. Frank R. Lichtenberg, 1996. "The Effect of Pharmaceutical Utilization and Innovation on Hospitalization and Mortality," NBER Working Papers 5418, National Bureau of Economic Research, Inc.
    4. M. Hashem Pesaran & Yongcheol Shin & Richard J. Smith, 2001. "Bounds testing approaches to the analysis of level relationships," Journal of Applied Econometrics, John Wiley & Sons, Ltd., vol. 16(3), pages 289-326.
    5. Pierre-Yves Crémieux & Pierre Ouellette & Caroline Pilon, 1999. "Health care spending as determinants of health outcomes," Health Economics, John Wiley & Sons, Ltd., vol. 8(7), pages 627-639.
    6. Granger, C. W. J. & Newbold, P., 1974. "Spurious regressions in econometrics," Journal of Econometrics, Elsevier, vol. 2(2), pages 111-120, July.
    7. Johansen, Soren, 1995. "Likelihood-Based Inference in Cointegrated Vector Autoregressive Models," OUP Catalogue, Oxford University Press, number 9780198774501, June.
    8. Carrion-i-Silvestre, Josep Lluis, 2005. "Health care expenditure and GDP: Are they broken stationary?," Journal of Health Economics, Elsevier, vol. 24(5), pages 839-854, September.
    9. Peter Zweifel & Lukas Steinmann & Patrick Eugster, 2005. "The Sisyphus Syndrome in Health Revisited," International Journal of Health Economics and Management, Springer, vol. 5(2), pages 127-145, June.
    10. Blomqvist, A. G. & Carter, R. A. L., 1997. "Is health care really a luxury?," Journal of Health Economics, Elsevier, vol. 16(2), pages 207-229, April.
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    Cited by:

    1. Badi Baltagi & Francesco Moscone & Elisa Tosetti, 2012. "Medical technology and the production of health care," Empirical Economics, Springer, vol. 42(2), pages 395-411, April.
    2. Michele Sennhauser, 2009. "Why the Linear Utility Function is a Risky Choice in Discrete-Choice Experiments," SOI - Working Papers 1014, Socioeconomic Institute - University of Zurich.
    3. Polk, Andreas & Schmutzler, Armin & Müller, Adrian, 2014. "Lobbying and the power of multinational firms," European Journal of Political Economy, Elsevier, vol. 36(C), pages 209-227.
    4. Wen-Yi Chen & Miin-Jye Wen & Yu-Hui Lin & Yia-Wun Liang, 2016. "On the relationship between healthcare expenditure and longevity: evidence from the continuous wavelet analyses," Quality & Quantity: International Journal of Methodology, Springer, vol. 50(3), pages 1041-1057, May.
    5. Cappellari, Lorenzo & De Paoli, Anna & Turati, Gilberto, 2014. "Do Market Incentives in the Hospital Industry Affect Subjective Health Perceptions? Evidence from the Italian PPS-DRG Reform," IZA Discussion Papers 8636, Institute for the Study of Labor (IZA).
    6. Yia-Wun Liang & Wen-Yi Chen & Yu-Hui Lin, 2015. "Estimating a Hospital Production Function to Evaluate the Effect of Nurse Staffing on Patient Mortality in Taiwan: The Longitudinal Count Data Approach," Journal for Economic Forecasting, Institute for Economic Forecasting, vol. 0(4), pages 154-169, December.

    More about this item


    Health; Life expectancy; Innovation; Pharmaceuticals; Health care expenditure; Cointegration;

    JEL classification:

    • I1 - Health, Education, and Welfare - - Health
    • H5 - Public Economics - - National Government Expenditures and Related Policies


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