The impact of healthcare spending on health outcomes: A meta-regression analysis
While numerous studies assess the impact of healthcare spending on health outcomes, typically reporting multiple estimates of the elasticity of health outcomes (most often measured by a mortality rate or life expectancy) with respect to healthcare spending, the extent to which study attributes influence these elasticity estimates is unclear. Accordingly, we utilize a meta-data set (consisting of 65 studies completed over the 1969–2014 period) to examine these elasticity estimates using meta-regression analysis (MRA). Correcting for a number of issues, including publication selection bias, healthcare spending is found to have the greatest impact on the mortality rate compared to life expectancy. Indeed, conditional on several features of the literature, the spending elasticity for mortality is near −0.13, whereas it is near to +0.04 for life expectancy. MRA results reveal that the spending elasticity for the mortality rate is particularly sensitive to data aggregation, the specification of the health production function, and the nature of healthcare spending. The spending elasticity for life expectancy is particularly sensitive to the age at which life expectancy is measured, as well as the decision to control for the endogeneity of spending in the health production function. With such results in hand, we have a better understanding of how modeling choices influence results reported in this literature.
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Volume (Year): 179 (2017)
Issue (Month): C ()
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Please report citation or reference errors to , or , if you are the registered author of the cited work, log in to your RePEc Author Service profile, click on "citations" and make appropriate adjustments.:
- Deirdre N. McCloskey & Stephen T. Ziliak, 1996. "The Standard Error of Regressions," Journal of Economic Literature, American Economic Association, vol. 34(1), pages 97-114, March.
- A. Colin Cameron & Jonah B. Gelbach & Douglas L. Miller, 2008.
"Bootstrap-Based Improvements for Inference with Clustered Errors,"
The Review of Economics and Statistics,
MIT Press, vol. 90(3), pages 414-427, August.
- Doug Miller & A. Colin Cameron & Jonah B. Gelbach, 2006. "Bootstrap-Based Improvements for Inference with Clustered Errors," Working Papers 621, University of California, Davis, Department of Economics.
- A. Colin Cameron & Jonah B. Gelbach & Douglas L. Miller, 2007. "Bootstrap-Based Improvements for Inference with Clustered Errors," NBER Technical Working Papers 0344, National Bureau of Economic Research, Inc.
- 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.
- Martin, Stephen & Rice, Nigel & Smith, Peter C., 2008. "Does health care spending improve health outcomes? Evidence from English programme budgeting data," Journal of Health Economics, Elsevier, vol. 27(4), pages 826-842, July.
- Stephen Hall & P. Swamy & George Tavlas, 2012. "Generalized cointegration: a new concept with an application to health expenditure and health outcomes," Empirical Economics, Springer, vol. 42(2), pages 603-618, April.
- Stephen Hall & P. A. V. B. Swamy & George S. Tavlas, 2011. "Generalized Cointegration: A New Concept with an Application to Health Expenditure and Health Outcomes," Discussion Papers in Economics 11/22, Department of Economics, University of Leicester.
- Sanjeev Gupta & Marijn Verhoeven & Erwin R. Tiongson, 2003. "Public spending on health care and the poor," Health Economics, John Wiley & Sons, Ltd., vol. 12(8), pages 685-696.
- Leigh, Andrew & Jencks, Christopher, 2007. "Inequality and mortality: Long-run evidence from a panel of countries," Journal of Health Economics, Elsevier, vol. 26(1), pages 1-24, January.
- Leigh, Andrew & Jencks, Christopher, 2006. "Inequality and Mortality: Long-Run Evidence from a Panel of Countries," Working Paper Series rwp06-032, Harvard University, John F. Kennedy School of Government.
- Andrew Leigh & Christopher Jencks, 2006. "Inequality and Mortality: Long-Run Evidence from a Panel of Countries," CEPR Discussion Papers 533, Centre for Economic Policy Research, Research School of Economics, Australian National University.
- T. D. Stanley, 2008. "Meta-Regression Methods for Detecting and Estimating Empirical Effects in the Presence of Publication Selection," Oxford Bulletin of Economics and Statistics, Department of Economics, University of Oxford, vol. 70(1), pages 103-127, 02.
- T.D. Stanley, 2006. "Meta-Regression Methods for Detecting and Estimating Empirical Effects in the Presence of Publication Selection," Economics Series 2006_20, Deakin University, Faculty of Business and Law, School of Accounting, Economics and Finance.
- 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.
- Hitiris, Theo & Posnett, John, 1992. "The determinants and effects of health expenditure in developed countries," Journal of Health Economics, Elsevier, vol. 11(2), pages 173-181, August.
- Gallet, Craig A. & Doucouliagos, Hristos, 2014. "The income elasticity of air travel: A meta-analysis," Annals of Tourism Research, Elsevier, vol. 49(C), pages 141-155.
- Craig A. Gallet & Hristos Doucouliagos, 2014. "The Income Elasticity Of Air Travel: A Meta-Analysis," Economics Series 2014_6, Deakin University, Faculty of Business and Law, School of Accounting, Economics and Finance.
- Farasat A. S. Bokhari & Yunwei Gai & Pablo Gottret, 2007. "Government health expenditures and health outcomes," Health Economics, John Wiley & Sons, Ltd., vol. 16(3), pages 257-273.
- Farasat A.S. Bokhari & Yunwei Gai & Pablo Gottret, 2005. "Government Health Expenditures and Health Outcomes," Working Papers wp2005_02_01, Department of Economics, Florida State University, revised May 2006.
- John Nixon & Philippe Ulmann, 2006. "The relationship between health care expenditure and health outcomes," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 7(1), pages 7-18, March.
- Lichtenberg, Frank R., 2004. "Sources of U.S. longevity increase, 1960-2001," The Quarterly Review of Economics and Finance, Elsevier, vol. 44(3), pages 369-389, July.
- Doucouliagos, Chris & Stanley, T.D. & Giles, Margaret, 2012. "Are estimates of the value of a statistical life exaggerated?," Journal of Health Economics, Elsevier, vol. 31(1), pages 197-206.
- Hristos Doucouliagos & T.D. Stanley & Margaret Giles, 2011. "Are Estimates of the Value of a Statistical Life Exaggerated?," Economics Series 2011_2, Deakin University, Faculty of Business and Law, School of Accounting, Economics and Finance.
- Gupta, Sanjeev & Verhoeven, Marijn & Tiongson, Erwin R., 2002. "The effectiveness of government spending on education and health care in developing and transition economies," European Journal of Political Economy, Elsevier, vol. 18(4), pages 717-737, November.
- William Comanor & H. Frech & Richard Miller, 2006. "Is the United States an outlier in health care and health outcomes? A preliminary analysis," International Journal of Health Economics and Management, Springer, vol. 6(1), pages 3-23, March.
- Ivaschenko, Oleksiy, 2005. "The patterns and determinants of longevity in Russia's regions: Evidence from panel data," Journal of Comparative Economics, Elsevier, vol. 33(4), pages 788-813, December.
- G. Emmanuel Guindon & Paul Contoyannis, 2012. "A Second Look At Pharmaceutical Spending As Determinants Of Health Outcomes In Canada," Health Economics, John Wiley & Sons, Ltd., vol. 21(12), pages 1477-1495, December.
- 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.
- T.D. Stanley & Hristos Doucouliagos & Margaret Giles & Jost H. Heckemeyer & Robert J. Johnston & Patrice Laroche & Jon P. Nelson & Martin Paldam & Jacques Poot & Geoff Pugh & Randall S. Rosenberger & , 2013. "Meta-Analysis Of Economics Research Reporting Guidelines," Journal of Economic Surveys, Wiley Blackwell, vol. 27(2), pages 390-394, 04.
- T.D. Stanley & Hristos Doucouliagos & Margaret Giles & Jost H. Heckemeyer & Robert J. Johnston & Patrice Laroche & Jon P. Nelson & Martin Paldam & Jacques Poot & Geoff Pugh & Randall S. Rosenberger & , 2013. "Meta-analysis of Economics Research Reporting Guidelines," Post-Print hal-01369455, HAL.
- Asiskovitch, Sharon, 2010. "Gender and health outcomes: The impact of healthcare systems and their financing on life expectancies of women and men," Social Science & Medicine, Elsevier, vol. 70(6), pages 886-895, March.
- Zafer Caliskan, 2009. "The relationship between pharmaceutical expenditure and life expectancy: evidence from 21 OECD countries," Applied Economics Letters, Taylor & Francis Journals, vol. 16(16), pages 1651-1655. Full references (including those not matched with items on IDEAS)
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