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International cross-section analysis of the determination of mortality

Author

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  • Gravelle, H.S.E.
  • Backhouse, M.E.

Abstract

An essential ingredient in the evaluation of policies concerning health services is knowledge of the impact of health services and other factors on the health of the population. One method of obtaining this information is from the regression analysis of international cross-section data on mortality rates, health service provision, income levels, consumption patterns, and other variables hypothesised to affect population health. The investigation of the determinants of population health is in many ways akin to the estimation of production functions which describe the relationship between the output of goods or services and the mix of inputs used in their production. The purpose of our paper is to use this analogy to discuss, and provide examples of, the problems which arise with the statistical investigation of mortality rates. Issues raised include simultaneous equation bias, multicollinearity, selection of explanatory variables, omitted variable bias, definition and measurement of variables, functional forms, lagged relationships and temporal stability. These problems are illustrated by replication and re-analysis, using new data, of the well known study by Cochrane, St Leger and Moore.

Suggested Citation

  • Gravelle, H.S.E. & Backhouse, M.E., 1987. "International cross-section analysis of the determination of mortality," Social Science & Medicine, Elsevier, vol. 25(5), pages 427-441, January.
    • Handle: RePEc:eee:socmed:v:25:y:1987:i:5:p:427-441
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    Cited by:

    1. Lionel Perrier & Magali Morelle & Nathalie Havet & Anthony Montella & Bertrand Favier & David Perol & Frédéric Gomez & Marie-Odile Carrere & Paul Rebattu, 2009. "The effect of health care expenditures on survival in locally advanced and metastatic Non Small Cell Lung Cancer," Working Papers 0903, Groupe d'Analyse et de Théorie Economique Lyon St-Étienne (GATE Lyon St-Étienne), Université de Lyon.
    2. James Lomas & Stephen Martin & Karl Claxton, 2018. "Estimating the marginal productivity of the English National Health Service from 2003/04 to 2012/13," Working Papers 158cherp, Centre for Health Economics, University of York.
    3. Jessica Ochalek & James Lomas & Karl Claxton, 2015. "Cost per DALY averted thresholds for low- and middle-income countries: evidence from cross country data," Working Papers 122cherp, Centre for Health Economics, University of York.
    4. 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.
    5. Jennifer Franz & Felix R. FitzRoy, 2005. "Child mortaility, poverty and environment in developing countries," Discussion Paper Series, School of Economics and Finance 200518, School of Economics and Finance, University of St Andrews.
    6. Stephen Martin & Nigel Rice & Peter C Smith, 2007. "The Link Between Health Care Spending and Health Outcomes: Evidence from English Programme Budgeting Data," Working Papers 024cherp, Centre for Health Economics, University of York.
    7. Rice, N & Robone, S & Smith, P.C, 2008. "International Comparison of Public Sector Performance: The Use of Anchoring Vignettes to adjust Self-Reported Data," Health, Econometrics and Data Group (HEDG) Working Papers 08/28, HEDG, c/o Department of Economics, University of York.
    8. Cacace, Mirella & Ettelt, Stefanie & Mays, Nicholas & Nolte, Ellen, 2013. "Assessing quality in cross-country comparisons of health systems and policies: Towards a set of generic quality criteria," Health Policy, Elsevier, vol. 112(1), pages 156-162.
    9. Stephen Martin & Nigel Rice & Peter C Smith, 2007. "Further evidence on the link between health care spending and health outcomes in England," Working Papers 032cherp, Centre for Health Economics, University of York.
    10. Edney, L.C. & Haji Ali Afzali, H. & Cheng, T.C. & Karnon, J., 2018. "Mortality reductions from marginal increases in public spending on health," Health Policy, Elsevier, vol. 122(8), pages 892-899.
    11. Jonathan Siverskog & Martin Henriksson, 2019. "Estimating the marginal cost of a life year in Sweden’s public healthcare sector," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 20(5), pages 751-762, July.
    12. Stephen Martin & Nigel Rice & Peter C Smith, 2008. "The link between health care spending and health outcomes for the new English Primary Care Trusts," Working Papers 042cherp, Centre for Health Economics, University of York.
    13. Praveen Thokala & Jessica Ochalek & Ashley A. Leech & Thaison Tong, 2018. "Cost-Effectiveness Thresholds: the Past, the Present and the Future," PharmacoEconomics, Springer, vol. 36(5), pages 509-522, May.
    14. Richard Heijink & Xander Koolman & Gert Westert, 2013. "Spending more money, saving more lives? The relationship between avoidable mortality and healthcare spending in 14 countries," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 14(3), pages 527-538, June.

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