title: The impact of healthcare spending on health outcomes: A meta-regression analysis.
abstract: 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.
authors.affiliation: California State University at Sacramento, Sacramento, CA, USA. Electronic address: cgallet@csus.edu.
authors.forename: Craig A
authors.initials: CA
authors.lastname: Gallet
authors.affiliation: Deakin University, Victoria, Australia. Electronic address: douc@deakin.edu.au.
authors.forename: Hristos
authors.initials: H
authors.lastname: Doucouliagos
mesh_terms: D000367:Age Factors; D003365:Costs and Cost Analysis; D019049:Developed Countries; D005102:Health Expenditures / Q000706:statistics & numerical data*; D006801:Humans; D008017:Life Expectancy; D009026:Mortality; D017063:Outcome Assessment, Health Care; D055553:Prescription Drugs / Q000191:economics; D017149:Private Sector / Q000191:economics; D017150:Public Sector / Q000191:economics; D012044:Regression Analysis; D012111:Residence Characteristics; D012737:Sex Factors; D012959:Socioeconomic Factors
chemical_list: D055553:Prescription Drugs
keywords: Healthcare spending; Life expectancy; Meta-regression; Mortality; Publication bias