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 1969e2014 period) to examine these elasticity estimates using metaregression
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 þ0.04 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.