The Effect of Health Care Cost Growth on the U.S. Economy. 3. Literature Review


This section presents findings from a systematic review of peer-reviewed academic papers, anecdotal evidence published in the popular press, and findings from secondary data published by government agencies and other research institutions. The literature review was carried out in the following three steps – developing key words or search terms, initial literature scan, and detailed review. Each of these three steps is described below.

ASPE published a background paper on the effects of health care spending growth on the economy (ASPE, 2005). This paper cites several other research papers, reports and newspaper articles. These papers and articles were reviewed to identify index terms or keywords for the literature review. Next, additional keywords or search terms were added to prepare a master list of keywords. A list of keywords and their combinations used for the literature search is provided in Appendix 1 at the end of this report. In the second step, these keywords were used to search the Medline, EconLit and Lexis–Nexis databases. In addition to searches within these databases, online searches were also conducted with Google using various combinations of keywords developed in step 1. Any relevant articles obtained through these searches were “reference mined,” i.e., the reference lists were reviewed for additional articles. Finally, all papers identified in the literature scan were examined for relevance and relevant papers were reviewed and summarized for inclusion in this report.

Overall, the literature review suggests that rapid growth in health care spending could affect the U.S. economy through several plausible mechanisms. It also shows that even though prior work has examined several aspects of the effect of rising health care costs on the economy and its sectors, several gaps remain. The main findings from this review are summarized below.

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