Background This study aims at analyzing the efficiency of the health systems of 31 European countries in treating COVID-19, for the period January 1, 2020 – January 1, 2021, by incorporating some factors from a multidimensional perspective. Methods The methodology used in the research was Data Envelopment Analysis (DEA), through which efficiency scores for health systems have been calculated. The research was performed considering three stages: the first wave (January 1–June 15), the relaxation period (June 15–October 1) and the second wave (October 1–December 31). In evaluating the determinants of the efficiency of health systems, six major fields of influence were taken into account: health care, health status, population, economic, cultural/societal and governmental issues, all covering 15 indicators. After measuring the efficiency, we used the Tobit type regression to establish the influencing elements on it. Results The results for the public health systems of European states were determined for each country and period. We evaluated the efficiency of health systems in Europe against COVID-19, starting from health inputs (COVID-19 cases, physicians, nurses, hospital beds, health expenditure) and output (COVID-19 deaths). The obtained outputs show that, especially in the first phase of the pandemic, the inefficiency of the health systems was quite high, mainly in Western countries (Italy, Belgium, Spain, UK). In the relaxation phase and in the second wave, the Western states, severely affected at the beginning of the pandemic, began to take adequate measures and improve the efficiency of their sanitary systems. Instead, Eastern European countries were hit hard by the inefficiency of health systems (Bulgaria, Greece, Hungary, Romania). After Tobit regression, results of the study show that the influencing elements are different for the three stages: concerning the first wave, comobirdities, population age, and population density are important; for relaxation period a great influence have government effectiveness and power distance; with respect to second wave, the relevant factors are education and population density. Conclusions The results obtained could serve as starting points for health policymakers to perform comparative analyzes in terms of good practices in the health system and to develop national plans to better deal with health crises. At the same time, they can be used internationally to achieve a coherent and effective community response to the pandemic.

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Achieving the goals of sustainable development and poverty reduction implies an important condition for access to electricity for the entire population. In the economic literature, the relationship between electricity consumption and economic growth has different perspectives. The lack of good governance within an economy, besides the deficiencies of energy resources, is a key issue in worsening energy issues for developing countries. These countries have failed to alleviate the energy crises that have hindered development prospects, amid flourishing corruption and inefficient governments. Our research, using a panel methodology, analyzes the long-term relationship between energy consumption, economic growth and good governance for 14 Central and Eastern European countries, over the period 1995–2017. The study demonstrates empirically that there is a causal relationship between electricity consumption and economic growth, underlining the fact that deficiencies in the energy system lead to slowing economic growth. The study also shows that good governance influences electricity and Gross Domestic Product (GDP) consumption, and the governments from Central and Eastern European countries have to restore good governance in the economy, creating an environment conducive to investment in the energy sector, which would increase competition and reduce inefficiencies in the production, transmission, and distribution of energy.

This study analyses the relationship between governmental expenditure and economic growth rate for 8 Eastern-European countries with data for 1995-2014 using the ARDL model. The main goal of the present study is to test the presence of a non-linear-Armey Curve type-relationship between the government size and economic growth and also to find an optimal level of public spending which maximizes economic growth. Our results reveal the occurrence of a significant cointegration of public spending and economic growth for all considered countries and show that the current share of public spending within the Gross Domestic Product (GDP) exceeds the optimal level calculated for the three countries for which the Armey-type phenomenon occurs. Also, the results suggest that the optimal percentage of governmental spending varies between 37 % and 41 % and the present level is higher than the optimal level for Bulgaria, Hungary and Romania. The outstripping of the optimal level may conclude to the idea that the weight of public sector should be slightly decreased in these countries since the public sector is not able to efficiently cope with its resources. Based on the study results, the weight of public expenditure should be reduced while the efficiency of public spending programs should be increased.