Environmental factors affecting European and Central Asian health-systems’ bias-corrected efficiency

Pérez-Cárceles, María Concepción; Gómez‐Gallego, Juan Cándido; Gómez-Gallego, María

doi:10.1080/00036846.2017.1420901

Cited by 11 publications

(13 citation statements)

References 50 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…This paper uses output-oriented DEA because changes to inputs are unlikely to take place in the short term in complex national health systems. 9 This approach is consistent with the existing literature, which has opted for output orientation in health system DEA [9][10][11] given that changes to inputs are unlikely to take place in the short-run and managers have little discretion over budget allocations. 12 13 Decentralised systems have far less control over how local units' budgets are allocated and cannot necessarily reallocate inputs.…”

Section: Data Envelopment Analysis (Dea)supporting

confidence: 67%

Assessing the efficiency of countries in making progress towards universal health coverage: a data envelopment analysis of 172 countries

et al. 2020

View full text Add to dashboard Cite

IntroductionMaximising efficiency of resources is critical to progressing towards universal health coverage (UHC) and the sustainable development goal (SDG) for health. This study estimates the technical efficiency of national health spending in progressing towards UHC, and the environmental factors associated with efficient UHC service provision.MethodsA two-stage efficiency analysis using Simar and Wilson’s double bootstrap data envelopment analysis investigates how efficiently countries convert health spending into UHC outputs (measured by service coverage and financial risk protection) for 172 countries. We use World Bank and WHO data from 2015. Thereafter, the environmental factors associated with efficient progress towards UHC goals are identified.ResultsThe mean bias-corrected technical efficiency score across 172 countries is 85.7% (68.9% for low-income and 95.5% for high-income countries). High-achieving middle-income and low-income countries such as El Salvador, Colombia, Rwanda and Malawi demonstrate that peer-relative efficiency can be attained at all incomes. Governance capacity, income and education are significantly associated with efficiency. Sensitivity analysis suggests that results are robust to changes.ConclusionWe provide a 2015 baseline for cross-country UHC technical efficiency scores. If countries wish to improve their UHC outputs within existing budgets, they should identify their current efficiency and try to emulate more efficient peers. Policy-makers should focus on strengthening institutions and implementing known best practices to replicate efficient systems. Using resources more efficiently is likely to positively impact UHC coverage goals and health outcomes, and without addressing gaps in efficiency progress towards achieving the SDGs will be impeded.

show abstract

Section: Data Envelopment Analysis (Dea)supporting

confidence: 67%

Assessing the efficiency of countries in making progress towards universal health coverage: a data envelopment analysis of 172 countries

et al. 2020

View full text Add to dashboard Cite

show abstract

“…Although education is widely recognized as the main driver of nation's state of health, this analysis shows that it does not significantly affect health system efficiency. The same is found for GDP per capita, in line with some other studies . Of all the analyzed environmental factors, only obesity significantly and negatively affects efficiency, in line with the findings of Afonso and Aubyn .…”

Section: Resultssupporting

confidence: 91%

“…The United States had the largest number of obese people among the over‐18 population (the only other country with over 30% obese was New Zealand, and the US was the only country that exceeded 35%) . Interestingly, the indicator ‘tobacco' did not contribute significantly to inefficiency, in contrast to the findings of Afonso and Aubyn and Pérez‐Cárceles et al Our result supports the finding that even though tobacco consumption receives more attention, obesity has a more deleterious effect on health . This is a valuable piece of information for insurance companies when creating risk categories, since it indicates that obese people should be put in a more risky category than tobacco consumers.…”

Section: Resultssupporting

confidence: 77%

See 1 more Smart Citation

Going beyond health efficiency: What really matters?

Radojičić

Jeremić

Savić

2019

Health Planning & Management

View full text Add to dashboard Cite

Both citizens and policymakers demand the best possible results from a country's healthcare system. It is of utmost importance to accurately and objectively assess the efficiency of a healthcare system and to note the key indicators, where resources are lost, and possibilities for improvement. This paper evaluates the efficiency of health systems in 38 countries, mainly members of the Organization for Economic Co-operation and Development, using data envelopment analysis (DEA). In the first stage, bootstrapped Ivanovic distance is used to generate weights for the indicators, thus taking into consideration different country's goals, but not to the extent of reducing the possibility of comparison. The analysis shows that human resources are the most important health system resource and countries should pay special attention to developing and employing competent medical workers. The reorganization of human resources and the funds allocated to them could also increase efficiency. The second stage examines environmental indicators to find the causes of inefficiency. No proof is found that any one basic health system funding model produces better health outcomes than the others. Obesity is identified as a major issue. K E Y W O R D Sefficiency evaluation, data envelopment analysis, health systems,

show abstract

“…The approach we adopt, developed by Simar and Wilson [32], accounts for the fact that DEA efficiency scores are bounded and corrects the standard errors obtained from conventional regression models such as Tobit, by simulating the unknown error correlation among efficiency scores and calculating bootstrapped standard errors. This method–henceforth Simar-Wilson–has been employed successfully in some previous efficiency studies focused on high-income countries [33] and, more recently, central European and central Asian countries [34]. Here we use Simar-Wilson cross-sectional regressions to estimate the degree of association between LAC countries’ average efficiency scores for each output as the dependent variable, and our potential efficiency determinants as explanatory variables.…”

Section: Methods and Datamentioning

confidence: 99%

Potential determinants of health system efficiency: Evidence from Latin America and the Caribbean

2019

View full text Add to dashboard Cite

This paper examines the levels of health system efficiency and their possible determinants across Latin American and Caribbean (LAC) countries using national-level data for those countries, as well as for other emerging and developed countries. The data are analyzed using data envelopment analyses and econometric advances that yield reliable estimations of the relationship between system efficiency and its potential determinants. We find that there is substantial room for efficiency improvements in the health system of most LAC countries. For example, LAC countries could improve life expectancy at birth by about five years on average at current public spending levels if they followed best practices. Furthermore, the paper assesses what factors amenable to policy act as the main possible levers for some countries to be able to translate a given level of health financing into better performance on access to care and health outcomes. Our econometric analyses suggest that efforts to increase health system efficiency could be focused in a few key policy areas associated with broader access to health services and better outcomes. These areas include general governance aspects, in addition to improvements in specific dimensions of the quality of health system institutions, notably stronger reliance on results-based management in the production of healthcare goods and services.

show abstract

Environmental factors affecting European and Central Asian health-systems’ bias-corrected efficiency

Cited by 11 publications

References 50 publications

Assessing the efficiency of countries in making progress towards universal health coverage: a data envelopment analysis of 172 countries

Assessing the efficiency of countries in making progress towards universal health coverage: a data envelopment analysis of 172 countries

Going beyond health efficiency: What really matters?

Potential determinants of health system efficiency: Evidence from Latin America and the Caribbean

Contact Info

Product

Resources

About