The Impact of Secondary Environmental Variables on OECD Healthcare Efficiency: A Robust Conditional Approach

Gearhart, Richard

doi:10.1515/bejeap-2018-0063

Cited by 7 publications

(10 citation statements)

References 49 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Which means, the widening or narrowing of the internal gap of the PMHE in the western region needs further verification. 9 During the sample period, the change of PMHE shows a clear σ convergence trend in the northeast. Although the changes in PMHE's internal differences in the above regions are different, the coefficient of variation showed a clear upward trend before 2010.…”

Section: Sfa Regression Results and Analysis At Stagementioning

confidence: 89%

“…In these studies, input indicators are normally labor, financial and material inputs, such as government medical and health expenditure, the number of beds in health institutions, medical and health institutions, health personnel, practicing (assistant) doctors, registered nurses and managerial personnel. Different scholars' studies used different output indicators, but most scholars examined such indicators as life expectancy, infant mortality rate, the number of outpatients, the number of hospital visits, the number of outpatients' surgeries, the number of inpatients' surgeries and the number of inpatients' days [2][3][4][5][6][7][8][9]. For example, Evans et al choose health expenditure per capita and academic level as input indicators to estimate health system efficiency, and concluded that the health system efficiency varied from completely efficient to completely inefficient [7].…”

Section: Literature Reviewmentioning

confidence: 99%

See 1 more Smart Citation

Is the allocation of medical and health resources effective? Characteristic facts from regional heterogeneity in China

Peng

Zhang

et al. 2020

Int J Equity Health

View full text Add to dashboard Cite

Background: Over the last decade, the expenditure on public medical and health has increased greatly in China, however, problems as low efficiency and unfairness still exist. How to accurately describe the effectiveness of existing medical and health resources in combination with regional heterogeneity is of great significance to China's medical and health reform. Methods: Based on provincial panel data for the period of 2005 to 2017, combining expected output and unexpected output, this paper constructs a super-efficiency three-stage SBM-DEA model, to measure and analyze the spatial-temporal heterogeneity characteristics and influencing factors of public medical and health efficiency (PMHE). Results: (1) After the impacts of random error and external environmental factors are removed, the mean value of overall PMHE is 0.9274, failing to reach DEA efficiency, and PMHE shows a fluctuated downward trend. (2) The adjusted PMHE level shows a prominent spatial imbalance at the stage 3. The average efficiency level is ranked by the East > the West > the Central > the Northeast. (3) The increases of GDP per capita and population density are beneficial to the improvement of PMHE, while income level and education level are disadvantageous to PMHE, and last, the urbanization level, an uncertain effect. (4) There is no σ convergence of the PMHE in the East, the Central and the West, that is, the internal differences may gradually expand in the future, while the Northeast shows a significant σ convergence trending of PMHE. (5) The state's allocation of medical and health resources has undergone major changes during "The Twelfth Five-Year Plan". Conclusion: This study innovatively incorporates undesired outputs of health care into the efficiency evaluation framework by constructing the main efficiency evaluation indicators. The results of the robust evaluation conclude that China's existing investment in medical and health resources is generally not effective. Therefore, although China's health care reform has made certain achievement, it is still necessary to expand the investment in health care resources.

show abstract

Section: Sfa Regression Results and Analysis At Stagementioning

confidence: 89%

Section: Literature Reviewmentioning

confidence: 99%

Is the allocation of medical and health resources effective? Characteristic facts from regional heterogeneity in China

Peng

Zhang

et al. 2020

Int J Equity Health

View full text Add to dashboard Cite

show abstract

“…There is now a good amount of evidence available about the relative levels of efficiency in the health sector of high-income countries [6, 7]. A recent review of the literature and other studies have concluded that there is evidence of widespread inefficiencies in the health sector of several OECD countries that help explain their differences in health attainment [8, 9].…”

Section: Introductionmentioning

confidence: 99%

“…urbanization, income distribution). Second, the influence of factors pertaining to the organization of healthcare delivery and the quality of health system institutions, found to be important for explaining variations in healthcare costs and efficiency in OECD countries [7, 22–24], has not been assessed systematically in a LMIC context using cross-country data. Third, although existing studies have examined health spending efficiency relative to some important health indicators (e.g.…”

Section: Introductionmentioning

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

“…Although the coefficient of variation of the PMHE fluctuated in the west from 2007 to 2010, it did not show large fluctuations during the sample period. Which means, the widening or narrowing of the internal gap of the PMHE in the western region needs further verification 9 . During the sample period, the change of PMHE shows a clear σ convergence trend in the northeast.…”

Section: ) Spatial Distribution Heterogeneity Characteristicsmentioning

confidence: 99%

Is the allocation of medical and health resources effective? Characteristic facts from regional heterogeneity in China

Peng

Zhang

2020

Preprint

View full text Add to dashboard Cite

Background: Over the last decade, the expenditure on public medical and health has increased greatly in China, however, problems as low efficiency and unfairness still exist. How to accurately describe the effectiveness of existing medical and health resources in combination with regional heterogeneity is of great significance to China's medical and health reform.Methods: Based on provincial panel data for the period of 2005 to 2017, combining expected output and unexpected output, this paper constructs a super-efficiency three-stage SBM-DEA model, to measure and analyze the spatial-temporal heterogeneity characteristics and influencing factors of public medical and health efficiency (PMHE). Results: (1)After the impacts of random error and external environmental factors are removed, the mean value of overall PMHE is 0.9274, failing to reach DEA efficiency, and PMHE shows a fluctuated downward trend. (2) The adjusted PMHE level shows a prominent spatial imbalance at the stage 3. The average efficiency level is ranked by the East > the West > the Central > the Northeast. (3) The increases of GDP per capita and population density are beneficial to the improvement of PMHE, while income level and education level are disadvantageous to PMHE, and last, the urbanization level, an uncertain effect. (4) There is no σ convergence of the PMHE in the East, the Central and the West, that is, the internal differences may gradually expand in the future, while the Northeast shows a significant σ convergence trending of PMHE. (5) The state's allocation of medical and health resources has undergone major changes during “The Twelfth Five-Year Plan”.Conclusion: This study innovatively incorporates undesired outputs of health care into the efficiency evaluation framework by constructing the main efficiency evaluation indicators. The results of the robust evaluation conclude that China's existing investment in medical and health resources is generally not effective. Therefore, although China's health care reform has made certain achievement, it is still necessary to expand the investment in health care resources.

show abstract

The Impact of Secondary Environmental Variables on OECD Healthcare Efficiency: A Robust Conditional Approach

Cited by 7 publications

References 49 publications

Is the allocation of medical and health resources effective? Characteristic facts from regional heterogeneity in China

Is the allocation of medical and health resources effective? Characteristic facts from regional heterogeneity in China

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

Is the allocation of medical and health resources effective? Characteristic facts from regional heterogeneity in China

Contact Info

Product

Resources

About