Going beyond health efficiency: What really matters?

Int J Health Plann Manage. 2020 Jan;35(1):318-338. doi: 10.1002/hpm.2914. Epub 2019 Nov 3.

Abstract

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.

Keywords: Ivanovic distance; OECD countries; data envelopment analysis; efficiency evaluation; health systems.

MeSH terms

  • Delivery of Health Care / organization & administration*
  • Delivery of Health Care / standards
  • Efficiency, Organizational*
  • Health Resources / organization & administration
  • Health Services Accessibility / organization & administration
  • Health Services Accessibility / standards
  • Humans
  • Quality Improvement / organization & administration
  • Quality Indicators, Health Care
  • Resource Allocation / organization & administration