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The robustness of cross-country healthcare rankings among homogeneous OECD countries

Author

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  • Richard Gearhart

    (California State University, Bakersfield)

Abstract

This paper re-examines analyses of cross-country healthcare efficiency using modern, non-parametric estimators and Malmquist indices to determine productivity changes over the panel. This paper finds that cross-country heterogeneity leads to different efficiency rankings than previously thought, and that the hyperbolic order-α estimator leads to more robust efficiency scores when looking across different output measures, only looking at the more homogeneous OECD countries. It finds that the United States, if excluding the percent of healthcare expenditures that are publicly financed, is one of the more inefficient healthcare delivery systems in the world. What are commonly thought of as well-run healthcare systems (Austria and France) are either inefficient themselves or have variation in their efficiency rankings, showcasing difficulties in using other countries’ healthcare systems as models for reform. It also finds that there has been productivity regression in all countries except the United States. These highlight the difficulties in cross-country efficiency comparisons.

Suggested Citation

  • Richard Gearhart, 2016. "The robustness of cross-country healthcare rankings among homogeneous OECD countries," Journal of Applied Economics, Universidad del CEMA, vol. 19, pages 113-144, May.
  • Handle: RePEc:cem:jaecon:v:19:y:2016:n:1:p:113-144
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    File URL: https://ucema.edu.ar/publicaciones/download/volume19/gearhart.pdf
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    Citations

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    Cited by:

    1. Roman Lacko & Zuzana Hajduová & Tomáš Bakalár & Henrieta Pavolová, 2022. "Efficiency and Productivity Differences in Healthcare Systems: The Case of the European Union," IJERPH, MDPI, vol. 20(1), pages 1-14, December.
    2. Mustapha D. Ibrahim & Sahand Daneshvar & Mevhibe B. Hocaoğlu & Olasehinde-Williams G. Oluseye, 2019. "An Estimation of the Efficiency and Productivity of Healthcare Systems in Sub-Saharan Africa: Health-Centred Millennium Development Goal-Based Evidence," Social Indicators Research: An International and Interdisciplinary Journal for Quality-of-Life Measurement, Springer, vol. 143(1), pages 371-389, May.
    3. Rouven Edgar Haschka & Katharina Schley & Helmut Herwartz, 2020. "Provision of health care services and regional diversity in Germany: insights from a Bayesian health frontier analysis with spatial dependencies," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 21(1), pages 55-71, February.
    4. Gearhart, Richard S. & Michieka, Nyakundi M., 2018. "A comparison of the robust conditional order-m estimation and two stage DEA in measuring healthcare efficiency among California counties," Economic Modelling, Elsevier, vol. 73(C), pages 395-406.
    5. Rodrigo Moreno-Serra & Misael Anaya-Montes & Peter C Smith, 2019. "Potential determinants of health system efficiency: Evidence from Latin America and the Caribbean," PLOS ONE, Public Library of Science, vol. 14(5), pages 1-21, May.
    6. Gearhart, Richard & Michieka, Nyakundi, 2019. "Natural resource abundance and healthcare efficiency in Appalachia: A robust conditional approach," Energy Policy, Elsevier, vol. 129(C), pages 985-996.

    More about this item

    Keywords

    United States healthcare; production efficiency; order- α; DEA; OECD;
    All these keywords.

    JEL classification:

    • C14 - Mathematical and Quantitative Methods - - Econometric and Statistical Methods and Methodology: General - - - Semiparametric and Nonparametric Methods: General
    • I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets
    • I12 - Health, Education, and Welfare - - Health - - - Health Behavior
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health

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