An international comparison of efficiency of inpatient mental health care systems
AbstractThere is a fundamental gap in the evidence base on quantitative cross-country comparison of mental healthcare systems due to the challenges of comparative analysis in mental health including a paucity of good quality data. We explore whether existing limited data sources can potentially be exploited to examine technical efficiency of inpatient mental healthcare systems in 32 OECD countries in 2010. We use two analytical approaches: Data Envelopment Analysis (DEA) with bootstrapping to produce confidence intervals of efficiency scores and country rankings, and Cluster Analysis to group countries according to two broad efficiency groupings. We incorporate environmental variables using a two-stage truncated regression. We find slightly tighter confidence intervals for the less efficient countries which loosely corresponds with the ‘inefficient’ cluster grouping in the Cluster Analysis. However there is little stability in country rankings making it difficult with current data to draw any policy inferences. Environmental factors do not appear to significantly impact on efficiency scores. The most pressing pursuit remains the search for better national data in mental healthcare to underpin future analyses. Otherwise the use of any sophisticated analytic techniques will prove futile for establishing robust conclusions regarding international comparisons of the performance of mental healthcare systems.
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Bibliographic InfoArticle provided by Elsevier in its journal Health Policy.
Volume (Year): 112 (2013)
Issue (Month): 1 ()
Contact details of provider:
Web page: http://www.elsevier.com/locate/healthpol
Cross-country comparisons; Inpatient mental health services; Data envelopment analyis; Cluster analysis; Bootstrapping;
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