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Determinants of health-system efficiency: evidence from OECD countries

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  • Pablo Cos
  • Enrique Moral-Benito

Abstract

This paper analyzes the most important determinants of healthcare efficiency across OECD countries. As previously documented in the literature, we first provide evidence of significant differences in the cross-country level of efficiency in healthcare provision. We then investigate how improvements in efficiency can be achieved by considering alternative efficiency indices (parametric and non-parametric) and a novel dataset with information on the characteristics of healthcare systems across OECD countries. Our empirical findings suggest a positive correlation between policies such as increasing the regulation of prices billed by providers and reducing the degree of gate keeping and the efficiency of national healthcare systems. Copyright Springer Science+Business Media New York 2014

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  • Pablo Cos & Enrique Moral-Benito, 2014. "Determinants of health-system efficiency: evidence from OECD countries," International Journal of Health Economics and Management, Springer, vol. 14(1), pages 69-93, March.
    • Handle: RePEc:kap:ijhcfe:v:14:y:2014:i:1:p:69-93
    DOI: 10.1007/s10754-013-9140-7
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    Cited by:

    1. Varabyova, Yauheniya & Müller, Julia-Maria, 2016. "The efficiency of health care production in OECD countries: A systematic review and meta-analysis of cross-country comparisons," Health Policy, Elsevier, vol. 120(3), pages 252-263.
    2. Justyna Kujawska, 2021. "Health System Efficiency in European Countries: Network Data Envelopment Analysis Approach," European Research Studies Journal, European Research Studies Journal, vol. 0(2), pages 1095-1117.
    3. Dino Rizzi & Michele Zanette, 2021. "Potential efficiency gains and expenditure savings in the Italian Regional Healthcare Systems," Politica economica, Società editrice il Mulino, issue 2, pages 187-214.
    4. Angelo Castaldo & Maria Alessandra Antonelli & Valeria De Bonis & Giorgia Marini, 2020. "Determinants of health sector efficiency: evidence from a two-step analysis on 30 OECD countries," Economics Bulletin, AccessEcon, vol. 40(2), pages 1651-1666.
    5. Erika Laranjeira & Helena Szrek, 2016. "Going beyond life expectancy in assessments of health systems’ performance: life expectancy adjusted by perceived health status," International Journal of Health Economics and Management, Springer, vol. 16(2), pages 133-161, June.
    6. Breitenbach, Marthinus C & Ngobeni, Victor & Ayte, Goodness, 2020. "The first 100 days of COVID-19 coronavirus – How efficient did country health systems perform to flatten the curve in the first wave?," MPRA Paper 8872, University Library of Munich, Germany.
    7. Breitenbach, Marthinus C & Ngobeni, Victor & Aye, Goodness C, 2020. "Global Healthcare Resource Efficiency in the Management of COVID-19 Death and Infection Prevalence Rates," MPRA Paper 104814, University Library of Munich, Germany.
    8. Panagiotis Mitropoulos, 2021. "Production and quality performance of healthcare services in EU countries during the economic crisis," Operational Research, Springer, vol. 21(2), pages 857-873, June.
    9. Dambar Uprety, 2019. "Skilled migration and health outcomes in developing countries," International Journal of Health Economics and Management, Springer, vol. 19(1), pages 1-14, March.
    10. Israr, Israr Hussain & Majid, Majid Ali Rana, 2017. "Technical Efficiency in the use of health care services in Punjab, Pakistan," MPRA Paper 91752, University Library of Munich, Germany, revised 12 May 2017.
    11. Marthinus C. Breitenbach & Victor Ngobeni & Goodness C. Aye, 2021. "Efficiency of Healthcare Systems in the First Wave of COVID-19 – A Technical Efficiency Analysis," Economic Studies journal, Bulgarian Academy of Sciences - Economic Research Institute, issue 6, pages 3-21.
    12. Constantin Ogloblin, 2023. "Health care financing and productivity of health care in OECD countries: a stochastic frontier analysis," Eurasian Economic Review, Springer;Eurasia Business and Economics Society, vol. 13(2), pages 259-283, June.
    13. Boffardi, Raffaele, 2022. "How efficient is the Italian health system? Evidence on the role of political-institutional dynamics," Socio-Economic Planning Sciences, Elsevier, vol. 84(C).
    14. Ozbugday, Fatih Cemil & Tirgil, Abdullah & Kose, Elif Gul, 2020. "Efficiency changes in long-term care in OECD countries: A non-parametric Malmquist Index approach," Socio-Economic Planning Sciences, Elsevier, vol. 70(C).
    15. Corrado Lo Storto, 2018. "Efficiency, Conflicting Goals and Trade-Offs: A Nonparametric Analysis of the Water and Wastewater Service Industry in Italy," Sustainability, MDPI, vol. 10(4), pages 1-22, March.
    16. Marianela Carrillo & Jesús M. Jorge, 2017. "DEA-Like Efficiency Ranking of Regional Health Systems in Spain," Social Indicators Research: An International and Interdisciplinary Journal for Quality-of-Life Measurement, Springer, vol. 133(3), pages 1133-1149, September.
    17. Santos, João Vasco & Martins, Filipa Santos & Pestana, Joana & Souza, Júlio & Freitas, Alberto & Cylus, Jonathan, 2023. "Should we adjust health expenditure for age structure on health systems efficiency? A worldwide analysis," LSE Research Online Documents on Economics 118298, London School of Economics and Political Science, LSE Library.
    18. Gearhart Richard, 2019. "The Impact of Secondary Environmental Variables on OECD Healthcare Efficiency: A Robust Conditional Approach," The B.E. Journal of Economic Analysis & Policy, De Gruyter, vol. 19(2), pages 1-16, April.

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    More about this item

    Keywords

    Healthcare systems; Efficiency; Bayesian model averaging; I12; I18; H51;
    All these keywords.

    JEL classification:

    • I12 - Health, Education, and Welfare - - Health - - - Health Behavior
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
    • H51 - Public Economics - - National Government Expenditures and Related Policies - - - Government Expenditures and Health

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