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The trade-off between health system resiliency and efficiency: evidence from COVID-19 in European regions

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  • Alvaro Almeida

    (Cef.up Center for Economics and Finance at UPorto
    Universidade do Porto)

Abstract

The objective of this paper was to investigate the existence of a trade-off between health system resilience and the economic efficiency of the health system, using data for 173 regions in the European Union and the European Free Trade Association countries. Data Envelopment Analysis was used to measure the efficiency of regional health systems before the COVID-19 pandemic. Then, a spatial econometrics model was used to estimate whether this measure of efficiency, adjusted for several covariates, has a significant impact on regional health system resilience during the COVID-19 pandemic, measured by the number of COVID-19 deaths per hundred thousand inhabitants. The results show that COVID-19 death rates were significantly higher in regions with higher population density, higher share of employment in industry, and higher share of women in the population. Results also show that regions with higher values of the health system efficiency index in 2017 had significantly higher rates of COVID-19 deaths in 2020 and 2021, suggesting the existence of a trade-off between health system efficiency and health system resilience during the COVID-19 pandemic.

Suggested Citation

  • Alvaro Almeida, 2024. "The trade-off between health system resiliency and efficiency: evidence from COVID-19 in European regions," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 25(1), pages 31-47, February.
    • Handle: RePEc:spr:eujhec:v:25:y:2024:i:1:d:10.1007_s10198-023-01567-w
    DOI: 10.1007/s10198-023-01567-w
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    References listed on IDEAS

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    1. María Arquer & Borja Ponte & Raúl Pino, 2022. "Examining the balance between efficiency and resilience in closed-loop supply chains," Central European Journal of Operations Research, Springer;Slovak Society for Operations Research;Hungarian Operational Research Society;Czech Society for Operations Research;Österr. Gesellschaft für Operations Research (ÖGOR);Slovenian Society Informatika - Section for Operational Research;Croatian Operational Research Society, vol. 30(4), pages 1307-1336, December.
    2. Charnes, A. & Cooper, W. W. & Rhodes, E., 1978. "Measuring the efficiency of decision making units," European Journal of Operational Research, Elsevier, vol. 2(6), pages 429-444, November.
    3. Andrea Ascani & Alessandra Faggian & Sandro Montresor, 2021. "The geography of COVID‐19 and the structure of local economies: The case of Italy," Journal of Regional Science, Wiley Blackwell, vol. 61(2), pages 407-441, March.
    4. Mounir Amdaoud & Giuseppe Arcuri & Nadine Levratto, 2021. "Are regions equal in adversity? A spatial analysis of spread and dynamics of COVID-19 in Europe," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 22(4), pages 629-642, June.
    5. Antonio Afonso & Miguel St. Aubyn, 2011. "Assessing health efficiency across countries with a two-step and bootstrap analysis," Applied Economics Letters, Taylor & Francis Journals, vol. 18(15), pages 1427-1430.
    6. Manuel Holz & Jochen Mayerl, 2021. "Early days of the pandemic—The association of economic and socio-political country characteristics with the development of the COVID-19 death toll," PLOS ONE, Public Library of Science, vol. 16(8), pages 1-13, August.
    7. Volkan Recai Cetin & Serdal Bahce, 2016. "Measuring the efficiency of health systems of OECD countries by data envelopment analysis," Applied Economics, Taylor & Francis Journals, vol. 48(37), pages 3497-3507, August.
    8. Beata Gavurova & Kristina Kocisova & Jakub Sopko, 2021. "Health system efficiency in OECD countries: dynamic network DEA approach," Health Economics Review, Springer, vol. 11(1), pages 1-25, December.
    9. Daxin Sun & Haksoon Ahn & Tomas Lievens & Wu Zeng, 2017. "Evaluation of the performance of national health systems in 2004-2011: An analysis of 173 countries," PLOS ONE, Public Library of Science, vol. 12(3), pages 1-13, March.
    10. Yong-bae Ji & Choonjoo Lee, 2010. "Data envelopment analysis," Stata Journal, StataCorp LP, vol. 10(2), pages 267-280, June.
    11. R. D. Banker & A. Charnes & W. W. Cooper, 1984. "Some Models for Estimating Technical and Scale Inefficiencies in Data Envelopment Analysis," Management Science, INFORMS, vol. 30(9), pages 1078-1092, September.
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    More about this item

    Keywords

    Health systems; Resilience; Efficiency; COVID-19;
    All these keywords.

    JEL classification:

    • I10 - Health, Education, and Welfare - - Health - - - General
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health

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