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Advancing Universal Health Coverage in the COVID-19 Era : An Assessment of Public Health Services Technical Efficiency and Applied Cost Allocation in Cambodia

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  • Robert John Kolesar

    (Abt Associates, UA - University of Antwerp, Cambodian Ministry of Economy and Finance, CERDI - Centre d'Études et de Recherches sur le Développement International - IRD - Institut de Recherche pour le Développement - CNRS - Centre National de la Recherche Scientifique - UCA - Université Clermont Auvergne)

  • Peter Bogetoft

    (CBS - Copenhagen Business School [Copenhagen])

  • Vanara Chea

    (Cambodian Ministry of Economy and Finance)

  • Guido Erreygers

    (UA - University of Antwerp)

  • Sambo Pheakdey

    (Cambodian Ministry of Economy and Finance)

Abstract

COVID-19 is causing serious impacts on tax revenue and consequentially on public health budgets. This study assesses Cambodia's public health services technical efficiency, unit costs, and utilization rates to quantify the extent to which current health financing can accommodate the expansion of social health protection coverage. Overall, for the public health system to be fully efficient output would need to increase by 34 and 73 percent for hospitals and health centers, respectively. We find public sector service quality, private sector providers, and non-discretionary financing to be statistically significant factors affecting technical efficiency. This study pioneers the application of Data Envelopment Analysis-Aumann-Shapley applied cost allocation to the health sector, enabling unit cost estimation for the major social health insurance payment categories. We estimate there is potential supply-side 'service space' to expand population coverage to an additional 4.69 million social health insurance beneficiaries with existing financing if the public health system were fully efficient.

Suggested Citation

  • Robert John Kolesar & Peter Bogetoft & Vanara Chea & Guido Erreygers & Sambo Pheakdey, 2021. "Advancing Universal Health Coverage in the COVID-19 Era : An Assessment of Public Health Services Technical Efficiency and Applied Cost Allocation in Cambodia," Working Papers hal-03437398, HAL.
    • Handle: RePEc:hal:wpaper:hal-03437398
    Note: View the original document on HAL open archive server: https://uca.hal.science/hal-03437398
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    1. Sokunthea Koy & Franziska Fuerst & Bunnareth Tuot & Maurice Starke & Steffen Flessa, 2023. "The Flipped Break-Even: Re-Balancing Demand- and Supply-Side Financing of Health Centers in Cambodia," IJERPH, MDPI, vol. 20(2), pages 1-20, January.
    2. Kaiser, Andrea Hannah & Okorafor, Okore & Ekman, Björn & Chhim, Srean & Yem, Sokunthea & Sundewall, Jesper, 2023. "Assessing progress towards universal health coverage in Cambodia: Evidence using survey data from 2009 to 2019," Social Science & Medicine, Elsevier, vol. 321(C).

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    Keywords

    health service efficiency; social health protection; costing; cost allocation; Universal Health Coverage;
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