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Is the quest for efficiency harmful to health equity? An examination of the health efficiency-equity nexus in OECD countries over the past two decades

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  • Bousmah, Marwân-al-Qays
  • Abu-Zaineh, Mohammad
  • Combes, Simon
  • Ventelou, Bruno

Abstract

Has the quest for efficiency in OECD health systems impacted the social gradient of health? We examined the cross-dynamics of the health system equity-efficiency nexus among OECD countries in the past two decades.

Suggested Citation

  • Bousmah, Marwân-al-Qays & Abu-Zaineh, Mohammad & Combes, Simon & Ventelou, Bruno, 2025. "Is the quest for efficiency harmful to health equity? An examination of the health efficiency-equity nexus in OECD countries over the past two decades," Social Science & Medicine, Elsevier, vol. 383(C).
    • Handle: RePEc:eee:socmed:v:383:y:2025:i:c:s0277953625007105
    DOI: 10.1016/j.socscimed.2025.118379
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    References listed on IDEAS

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    1. Pavitra Paul & Ulrich Nguemdjo & Armel Ngami & Natalia Kovtun & Bruno Ventelou, 2022. "Do efficiency and equity move together? Cross-dynamics of Health System performance and Universal Health Coverage," Humanities and Social Sciences Communications, Palgrave Macmillan, vol. 9(1), pages 1-8, December.
    2. Horton, Sarah, 2006. "The double burden on safety net providers: Placing health disparities in the context of the privatization of health care in the US," Social Science & Medicine, Elsevier, vol. 63(10), pages 2702-2714, November.
    3. Zack Cooper & Stuart V Craig & Martin Gaynor & John Van Reenen, 2019. "The Price Ain’t Right? Hospital Prices and Health Spending on the Privately Insured," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 134(1), pages 51-107.
    4. Morel, Sylvie, 2019. "Inequality and discrimination in access to urgent care in France Ethnographies of three healthcare structures and their audiences," Social Science & Medicine, Elsevier, vol. 232(C), pages 25-32.
    5. Mackenbach, Johan P. & Kunst, Anton E., 1997. "Measuring the magnitude of socio-economic inequalities in health: An overview of available measures illustrated with two examples from Europe," Social Science & Medicine, Elsevier, vol. 44(6), pages 757-771, March.
    6. Böhm, Katharina & Schmid, Achim & Götze, Ralf & Landwehr, Claudia & Rothgang, Heinz, 2013. "Five types of OECD healthcare systems: Empirical results of a deductive classification," Health Policy, Elsevier, vol. 113(3), pages 258-269.
    7. Milstein, Ricarda & Schreyoegg, Jonas, 2016. "Pay for performance in the inpatient sector: A review of 34 P4P programs in 14 OECD countries," Health Policy, Elsevier, vol. 120(10), pages 1125-1140.
    8. Jiaqi Xiao & Artūras Juodis & Yiannis Karavias & Vasilis Sarafidis & Jan Ditzen, 2023. "Improved tests for Granger noncausality in panel data," Stata Journal, StataCorp LLC, vol. 23(1), pages 230-242, March.
    9. Battese, G E & Coelli, T J, 1995. "A Model for Technical Inefficiency Effects in a Stochastic Frontier Production Function for Panel Data," Empirical Economics, Springer, vol. 20(2), pages 325-332.
    10. Artūras Juodis & Yiannis Karavias & Vasilis Sarafidis, 2021. "A homogeneous approach to testing for Granger non-causality in heterogeneous panels," Empirical Economics, Springer, vol. 60(1), pages 93-112, January.
    11. Armel Ngami & Bruno Ventelou, 2023. "Respective healthcare system performances taking into account environmental quality: what are the re-rankings for OECD countries?," Post-Print hal-04186935, HAL.
    12. Leemore Dafny & Kate Ho & Robin S. Lee, 2019. "The price effects of cross‐market mergers: theory and evidence from the hospital industry," RAND Journal of Economics, RAND Corporation, vol. 50(2), pages 286-325, June.
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