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Potential determinants of health system efficiency: Evidence from Latin America and the Caribbean

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  • Rodrigo Moreno-Serra
  • Misael Anaya-Montes
  • Peter C Smith

Abstract

This paper examines the levels of health system efficiency and their possible determinants across Latin American and Caribbean (LAC) countries using national-level data for those countries, as well as for other emerging and developed countries. The data are analyzed using data envelopment analyses and econometric advances that yield reliable estimations of the relationship between system efficiency and its potential determinants. We find that there is substantial room for efficiency improvements in the health system of most LAC countries. For example, LAC countries could improve life expectancy at birth by about five years on average at current public spending levels if they followed best practices. Furthermore, the paper assesses what factors amenable to policy act as the main possible levers for some countries to be able to translate a given level of health financing into better performance on access to care and health outcomes. Our econometric analyses suggest that efforts to increase health system efficiency could be focused in a few key policy areas associated with broader access to health services and better outcomes. These areas include general governance aspects, in addition to improvements in specific dimensions of the quality of health system institutions, notably stronger reliance on results-based management in the production of healthcare goods and services.

Suggested Citation

  • Rodrigo Moreno-Serra & Misael Anaya-Montes & Peter C Smith, 2019. "Potential determinants of health system efficiency: Evidence from Latin America and the Caribbean," PLOS ONE, Public Library of Science, vol. 14(5), pages 1-21, May.
    • Handle: RePEc:plo:pone00:0216620
    DOI: 10.1371/journal.pone.0216620
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    1. João Medeiros & Christoph Schwierz, 2015. "Efficiency estimates of health care systems," European Economy - Economic Papers 2008 - 2015 549, Directorate General Economic and Financial Affairs (DG ECFIN), European Commission.
    2. B. Hollingsworth & P. Smith, 2003. "Use of ratios in data envelopment analysis," Applied Economics Letters, Taylor & Francis Journals, vol. 10(11), pages 733-735.
    3. Rodrigo Moreno-Serra, 2014. "The impact of cost-containment policies on health expenditure: Evidence from recent OECD experiences," OECD Journal on Budgeting, OECD Publishing, vol. 13(3), pages 1-29.
    4. Herrera, Santiago & Pang, Gaobo, 2005. "Efficiency of public spending in developing countries : an efficiency frontier approach," Policy Research Working Paper Series 3645, The World Bank.
    5. William Greene, 2004. "Distinguishing between heterogeneity and inefficiency: stochastic frontier analysis of the World Health Organization's panel data on national health care systems," Health Economics, John Wiley & Sons, Ltd., vol. 13(10), pages 959-980, October.
    6. Richard Gearhart, 2016. "The robustness of cross-country healthcare rankings among homogeneous OECD countries," Journal of Applied Economics, Universidad del CEMA, vol. 19, pages 113-144, May.
    7. Pablo Gottret & George Schieber, 2006. "Health Financing Revisited : A Practitioner's Guide," World Bank Publications - Books, The World Bank Group, number 7094.
    8. Rodrigo Moreno-Serra & Peter C. Smith, 2015. "Broader health coverage is good for the nation's health: evidence from country level panel data," Journal of the Royal Statistical Society Series A, Royal Statistical Society, vol. 178(1), pages 101-124, January.
    9. Francesco Grigoli & Javier Kapsoli, 2018. "Waste not, want not: The efficiency of health expenditure in emerging and developing economies," Review of Development Economics, Wiley Blackwell, vol. 22(1), pages 384-403, February.
    10. 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.
    11. María Concepción Pérez-Cárceles & Juan Cándido Gómez-Gallego & María Gómez-Gallego, 2018. "Environmental factors affecting European and Central Asian health-systems’ bias-corrected efficiency," Applied Economics, Taylor & Francis Journals, vol. 50(32), pages 3432-3440, July.
    12. Christine de la Maisonneuve & Joaquim Oliveira Martins, 2013. "Public Spending on Health and Long-term Care: A new set of projections," OECD Economic Policy Papers 6, OECD Publishing.
    13. Christine de la Maisonneuve & Rodrigo Moreno‐Serra & Fabrice Murtin & Joaquim Oliveira Martins, 2017. "The Role of Policy and Institutions on Health Spending," Health Economics, John Wiley & Sons, Ltd., vol. 26(7), pages 834-843, July.
    14. Simar, Leopold & Wilson, Paul W., 2007. "Estimation and inference in two-stage, semi-parametric models of production processes," Journal of Econometrics, Elsevier, vol. 136(1), pages 31-64, January.
    15. Jacobs,Rowena & Smith,Peter C. & Street,Andrew, 2006. "Measuring Efficiency in Health Care," Cambridge Books, Cambridge University Press, number 9780521851442, October.
    16. 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.
    17. Adam Wagstaff & Mariam Claeson, 2004. "The Millennium Development Goals for Health : Rising to the Challenges," World Bank Publications - Books, The World Bank Group, number 14954.
    18. Richard Gearhart, 2016. "The Robustness of Cross-Country Healthcare Rankings Among Homogeneous Oecd Countries," Journal of Applied Economics, Taylor & Francis Journals, vol. 19(1), pages 113-143, May.
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