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Cross-country comparisons of technical efficiency of health production: a demonstration of pitfalls

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  • Jean Spinks
  • Bruce Hollingsworth

Abstract

It has been proposed that cross-country comparisons of the technical efficiency of health production, estimated using data envelopment analysis (DEA), have useful applications for policy makers. In theory such an analysis utilizes measures of the socioeconomic determinants of health relevant to all social policy, not just health policy. Using OECD and WHO data, this article critically analyses a number of outstanding theoretical questions regarding the use of DEA in this setting. It concludes that until such questions are addressed, the resultant implications for policy will be based on misleading information.

Suggested Citation

  • Jean Spinks & Bruce Hollingsworth, 2009. "Cross-country comparisons of technical efficiency of health production: a demonstration of pitfalls," Applied Economics, Taylor & Francis Journals, vol. 41(4), pages 417-427.
  • Handle: RePEc:taf:applec:v:41:y:2009:i:4:p:417-427
    DOI: 10.1080/00036840701604354
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    Citations

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    Cited by:

    1. 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.
    2. 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.
    3. Mathieu Lefebvre & Sergio Perelman & Pierre Pestieau, 2015. "Productivity and performance in the public sector," Working Papers of BETA 2015-15, Bureau d'Economie Théorique et Appliquée, UDS, Strasbourg.
    4. Anton Sorin Gabriel, 2013. "Technical Efficiency in the Use of Health Care Resources: A Cross-Country Analysis," Scientific Annals of Economics and Business, De Gruyter Open, vol. 60(1), pages 1-12, July.
    5. Francesco Grigoli & Eduardo Ley, 2012. "Quality of Government and Living Standards; Adjusting for the Efficiency of Public Spending," IMF Working Papers 12/182, International Monetary Fund.
    6. repec:spr:soinre:v:133:y:2017:i:3:d:10.1007_s11205-016-1398-y is not listed on IDEAS
    7. Francesco Grigoli, 2012. "Public Expenditure in the Slovak Republic; Composition and Technical Efficiency," IMF Working Papers 12/173, International Monetary Fund.
    8. Davutyan, Nurhan & Bilsel, Murat & Tarcan, Menderes, 2012. "Risk-Adjusted Mortality, varieties of congestion and patient satisfaction in Turkish provincial general hospitals," MPRA Paper 37437, University Library of Munich, Germany.
    9. Sharon Hadad & Yossi Hadad & Tzahit Simon-Tuval, 2013. "Determinants of healthcare system’s efficiency in OECD countries," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 14(2), pages 253-265, April.
    10. Sommersguter-Reichmann, Margit & Stepan, Adolf, 2015. "The interplay between regulation and efficiency: Evidence from the Austrian hospital inpatient sector," Socio-Economic Planning Sciences, Elsevier, vol. 52(C), pages 10-21.
    11. 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.
    12. repec:bla:ijhplm:v:31:y:2016:i:4:p:537-553 is not listed on IDEAS
    13. repec:spr:pharmo:v:1:y:2017:i:3:d:10.1007_s41669-017-0010-y is not listed on IDEAS
    14. repec:ibn:ijefaa:v:9:y:2017:i:4:p:172-184 is not listed on IDEAS
    15. Yi-Chung Hsu, 2014. "Efficiency in government health spending: a super slacks-based model," Quality & Quantity: International Journal of Methodology, Springer, vol. 48(1), pages 111-126, January.
    16. Varabyova, Yauheniya & Schreyögg, Jonas, 2013. "International comparisons of the technical efficiency of the hospital sector: Panel data analysis of OECD countries using parametric and non-parametric approaches," Health Policy, Elsevier, vol. 112(1), pages 70-79.
    17. John Buckell & Andrew Smith & Roberta Longo & David Holland, 2013. "Health inefficiency and unobservable heterogeneity - empirical evidence from pathology services in the UK National Health Service," Working Papers 1307, Academic Unit of Health Economics, Leeds Institute of Health Sciences, University of Leeds.
    18. Pınar Kaya Samut & Reyhan Cafrı, 2016. "Analysis of the Efficiency Determinants of Health Systems in OECD Countries by DEA and Panel Tobit," Social Indicators Research: An International and Interdisciplinary Journal for Quality-of-Life Measurement, Springer, vol. 129(1), pages 113-132, October.

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