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Improving the Efficiency of Health Care Spending: Selected Evidence on Hospital Performance


  • Espen Erlandsen


There are no ready-made data on hospital outputs and inputs which would allow comprehensive international comparisons of hospital efficiency to be carried out. This paper, therefore, relies on selected evidence to compare hospital efficiency in a subset of OECD countries, based on three different approaches relying on, respectively: i) unit costs for standard hospital treatments; ii) overall efficiency levels in a set of paired countries; iii) within-country dispersion in individual hospital efficiency. The analysis suggests substantial cross-country differences in hospital performance. Although country coverage varies between the different approaches, making it difficult to assess the extent to which comparisons provide a consistent picture of national efficiency levels, cross-checks between the different indicator sets tend to support the robustness of the country rankings. Améliorer l'efficacité des dépenses de santé : Indicateurs sélectifs de la performance des hôpitaux Il n’existe pas de données toutes faites sur les services fournis par les hôpitaux et les ressources qu’ils consomment qui permettraient d’effectuer des comparaisons internationales d’ensemble de l’efficacité des hôpitaux. Ce document s’appuie donc sur des indicateurs sélectifs pour comparer l’efficacité des hôpitaux dans un échantillon de pays de l’OCDE, sur la base de trois approches différentes, à savoir : i) les coûts unitaires pour des interventions hospitalières types ; ii) les niveaux d’efficacité globale entre pays pris deux à deux ; iii) la variabilité de l’efficacité entre hôpitaux d’un même pays. L’analyse montre des différences substantielles de performance entre pays. S’il est difficile d’évaluer dans quelle mesure ces comparaisons donnent une image cohérente des niveaux d’efficacité nationaux, car le nombre de pays couverts varie d’une approche à l’autre, des vérifications par recoupement des différents jeux d’indicateurs tendent à confirmer la robustesse du classement des pays.

Suggested Citation

  • Espen Erlandsen, 2007. "Improving the Efficiency of Health Care Spending: Selected Evidence on Hospital Performance," OECD Economics Department Working Papers 555, OECD Publishing.
  • Handle: RePEc:oec:ecoaaa:555-en

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    Cited by:

    1. Mas, Nuria & Cirera, Laia & Viñolas, Guillem, 2011. "Los sistemas de copago en Europa, Estados Unidos y Canadá: Implicaciones para el caso español," IESE Research Papers D/939, IESE Business School.

    More about this item


    coûts unitaires; diagnosis related groups; efficacité des hôpitaux; groupes homogènes de malades; health care; hospital efficiency; méthodes non paramétriques; non-parametric methods; services de santé; unit costs;

    JEL classification:

    • C14 - Mathematical and Quantitative Methods - - Econometric and Statistical Methods and Methodology: General - - - Semiparametric and Nonparametric Methods: General
    • D24 - Microeconomics - - Production and Organizations - - - Production; Cost; Capital; Capital, Total Factor, and Multifactor Productivity; Capacity
    • H41 - Public Economics - - Publicly Provided Goods - - - Public Goods
    • H51 - Public Economics - - National Government Expenditures and Related Policies - - - Government Expenditures and Health
    • I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets
    • I12 - Health, Education, and Welfare - - Health - - - Health Behavior
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health

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