COVID-19 and the efficiency of health systems in Europe

Abstract

Background This study aims at analyzing the efficiency of the health systems of 31 European countries in treating COVID-19, for the period January 1, 2020 – January 1, 2021, by incorporating some factors from a multidimensional perspective. Methods The methodology used in the research was Data Envelopment Analysis (DEA), through which efficiency scores for health systems have been calculated. The research was performed considering three stages: the first wave (January 1–June 15), the relaxation period (June 15–October 1) and the second wave (October 1–December 31). In evaluating the determinants of the efficiency of health systems, six major fields of influence were taken into account: health care, health status, population, economic, cultural/societal and governmental issues, all covering 15 indicators. After measuring the efficiency, we used the Tobit type regression to establish the influencing elements on it. Results The results for the public health systems of European states were determined for each country and period. We evaluated the efficiency of health systems in Europe against COVID-19, starting from health inputs (COVID-19 cases, physicians, nurses, hospital beds, health expenditure) and output (COVID-19 deaths). The obtained outputs show that, especially in the first phase of the pandemic, the inefficiency of the health systems was quite high, mainly in Western countries (Italy, Belgium, Spain, UK). In the relaxation phase and in the second wave, the Western states, severely affected at the beginning of the pandemic, began to take adequate measures and improve the efficiency of their sanitary systems. Instead, Eastern European countries were hit hard by the inefficiency of health systems (Bulgaria, Greece, Hungary, Romania). After Tobit regression, results of the study show that the influencing elements are different for the three stages: concerning the first wave, comobirdities, population age, and population density are important; for relaxation period a great influence have government effectiveness and power distance; with respect to second wave, the relevant factors are education and population density. Conclusions The results obtained could serve as starting points for health policymakers to perform comparative analyzes in terms of good practices in the health system and to develop national plans to better deal with health crises. At the same time, they can be used internationally to achieve a coherent and effective community response to the pandemic.

Sustainable human resource management the mediating role between work engagement and teamwork performance

“…However, despite the importance of the sector for society, the European Union cannot intervene directly or impose binding decisions, because public health is a common task shared among the member countries. The differences between public health systems at the European level are determined by factors such as infrastructure, the quality of public policies, culture, legislation, and human resource management [ 92 ]. Going deeper into this idea, there are differences between the technical efficiency (obtaining more products than inputs) and the allocative efficiency (distribution of resources) of each country [ 93 ].…”

“…Based on this differentiation, in Europe, the health system has adopted the Beveridge model (Cyprus, Denmark, Spain, Finland, Ireland, Italy, Latvia, Malta, Portugal, United Kingdom and Sweden), which is based on a predominantly National Health System, or the Bismarck model (Germany, Austria, Belgium, Bulgaria, Croatia, Slovakia, Slovenia, Estonia, France, Greece, Hungary, Lithuania, Luxembourg, Netherlands, Poland, Czech Republic and Romania), which implies that the financing of the health system is carried out through compulsory contributions to social security, generally through employers and employees, that is a Social Health Insurance System, altough, in the European case, both share some characteristics. However, in addition to these two models, there is also the mixed model, in which private financing of voluntary insurance systems is significant (Private Health Insurance System) [ 92 ].…”

Approaches related to the effects of Covid-19 pandemics on financing of the healthcare system in Romania

“…An analysis of the effectiveness of European improved health systems COVID-19 ( 23 ) considers indicators such as: COVID-19 cases, physicians, nurses, hospital beds, health expenditure and COVID-19 deaths. From the analysis of these indicators, the authors explain that in the initial phase of the pandemic, European health systems were inefficient especially in Italy, Belgium, Spain and UK.…”

Global Healthcare Needs Related to COVID-19: An Evidence Map of the First Year of the Pandemic

“…Limited or inadequate medicines, equipment, personnel, and facilities were reported [ 9 , 10 , 11 ]. Appropriate service delivery was further compounded by ineffective public health policies and initiatives [ 12 ], financial instability, and health information and communication challenges [ 3 ].…”