Health system efficiency in OECD countries: dynamic network DEA approach

Gavurová, Beata; Kočišová, Kristína; Sopko, Jakub

doi:10.1186/s13561-021-00337-9

Cited by 42 publications

(31 citation statements)

References 57 publications

(115 reference statements)

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“…Based on the DEA results, and especially on mean results (Table 4 ) the health systems of European countries could be grouped into three categories of efficiency [ 11 , 18 , 27 ]: category 1 : high efficiency (0.75–1): Austria, Croatia, Cyprus, Czechia, Denmark, Estonia, Finland, Iceland, Ireland, Latvia, Luxembourg, Malta, Norway (only country with very high efficiency (= 1), Portugal, Slovakia, Slovenia, Switzerland; category 2 : average efficiency: (0.5–0.75): Belgium, Bulgaria, France, Germany, Greece, Hungary, Netherlands, Poland, Spain, Sweden, UK’ category 3: low efficiency (< 0.5): Italy and Romania. States with low efficiency health systems have demonstrated vulnerabilities in how resources were used in the first year of the pandemic, by reference to the needs.…”

Section: Resultsmentioning

confidence: 99%

COVID-19 and the efficiency of health systems in Europe

Lupu

Ţigănaşu

2022

Health Econ Rev

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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.

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Section: Resultsmentioning

confidence: 99%

COVID-19 and the efficiency of health systems in Europe

Lupu

Ţigănaşu

2022

Health Econ Rev

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“…These factors are also a part of the SDG 3. Prevention programs and systems of health literacy, which have to be a part of educational systems, play an important role in the process of reducing differences in health among countries ( 51 , 68 – 70 ). In recent years, environmental literacy has been an important topic for many countries in relation to environmental strategies and reduction of environmental risks.…”

Section: Discussionmentioning

confidence: 99%

Sustainable Health and Wellbeing in the European Union

Gavurová

Megyesiova

2022

Front. Public Health

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BackgroundAltogether, 17 Sustainable Development Goals (SDGs) are an urgent call for action to end poverty, protect the planet, and ensure prosperity for all. Goal 3 is crucial in terms of good health and wellbeing. The main aim of this study is to analyze and evaluate differences among indicators of SDG 3: Sustainable health and wellbeing in the EU countries.MethodsThe status and development of the EU Member States regarding their successes or failures in terms of Goal 3 were subjected to analysis. Altogether, 11 indicators were used to rank the EU countries using the TOPSIS and ranking methods. The ranks were assigned to the countries in two periods. The first period is related to the time from 2010 till 2014, and the second period from 2015 till 2019.ResultsThe EU countries achieved a positive development in 10 of 11 indicators that monitor the achievement of the EU in terms of Goal 3. The only variable that changed negatively was the obesity rate. Positivity was observed in the decline of the standardized preventable and treatable mortality, which declined from 317.3 in the first period to 295 in the second period; the drop of the population weighted annual mean concentration of fine particulate PM2.5, from 16.4 to 13.6 μg/m3, and also in the increase of the share of people with good or very good perceived health, which was combined with a decrease of the self-reported unmet need for medical examination and care. The best-rated country in terms of SDG 3 was, in both periods, Sweden, while the worst-rated was Latvia.ConclusionsGovernments and institutions in the EU can intervene to increase the accessibility and quality of the health care system, but every citizen should try to do their best to reduce some of the risk factors, such as smoking or obesity, to try living healthier and to help to achieve higher ambitions in terms of sustainable health and wellbeing.

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“…Considering the similarities of effectiveness and feasibility of measures in the short run and the long run, we found that more effective and applicable measures in the short run and the long run were those the ones that increased the efficiency of health resources and the correct use of resources, leading to making a resilient health system against sanctions. Several studies have concluded that the main issue in all health systems is inefficiency and the waste of health resources [ 35 , 36 ]. Thus, it is essential to ensure efficiency improvement to make a resilient health system cope with catastrophic events.…”

Section: Discussionmentioning

confidence: 99%

Health system to response to economic sanctions: global evidence and lesson learned from Iran

Sajadi

Majdzadeh

2022

Global Health

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Background Sanctions have direct and indirect impacts on people’s lives. Therefore, the health systems of countries targeted by sanctions must respond effectively. This study proposes a set of mitigating measures and response strategies to improve the health systems of countries under sanctions. Methods This three-stage study was conducted in Iran within the 2020–2021 period, in which a rapid review of evidence was carried out to identify the measures implemented or proposed to make the health system resilient in confronting sanctions. A qualitative approach was then adopted to determine how the health system could be improved to response to sanctions from the perspectives of 10 key experts. Semi-structured interviews and document analysis were conducted for data collection. Finally, a two-round Delphi technique was employed to help eleven experts reach a consensus on a set of mitigating measures, which were then prioritized. Results In this research, 62 proposed or implemented mitigating measures were extracted from 13 eligible studies to improve the health system performance in confronting sanctions. Moreover, 18 measures were identified in interviews for a better health system response to sanctions. They were then classified as five categories: sustained financing, good governance, integrated and updated health information systems, qualified workforce, and efficient and equitable service delivery. In the first Delphi round, 28 mitigating measures were discovered. Nine measures were identified as more effective and feasible in both short and long runs. They were introduced as below: conducting proactive inventory control, developing the nationally essential list of medicines, providing additional clarification that oil revenues can be freely used for medicines procurement, defining tailored health service packages for vulnerable populations, establishing and enhancing an efficient surveillance system, reducing prices of imported medicines, developing dual policies of equity and priority for vulnerable groups, institutionalizing fair and effective resource allocations, and providing clinical guidelines. Conclusions According to the findings, the most critical areas for the resilience of a health system in confronting sanctions include strengthening particular components of governance, improving efficiency, and caring for vulnerable populations. The experts collectively emphasized investment in domestic capacities, public participation, and health diplomacy. Despite the proposed measures, it is unclear how effective these are and, especially whether they can significantly affect the harsh impacts of sanctions on health. Moreover, intensive and long-term sanctions have significant irreversible outcomes that cannot be reversed easily or quickly.

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Health system efficiency in OECD countries: dynamic network DEA approach

Cited by 42 publications

References 57 publications

COVID-19 and the efficiency of health systems in Europe

COVID-19 and the efficiency of health systems in Europe

Sustainable Health and Wellbeing in the European Union

Health system to response to economic sanctions: global evidence and lesson learned from Iran

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