Productive Efficiency and Heterogeneity of Health Care Systems: Results of a Measurement for OECD Countries

Abstract

Standard-Nutzungsbedingungen:Die Dokumente auf EconStor dürfen zu eigenen wissenschaftlichen Zwecken und zum Privatgebrauch gespeichert und kopiert werden.Sie dürfen die Dokumente nicht für öffentliche oder kommerzielle Zwecke vervielfältigen, öffentlich ausstellen, öffentlich zugänglich machen, vertreiben oder anderweitig nutzen.Sofern die Verfasser die Dokumente unter Open-Content-Lizenzen (insbesondere CC-Lizenzen) zur Verfügung gestellt haben sollten, gelten abweichend von diesen Nutzungsbedingungen die in der dort genannten Lizenz gewährten Nutzungsrechte. Abstract: Health system efficiency is a major target of health policy but its conceptualization and measurement are still a problem in health economics. Because health status is influenced by many factors outside the health system, I argue that measurements of health system efficiency should focus on the process of turning financial input into additional health output rather than the levels of health status reached. When analyzing levels of health status using regression methods, the appropriate efficiency indicator is hence not a country-specific intercept based on the achieved health status, but a country-specific slope for input factors in the production function of health outcomes. The slopes represent health system efficiency, while the intercepts represent health relevant heterogeneity among countries. Using data on OECD members these slopes are estimated. Countries differ far more in their residual heterogeneity than in the rate by which their health system turns money into life years. Terms of use: Documents in

Analyzing Whether Countries Are Equally Efficient at Improving Longevity for Men and Women

“…11 Real gross domestic product (GDP) per capita was obtained from the OECD Statistical Extracts 12 and, similarly to previous work, was used to account for differences in levels of economic development between countries. 5,9 Analyses Conducted Our analytical objective was to assess the country-specific relation between total health expenditures per capita (TEH itÀ1 ) and life expectancy (L it Þ, where i indexes country and t indexes year. Specifically, we estimated the country-specific effect of a 1% annual increase in health expenditures on the percent change in life expectancy, interpreted as an elasticity, by regressing the natural log of L it on a vector of country dummy variables (a i Þ, a vector of cross-products between a i and the natural log of TEH itÀ1 , the natural log of social expenditures (SOCX itÀ1 Þ, and the natural log of GDP per capita (GDP it Þ:…”

“…We chose not to include year fixed effects because they imply a "natural" increase in life expectancy that occurs over time. 5,9 Rather, we controlled for potential confounding by time-varying social expenditures and levels of economic development, measured by GDP per capita. 13 Gender-specific associations between health expenditures and life expectancy were estimated by running separate models with male and female life expectancy as the dependent variable, similar to the work of Asiskovitch.…”

“…In previous research, the most accepted method for assessing health system efficiency has been to investigate the relation between health spending and life expectancy. 5,6 This notion of efficiency is predicated on the ability of nations to strategically finance their health systems to attain key health goals. As is common in the literature, efficiency is defined by the changes in life expectancy that result from variation in health expenditures.…”

“…5,8 However, prior work has not accounted for social expenditures across countries, which are associated with population health in the OECD. 9 The identification of differential healthspending efficiencies across genders has been limited to the important contribution of Asiskovitch, who found that men gain more per dollar spent than women on average across the OECD.…”

Corporate social responsibility and firm efficiency: a latent class stochastic frontier analysis

“…5 The identification problem still arises if we consider the ''true'' fixed (or random) effect model (Greene 2004a(Greene , 2008, in this case the inefficiency is free to vary over time and all time invariant effects are measured by unobserved heterogeneity, but we need some additional assumptions (out of sample) on the parametric distribution of a j and then on u it , see Kotzian (2009), for a fully parametric specification of the models above. 6 More specifically, the Gaussian quadrature is satisfactory if the distribution of the compound error is Gaussian and sufficient quadrature points are used.…”