The Health Sector in the Slovak Republic: Efficiency and Reform

Gunnarsson, Victoria; Lugaresi, Sergio; Verhoeven, Marijn

doi:10.2139/ssrn.1033209

Cited by 9 publications

(12 citation statements)

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“…The sequencing of possible reforms and related political economy issues are beyond the scope of this paper.12 The results are broadly comparable to those inVerhoeven, Gunnarsson, and Lugaresi (2007), which analyzes health care spending in the Slovak Republic.…”

mentioning

confidence: 69%

“…As noted earlier, the analysis generates a bestpractice frontier of input-output combinations (e.g., social spending and outcomes) that dominate the other combinations in the sample, and countries that are not on the frontier are then ranked according to the distance from the frontier. Similar to Verhoeven, Gunnarsson, and Lugaresi (2007) and Verhoeven, Gunnarsson, and Carcillo (2007), correlation analyses are also conducted to understand reasons for variation in efficiency across countries. Finally, in highlighting potential efficiency-enhancing reforms, the section draws on the findings in the World Bank's Public Finance Review.…”

Section: The Relative Efficiency Of Social Spendingmentioning

confidence: 99%

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Government Spendingon Health Care and Education in Croatia: Efficiency and Reform Options

Gunnarsson

Jafarov²

2008

IMF Working Papers

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This Working Paper should not be reported as representing the views of the IMF.The views expressed in this Working Paper are those of the author(s) and do not necessarily represent those of the IMF or IMF policy. Working Papers describe research in progress by the author(s) and are published to elicit comments and to further debate. This paper assesses the relative efficiency of government spending on health care and education in Croatia by using the so-called Data Envelopment Analysis. The analysis finds evidence of significant inefficiencies in Croatia's spending on health care and education, related to inadequate cost recovery, weaknesses in the financing mechanisms and institutional arrangements, weak competition in the provision of these services, and weaknesses in targeting public subsidies on health care and education. These inefficiencies suggest that government spending on health and education could be reduced without undue sacrifices in the quality of these services. The paper identifies ways to do that.

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mentioning

confidence: 69%

Section: The Relative Efficiency Of Social Spendingmentioning

confidence: 99%

Government Spendingon Health Care and Education in Croatia: Efficiency and Reform Options

Gunnarsson

Jafarov²

2008

IMF Working Papers

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“…However, other studies found that higher GDP per capita was associated with lower technical e ciency of health systems. This was thought to be because of increased cost of healthcare because of unnecessary care and higher relative prices of healthcare in richer countries [97].…”

Section: Macro-economic Characteristicsmentioning

confidence: 99%

Analysing the Efficiency of National and Sub-national health systems - A Systematic Review of Literature

Mbau

Musiega

Nyawira

et al. 2022

Preprint

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Introduction Health system efficiency is a priority concern for policy makers globally as countries aim to achieve universal health coverage. Efficiency analysis in the health sector has typically focused on the efficiency of healthcare facilities (hospitals, primary healthcare facilities), with few studies focusing on system level (national or sub-national) efficiency. We carried out a thematic review of literature that assessed the efficiency of health systems at the national and sub-national level. Methods We conducted a systematic search of PubMed, Google, and Google scholar between 2000 and 2021 and a manual search of relevant papers’ reference lists. A total of 131 papers were identified. We analysed and synthesized data from the selected papers using a thematic approach. Findings There were more publications from high and upper middle-income countries (62%) than from low income and lower-middle income countries. There were also more publications focusing on national level (60%) compared to sub-national health systems efficiency. Only 5% of studies used either qualitative methods or mixed methods while 95% used quantitative approaches. Data envelopment analysis was the most common methodological approach used, followed by stochastic frontier analysis. A range of regression methods were used to identify the determinants of health system efficiency. While studies used a range of inputs, these generally considered the building blocks of health systems, health risk factors, and social determinants of health. Outputs used in efficiency analysis could be classified as either intermediate health outputs, single health outcomes or composite measures of health outcomes. Factors that were found to affect health system technical efficiency include demographic and socio-economic characteristics of the population, macro-economic characteristics of the national and sub-national regions, population health and wellbeing, the governance and political characteristics of these regions, and health system characteristics. Conclusion This review highlights the limited evidence on health system efficiency in low- and middle-income countries. It also reveals the dearth of efficiency studies that use mixed methods approaches by incorporating qualitative inquiry. The review offers insights on the drivers of the technical efficiency of national and sub-national health systems, highlights potential targets for reforms to improve health system efficiency.

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“…A limited number of publications have addressed the functioning of public health facilities in a health system with significant arrears. Most of the available papers elaborated on cases of facilities in European post‐socialist countries 10‐15 . The complementary studies on responses to the deterioration of health facilities' financial performance have focused on hospitals, as they consume a substantial share of public health expenditures 3,16‐19 .…”

Section: Introductionmentioning

confidence: 99%

“…Most of the available papers elaborated on cases of facilities in European post-socialist countries. [10][11][12][13][14][15] The complementary studies on responses to the deterioration of health facilities' financial performance have focused on hospitals, as they consume a substantial share of public health expenditures. 3,[16][17][18][19] For example, a study from Poland indicated that a mix of both system and micro-level factors contributed to undermining public hospital financial standing, with poor management, weak owner control, and the state of hospital infrastructure being the lead factors at a facility level.…”

Section: Introductionmentioning

confidence: 99%

Financial sustainability strategies of public primary health care centres in the Republic of Srpska, Bosnia and Herzegovina

Rakić

Djudurovic

Antonić

2021

Health Planning & Management

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Background: The literature on the functioning of public health facilities in health systems with significant arrears is limited. The growing liabilities of health facilities and the accumulating arrears have been a challenge in the Republic of Srpska. Most public primary healthcare (PHC) centres generated a gross loss in 2018. Method: Guided by the 'positive deviance' approach, we used an exploratory case study design to identify strategies used by managers to achieve financial sustainability in eight top-performing PHC centres. Qualitative data were collected through face-to-face in-depth semistructured interviews with key informants from the PHC centres that reported positive financial results in 2018. Results: Seven organisational goals, comprising 34 financial sustainability strategies, were recognised during the data analysis and were used to build an organisational-level model for a PHC centre. Conclusion: Managers concurrently used multiple strategies to ensure financial sustainability. Each centre tailored its range of strategies to the organisational context, local context, and wider environment of the health system. The strategies were conceived and implemented by managers operating at different organisational levels under the leadership of top-level managers. Managers of indebted health facilities can learn from the positively deviant peers who manage facilities that achieved satisfactory financial performance.

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The Health Sector in the Slovak Republic: Efficiency and Reform

Cited by 9 publications

References 2 publications

Government Spendingon Health Care and Education in Croatia: Efficiency and Reform Options

Government Spendingon Health Care and Education in Croatia: Efficiency and Reform Options

Analysing the Efficiency of National and Sub-national health systems - A Systematic Review of Literature

Financial sustainability strategies of public primary health care centres in the Republic of Srpska, Bosnia and Herzegovina

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