IDEAS home Printed from https://ideas.repec.org/p/hal/journl/hal-04350906.html
   My bibliography  Save this paper

Healthcare system efficiency and drivers: Re-evaluation of OECD countries for COVID-19

Author

Listed:
  • Gökçe Manavgat

    (Toros university)

  • Martine Audibert

    (CERDI - Centre d'Études et de Recherches sur le Développement International - UCA [2017-2020] - Université Clermont Auvergne [2017-2020] - CNRS - Centre National de la Recherche Scientifique)

Abstract

The Covid-19 pandemic has raised concerns about the resilience of health systems. The aim of this study is twofold: i) to measure and compare the resilience of health system efficiency of OECD countries before and during Covid-19 and ii) to determine the healthcare efficiency drivers (e.g., socioeconomic) of health system performance. Using a dataset of 31 OECD countries for 2018 and 2020, we first estimate bias-adjusted efficiency scores, followed by a double bootstrap truncated regression procedure to study the drivers associated with health system efficiency. We find that the health system efficiency overall score decreased among OECD countries during the Covid-19 pandemic compared to before Covid-19. Estonia and Japan retained their full efficiency scoreduring Covid-19. We find a negative association between health system efficiency and unemployment rate, share of health expenditure in GDP, and share of population over 65. Conversely, high vaccination rates contribute positively to health system efficiency during the Covid-19 period.

Suggested Citation

  • Gökçe Manavgat & Martine Audibert, 2024. "Healthcare system efficiency and drivers: Re-evaluation of OECD countries for COVID-19," Post-Print hal-04350906, HAL.
    • Handle: RePEc:hal:journl:hal-04350906
    DOI: 10.1016/j.ssmhs.2023.100003
    Note: View the original document on HAL open archive server: https://hal.science/hal-04350906
    as

    Download full text from publisher

    File URL: https://hal.science/hal-04350906/document
    Download Restriction: no
    File URL: https://libkey.io/10.1016/j.ssmhs.2023.100003?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    References listed on IDEAS

    as
    1. Marlène Guillon & Martine Audibert & Jacky Mathonnat, 2022. "Efficiency of district hospitals in Zimbabwe: Assessment, drivers and policy implications," International Journal of Health Planning and Management, Wiley Blackwell, vol. 37(1), pages 271-280, January.
    2. Sharon Hadad & Yossi Hadad & Tzahit Simon-Tuval, 2013. "Determinants of healthcare system’s efficiency in OECD countries," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 14(2), pages 253-265, April.
    3. Afonso, Antonio & St. Aubyn, Miguel, 2005. "Non-Parametric Approaches to Education and Health Efficiency in OECD Countries," Journal of Applied Economics, Universidad del CEMA, vol. 8(2), pages 1-20, November.
    4. Pınar Kaya Samut & Reyhan Cafrı, 2016. "Analysis of the Efficiency Determinants of Health Systems in OECD Countries by DEA and Panel Tobit," Social Indicators Research: An International and Interdisciplinary Journal for Quality-of-Life Measurement, Springer, vol. 129(1), pages 113-132, October.
    5. Gökçe MANAVGAT & Ayhan DEMİRCİ, 2020. "Decentralization Matter of Healthcare and Effect on Regional Healthcare Efficiency: Evidence from Turkey," Sosyoekonomi Journal, Sosyoekonomi Society, issue 28(44).
    6. Mounir Amdaoud & Giuseppe Arcuri & Nadine Levratto, 2021. "Are regions equal in adversity? A spatial analysis of spread and dynamics of COVID-19 in Europe," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 22(4), pages 629-642, June.
    7. Mark Berger & Jodi Messer, 2002. "Public financing of health expenditures, insurance, and health outcomes," Applied Economics, Taylor & Francis Journals, vol. 34(17), pages 2105-2113.
    8. Charnes, A. & Cooper, W. W. & Rhodes, E., 1978. "Measuring the efficiency of decision making units," European Journal of Operational Research, Elsevier, vol. 2(6), pages 429-444, November.
    9. Andreas Behr & Katja Theune, 2017. "Health System Efficiency: A Fragmented Picture Based on OECD Data," PharmacoEconomics - Open, Springer, vol. 1(3), pages 203-221, September.
    10. Cristian Nedelea, I. & Matthew Fannin, J., 2013. "Analyzing cost efficiency of Critical Access Hospitals," Journal of Policy Modeling, Elsevier, vol. 35(1), pages 183-195.
    11. Simar, Leopold & Wilson, Paul W., 2007. "Estimation and inference in two-stage, semi-parametric models of production processes," Journal of Econometrics, Elsevier, vol. 136(1), pages 31-64, January.
    12. Volkan Recai Cetin & Serdal Bahce, 2016. "Measuring the efficiency of health systems of OECD countries by data envelopment analysis," Applied Economics, Taylor & Francis Journals, vol. 48(37), pages 3497-3507, August.
    13. Ergun Oksuz & Simten Malhan & Mustafa Sait Gonen & Zekayi Kutlubay & Yilmaz Keskindemirci & Fehmi Tabak, 2021. "COVID-19 healthcare cost and length of hospital stay in Turkey: retrospective analysis from the first peak of the pandemic," Health Economics Review, Springer, vol. 11(1), pages 1-12, December.
    14. Nurhafiza Md Hamzah & Ming-Miin Yu & Kok Fong See, 2021. "Assessing the efficiency of Malaysia health system in COVID-19 prevention and treatment response," Health Care Management Science, Springer, vol. 24(2), pages 273-285, June.
    15. Dan Lupu & Ramona Tiganasu, 2022. "COVID-19 and the efficiency of health systems in Europe," Health Economics Review, Springer, vol. 12(1), pages 1-15, December.
    16. Muhammed Ordu & Hediye Kirli Akin & Eren Demir, 2021. "Healthcare systems and Covid19: Lessons to be learnt from efficient countries," International Journal of Health Planning and Management, Wiley Blackwell, vol. 36(5), pages 1476-1485, September.
    17. Böhm, Katharina & Schmid, Achim & Götze, Ralf & Landwehr, Claudia & Rothgang, Heinz, 2013. "Five types of OECD healthcare systems: Empirical results of a deductive classification," Health Policy, Elsevier, vol. 113(3), pages 258-269.
    18. R. D. Banker & A. Charnes & W. W. Cooper, 1984. "Some Models for Estimating Technical and Scale Inefficiencies in Data Envelopment Analysis," Management Science, INFORMS, vol. 30(9), pages 1078-1092, September.
    19. Groot, Wim & Maassen van den Brink, Henriette, 2007. "The health effects of education," Economics of Education Review, Elsevier, vol. 26(2), pages 186-200, April.
    20. Antonio Afonso & Miguel St. Aubyn, 2011. "Assessing health efficiency across countries with a two-step and bootstrap analysis," Applied Economics Letters, Taylor & Francis Journals, vol. 18(15), pages 1427-1430.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Pınar Kaya Samut & Reyhan Cafrı, 2016. "Analysis of the Efficiency Determinants of Health Systems in OECD Countries by DEA and Panel Tobit," Social Indicators Research: An International and Interdisciplinary Journal for Quality-of-Life Measurement, Springer, vol. 129(1), pages 113-132, October.
    2. Kristína Kočišová & Jakub Sopko, 2020. "The Efficiency of Public Health and Medical Care Systems in EU Countries: Dynamic Network Data Envelopment Analysis," Acta Universitatis Agriculturae et Silviculturae Mendelianae Brunensis, Mendel University Press, vol. 68(2), pages 383-394.
    3. Angelo Castaldo & Maria Alessandra Antonelli & Valeria De Bonis & Giorgia Marini, 2020. "Determinants of health sector efficiency: evidence from a two-step analysis on 30 OECD countries," Economics Bulletin, AccessEcon, vol. 40(2), pages 1651-1666.
    4. Pourmahmoud, Jafar & Bagheri, Narges, 2023. "Uncertain Malmquist productivity index: An application to evaluate healthcare systems during COVID-19 pandemic," Socio-Economic Planning Sciences, Elsevier, vol. 87(PA).
    5. Alvaro Almeida, 2024. "The trade-off between health system resiliency and efficiency: evidence from COVID-19 in European regions," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 25(1), pages 31-47, February.
    6. Muchen Luo & Yimin Wu, 2022. "Data-Driven Evaluation and Optimisation of Livelihood Improvement Efficiency," Sustainability, MDPI, vol. 14(13), pages 1-24, July.
    7. Mustapha D. Ibrahim & Sahand Daneshvar & Mevhibe B. Hocaoğlu & Olasehinde-Williams G. Oluseye, 2019. "An Estimation of the Efficiency and Productivity of Healthcare Systems in Sub-Saharan Africa: Health-Centred Millennium Development Goal-Based Evidence," Social Indicators Research: An International and Interdisciplinary Journal for Quality-of-Life Measurement, Springer, vol. 143(1), pages 371-389, May.
    8. Puertas, Rosa & Marti, Luisa & Guaita-Martinez, José M., 2020. "Innovation, lifestyle, policy and socioeconomic factors: An analysis of European quality of life," Technological Forecasting and Social Change, Elsevier, vol. 160(C).
    9. George Fragkiadakis & Michael Doumpos & Constantin Zopounidis & Christophe Germain, 2016. "Operational and economic efficiency analysis of public hospitals in Greece," Post-Print hal-01414677, HAL.
    10. Veronese da Silva, Aline & Costa, Marcelo Azevedo & Lopes-Ahn, Ana Lúcia, 2022. "Accounting multiple environmental variables in DEA energy transmission benchmarking modelling: The 2019 Brazilian case," Socio-Economic Planning Sciences, Elsevier, vol. 80(C).
    11. Gargi Sanati & Anup Kumar Bhandari, 2024. "Dynamics of Operational Efficiency in Credit Lending and Recovery of Stressed Assets: An Alternative Approach with Undesirable By-Products," Journal of Quantitative Economics, Springer;The Indian Econometric Society (TIES), vol. 22(2), pages 365-394, June.
    12. Cosmin Eugen ENACHE, 2012. "The efficiency of expenditure-related redistributive policies in the European countries," Timisoara Journal of Economics, West University of Timisoara, Romania, Faculty of Economics and Business Administration, vol. 5(18), pages 380-394.
    13. Sona Stikarova, 2014. "Economic growth, inequality and efficiency," Department of Economic Policy Working Paper Series 006, Department of Economic Policy, Faculty of National Economy, University of Economics in Bratislava.
    14. Tao Du, 2017. "Performance Measurement of Healthcare Service and Association Discussion between Quality and Efficiency: Evidence from 31 Provinces of Mainland China," Sustainability, MDPI, vol. 10(1), pages 1-19, December.
    15. Simar, Léopold & Wilson, Paul W., 2020. "Technical, allocative and overall efficiency: Estimation and inference," European Journal of Operational Research, Elsevier, vol. 282(3), pages 1164-1176.
    16. Varabyova, Yauheniya & Schreyögg, Jonas, 2013. "International comparisons of the technical efficiency of the hospital sector: Panel data analysis of OECD countries using parametric and non-parametric approaches," Health Policy, Elsevier, vol. 112(1), pages 70-79.
    17. Azar Dufrechou, Paola, 2016. "The efficiency of public education spending in Latin America: A comparison to high-income countries," International Journal of Educational Development, Elsevier, vol. 49(C), pages 188-203.
    18. Marianela Carrillo & Jesús M. Jorge, 2017. "DEA-Like Efficiency Ranking of Regional Health Systems in Spain," Social Indicators Research: An International and Interdisciplinary Journal for Quality-of-Life Measurement, Springer, vol. 133(3), pages 1133-1149, September.
    19. George Fragkiadakis & Michael Doumpos & Constantin Zopounidis & Christophe Germain, 2016. "Operational and economic efficiency analysis of public hospitals in Greece," Annals of Operations Research, Springer, vol. 247(2), pages 787-806, December.
    20. Sebastian Kohl & Jan Schoenfelder & Andreas Fügener & Jens O. Brunner, 2019. "The use of Data Envelopment Analysis (DEA) in healthcare with a focus on hospitals," Health Care Management Science, Springer, vol. 22(2), pages 245-286, June.

    More about this item

    Keywords

    Health system efficiency; Covid-19; DEA Bias-adjusted efficiency scores; Double bootstrap truncated regression;
    All these keywords.

    NEP fields

    This paper has been announced in the following NEP Reports:

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:hal:journl:hal-04350906. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: CCSD (email available below). General contact details of provider: https://hal.archives-ouvertes.fr/ .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.