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Measuring the efficiency of health systems in Asia: A data envelopment analysis

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Ahmed, Sayem, Hasan, Zahid, MacLennan, Mary, Dorin, Farzana, Ahmed, Mohammad Wahid, Hasan, Mehedi, Hasan, Shaikh Mehdi, Islam, Mohammad Touhidul and Khan, Jahangir (2019) 'Measuring the efficiency of health systems in Asia: A data envelopment analysis'. BMJ Open, Vol 9, e022155.

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Abstract

OBJECTIVE:
This study aims to estimate the technical efficiency of health systems in Asia.
SETTINGS:
The study was conducted in Asian countries.
METHODS:
We applied an output-oriented data envelopment analysis (DEA) approach to estimate the technical efficiency of the health systems in Asian countries. The DEA model used per-capita health expenditure (all healthcare resources as a proxy) as input variable and cross-country comparable health outcome indicators (eg, healthy life expectancy at birth and infant mortality per 1000 live births) as output variables. Censored Tobit regression and smoothed bootstrap models were used to observe the associated factors with the efficiency scores. A sensitivity analysis was performed to assess the consistency of these efficiency scores.
RESULTS:
The main findings of this paper demonstrate that about 91.3% (42 of 46 countries) of the studied Asian countries were inefficient with respect to using healthcare system resources. Most of the efficient countries belonged to the high-income group (Cyprus, Japan, and Singapore) and only one country belonged to the lower middle-income group (Bangladesh). Through improving health system efficiency, the studied high-income, upper middle-income, low-income and lower middle-income countries can improve health system outcomes by 6.6%, 8.6% and 8.7%, respectively, using the existing level of resources. Population density, bed density, and primary education completion rate significantly influenced the efficiency score.
CONCLUSION:
The results of this analysis showed inefficiency of the health systems in most of the Asian countries and imply that many countries may improve their health system efficiency using the current level of resources. The identified inefficient countries could pay attention to benchmarking their health systems within their income group or other within similar types of health systems.

Item Type: Article
Subjects: WA Public Health > Health Problems of Special Population Groups > WA 395 Health in developing countries
WA Public Health > Statistics. Surveys > WA 900 Public health statistics
WA Public Health > Statistics. Surveys > WA 950 Theory or methods of medical statistics. Epidemiologic methods
Faculty: Department: Clinical Sciences & International Health > Clinical Sciences Department
Digital Object Identifer (DOI): https://doi.org/10.1136/bmjopen-2018-022155
Depositing User: Stacy Murtagh
Date Deposited: 01 Apr 2019 15:04
Last Modified: 04 Apr 2019 14:33
URI: http://archive.lstmed.ac.uk/id/eprint/10068

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