Decomposition of total factor productivity in world health production: a stochastic frontier approach

Abstract

While countries around the globe have increased spending on health care, economists and policy makers have raised concerns over the productivity and efficiency of health care. This article applies a stochastic frontier approach to address this issue using data from 141 countries for the period 1993 to 1997. From the perspective of productivity change, our results suggest that gains in population health will be greater provided that more resources are allocated to investment in human capital. We also show that the scale component accounts for 65–70% of the productivity change. That is, omitting the scale component in our case will result in a significant underestimation of the decline in the productivity of world health production. We do not find evidence supporting the hypothesis that production frontiers differ between Organization for Economic Cooperation and Development (OECD) and non-OECD countries. However, the change in productivity and scale elasticity do vary significantly between these countries.

Acknowledgements

We are grateful to Drs David Evans, Ajay Tandon, Christopher Murray and Jeremy Laurer and the WHO for allowing us to use their data.

Notes

¹ We would like to thank an anonymous referee for bringing this issue to our attention.