What predicts the technical efficiency in healthcare systems of OECD countries? A two-stage DEA approach

ABSTRACT

Background: Waste in healthcare systems can only be revealed by performance measurements.

Aims: This study revealed the technical efficiency of healthcare systems and their determinants in the Organization for Economic Co-operation and Development countries.

Methods: We developed a data envelopment analysis (DEA) model and a panel Tobit regression model. Gross domestic product per capita, the economic growth rate, Gini Coefficient, the unemployment rate, 2008 global financial crisis, alcohol consumption, obesity and smoking rates, the ratio of dependent populations, and the ratio of university graduates were regressors in the panel Tobit. We employed a Simar and Wilson (2007) regression to check the robustness of Tobit results.

Results: Gross domestic product per capita and the ratio of university graduates significantly and negatively affected inefficiency scores (p < 0.05). The unemployment rate, Gini Coefficient, 2008 global financial crisis, alcohol consumption, obesity and smoking rates, and the ratio of dependent populations significantly and positively affected inefficiency scores (p < 0.05). The economic growth rate also positively affected inefficiency scores but it was not found to be significant (p > 0.05). Simar and Wilson (2007) results were found to be consistent with Tobit results.

Conclusions: Decision-makers should try to reveal the factors affecting the performance of healthcare systems.

KEYWORDS:

• Healthcare systems
• technical efficiency
• data envelopment analysis
• panel tobit
• Simar and Wilson (2007) regression

Acknowledgement

This study was produced from the doctoral thesis written by Murat KONCA under the supervision of Professor Mehmet TOP.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Notes on contributors

Murat Konca

PhD., Murat KONCA is a research assistant at the Department of Health Care Management at Karatekin University, Çankırı, Turkey. Interests cover health economics, health policy, and performance measurement in healthcare systems.

Mehmet Top

Prof., Mehmet TOP is a Professor at the Department of Health Care Management at Hacettepe University, Ankara, Turkey. Interests cover health economics, health policy, and performance measurement in healthcare systems.