Efficiency and productivity of the health systems of the countries of the European Union.

Authors

  • Juan Cándido Gómez Gallego Departamento de Economía Financiera y Contabilidad, Universidad Católica de Murcia, España. e-mail: jcandido@ucam.edu
  • Javier Fernando García García Departamento Ciencias de la Salud, Universidad Católica de Murcia, España. e-mail: fggar@gmail.com
  • María Gómez Gallego Departamento Ciencias de la Salud, Universidad Católica de Murcia, España. e-mail: mggallego@ucam.edu

DOI:

https://doi.org/10.25115/eea.v37i2.2613

Keywords:

Health systems, efficiency, DEA-bootstrap, Malmquist index

Abstract

In this paper the technical efficiency of the health systems of 28 UE countries is analyzed. Such analysis assumes the cross-efficiency calculations and the valuation of productivity changes between the years 2012-2015. The source of data is the Eurostat online database. DEA- bootstrap is applied and Malmquist index are calculated. The results appears co confirm that EU countries have suffered a small increase in productivity in HS, which is related with positive changes in efficiency but not in technology. Even so, further research should be necessary to find the latent factors to explain the productivity levels of the HS in EU.

Downloads

Download data is not yet available.

References

AFONSO, A., AUBYN, M. (2005). “Non-parametric approaches to education and health efficiency in OECD countries”. Journal of Applied Economics, 8(2), 227-246.

AFONSO, A., AUBYN, M. (2011). “Assessing health efficiency across countries with a two-step and bootstrap analysis”. Applied Economics Letters, 18 (15), 1427-1430.

ANDERSON, T.R., HOLLINGSWORTH, K., INMAN, L. (2002). “The fixed weighting nature of a cross-evaluation model”. Journal of Productivity Analysis, 17 (3), 249–255.

ANTOÑANZAS, F., JUÁREZ-CASTELLÓ C.A., RODRÍGUEZ-IBEAS, R. (2016). “Improving health care systems by building ‘more Europe". European Journal of Health Economics, 17, 787-789.

ASANDULUIA, L., ROMANB, M., FATULESCUA, P. (2014). “The efficiency of healthcare systems in Europe: a data envelopment analysis approach”. Procedia Economics and Finance, 10 (26), 261-268.

BALK, B.M. (2001). “Scale efficiency and productivity change”. Journal of Productivity Analysis, 15 (3), 159-183.

BANKER, R.D., CHARNES, A., COOPER, W.W. (1984): “Some models for estimating technical and scale inefficiencies in Data Envelopment Analysis”. Manage. Sci. 30, 1078-1092.

CHARNES, A., COOPER, W.W. (1984). “Some models for estimating technical and scale inefficiencies in Data Envelopment Analysis”. Manage. Sci. 30, 1078-1092.

CAVES, D.W., CHRISTENSEN, L.R., DIEWERT W.E.(1982). “The economic theory of index numbers and the measurement of input, output, and productivity”. Econometrica: J Econometric Soc., 1, 1393–1414.

CHARNES, A., COOPER, W.W., RHODES, E. (1978). “Measuring the efficiency of decision-making units”.

European Journal of Operational Research, 2, 429-444.

COOPER, W.W., SEIFORD, L.M., TONE, K. (2007). Data Envelopment Analysis, Springer.

DEBREU, G. (1951). “The Coefficient of Resource Utilization”. Econométrica, 19 (3): 273–292.

DE VOGLI, R., MISTRY, R., GNESOTTO, R., CORNIA, G.A. (2005). “Has the relation between income inequality and life expectancy disappeared? Evidence from Italy and top industrialized countries”. Journal of Epidemiology and Community Health, 59 (2), 158–162.

DOYLE, J., & GREEN, R. (1994). “Efficiency and cross-efficiency in DEA: Derivations, meanings and uses”. Journal of the operational research society, 45 (5), 567-578.

FARRELL, M.J. (1957). “The measurement of productive efficiency”. Journal of the Royal Statistical Society. Series A, 120 (3), 253-281.

GEARHART, R. (2016). “No Theory: An Explanation of the Lack of Consistency in Cross-Country Health Care Comparisons Using Non-Parametric Estimators.” Health Economics Review, 6, 40.

GEORGIOU, G. (2010). “The Budget of the European Union and its Contribution to Finance Programs for Health and Consumer Protection”. European Planning Studies, 9 (8), 1031-1038.

GONZÁLEZ, E., CÁRCABA, A., VENTURA, J. (2010). “Value efficiency analysis of health systems: public financing does play a role?” Journal of Public Health, 18, 337-350.

GRIFELL-TATJÉ, E., LOVELL, C.A.K. (1997). “The Sources of Productivity Change in Spanish Banking”. European Journal of Operational Research 98 (2), 364-380.

HERNÁNDEZ, P., MORAL-BENITO, E.(2014). “Determinants of health-system efficiency: evidence from OECD countries”. International Journal of Health Economics and Management, 14, 69-93.

JACOBS, R, SMITH, P.C, STREET, A. (2006). “Measuring efficiency in health care: analytic techniques and health policy. Cambridge Univ. Pr.

KOOPMANS, T.C. (1951). Analysis of production as an efficient combination of activities. In: Koopmans, T.C. (Eds.). Activity Analysis of Production and Allocation. Wiley, New York, 33-97.

LEITNER, S. (2015). “Effects of income inequality on publication health and social outcomes at the regional level in the EU”. No. 113. The Vienna Institute for International Economic Studies, Wiener Institut für Internationale Wirtschaftsvergleiche.

LEWIN, A.Y. & R.C. MOREY (1981). “Measuring the Output Potential of Public Sector Organizations: An Application of Data Envelopment Analysis”. Int. J Policy Analysis and Information Systems, 5 (4): 267-285.

LIANG, L., WU, J., COOK, W. D., & ZHU, J. (2008). “The DEA game cross-efficiency model and its Nash equilibrium”. Operations research, 56 (5), 1278-1288.

MIRZOSAID, S. (2011). “Health expenditure efficiency in the Commonwealth of Independent States: A data envelopment analysis approach”. Transition Studies Review, 18,384-404.

MORENO-ENGUIX, M.R., GÓMEZ-GALLEGO, J.C., GÓMEZ-GALLEGO, M. (2017). “Analysis and determination the efficiency of then European health systems”. Int J Health Plann. Mgmt., 33, 136-154.

NUTI, S., DARAIO, C., SPERONI, C., VAINIERI, M. (2011). “Relationships between technical efficiency and the quality and costs of health care in Italy”. International Journal for Quality in Health Care, 23(3), 324-330.

PÉREZ-CÁRCELES, M.C., GÓMEZ-GALLEGO, J.C., GÓMEZ- GALLEGO, M. (2017). “Environmental factors affecting European and Central Asian health-systems’ bias-corrected efficiency”. Applied Economics, 50 (32), 3432-3440.

QUAGLIO, G., KARAPIPERIS, T., VAN WOENSEL, L., ARNOLD, E.; MCDAID, D. (2013). Austerity and health in Europe. Health Policy, 113(1), 13-19.

RETZLAFF-ROBERTS, D., CHAN, C.F., RUBIN, R.M. (2004). “Technical efficiency in the use of health care resources: a comparison of OECD countries”. Health Policy, 69, 55-72.

SAURINA, C., VALL-LLORESA, L., SÁEZ, M. (2012). “Factors determining access to and use of primary health care services in the Girona health region". European Journal of Health Economics, 13 (4), 419-427.

SEXTON, T.R., SILKMAN, R.H. & HOGAN, A.J., (1986). “Data Envelopment Analysis: critique and extensions, en R.H. In: Silkman R.H. (ed.): Measuring efficiency: an assessment of Data Envelopment Analysis, Jossey-Bass, San Francisco. CA, 73–105.

SHEPHARD, R.W. (1953). Cost and production functions. Princeton.

SHEPHARD, R.W. (1970). Theory of cost and production functions.Princeton.

SIMAR, L., WILSON, P.W. (1998): “Sensitivity analysis of efficiency scores: how to bootstrap in nonparametric frontier models”. Management Science, 44 (4), 49-61.

SIMAR, L., WILSON, P.W. (2007). “Estimation and inference in two-stage. Semi-parametric models of production processes”. Journal of Econometrics, 136 (1), 31-64.

SORENSON, C., DRUMMOND, M., BHUIYAN KHAN, B. (2013). “Medical technology as a key driver of rising health expenditure: disentangling the relationship”. Clinico economics and Outcomes Research, 5, 223-234.

SPINKS, J., HOLLINGSWORTH, B. (2009). “Cross-country comparisons of technical efficiency of health production: a demonstration of pitfalls”. Applied Economics, 41, 417-427.

TUDOREL, A., MITRUT, C., CONSTANTIN, D., OANCEA, L. (2009). "The Impact of Decentralization on Public Health System’s Results. The Case of Romania". Theoretical and Applied Economics, Asociatia Generala a Economistilor din Romania-AGER, 10(10(539)), 17-22.

VARABYOVA, Y., MÜLLER, J.M. (2016). “The efficiency of health care production in OECD countries: A systematic review and meta-analysis of cross-country comparisons”. Health Policy, 120, 252-263.

Published

2019-10-08