Comparative efficiency of national health systems: cross national econometric analysis.

OBJECTIVE

To improve the evidence base for health policy by devising a method to measure and monitor the performance of health systems.

DESIGN

Estimation of the relation between levels of population health and the inputs used to produce health.

SETTING

191 countries.

MAIN OUTCOME MEASURE

Health system efficiency (performance).

RESULTS

Estimated efficiency varied from nearly fully efficient to nearly fully inefficient. Countries with a history of civil conflict or high prevalence of HIV and AIDS were less efficient. Performance increased with health expenditure per capita.

CONCLUSIONS

Increasing the resources for health systems is critical to improving health in poor countries, but important gains can be made in most countries by using existing resources more efficiently.