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卫生系统效率:基于经合组织数据的碎片化图景。

Health System Efficiency: A Fragmented Picture Based on OECD Data.

作者信息

Behr Andreas, Theune Katja

机构信息

University of Duisburg-Essen, 45117, Essen, Germany.

出版信息

Pharmacoecon Open. 2017 Sep;1(3):203-221. doi: 10.1007/s41669-017-0010-y.

Abstract

BACKGROUND

Globally, health expenditure as a percentage of GDP has increased in recent years, so evaluating the health care systems used in different countries is an important tool for identifying best practices and improving inefficient health care systems.

OBJECTIVE

We investigate health system efficiency at the country level based on OECD health data. We focus on several aspects of health care systems to identify specific inefficiencies within them. This information hints at potential policy interventions that could improve specific parts of a country's health care system.

METHODS

A discussion is provided of ideal-typical evaluations of health systems, ignoring data restrictions, which provide the theoretical basis for an analysis performed under factual data restrictions. This investigation includes health care systems in 34 countries and is based on OECD health data. Health care system efficiency scores are obtained using data envelopment analysis (DEA). Relative productivity measures are calculated based on average DEA prices. Given the severe data limitations involved, instead of performing an all-encompassing analysis of each health care system, we focus on several aspects of each system, performing five partial analyses.

RESULTS

For each country, the efficiencies yielded by the five partial analyses varied considerably, resulting in an ambiguous picture of the efficiencies of the various health care systems considered. A synopsis providing comprehensive rankings of the analyzed countries is provided.

CONCLUSION

Analysis of several aspects of the health care systems considered here highlights potential improvements in specific areas of these systems, thereby providing information for policymakers on where to focus when aiming to improve a country's health care system.

摘要

背景

在全球范围内,卫生支出占国内生产总值的百分比近年来有所增加,因此评估不同国家所采用的医疗保健系统是识别最佳实践和改进低效医疗保健系统的重要工具。

目的

我们基于经合组织(OECD)的卫生数据,在国家层面调查卫生系统效率。我们关注医疗保健系统的几个方面,以识别其中的具体低效率之处。这些信息暗示了可能改善一个国家医疗保健系统特定部分的潜在政策干预措施。

方法

提供了对卫生系统理想类型评估的讨论,忽略数据限制,这为在实际数据限制下进行的分析提供了理论基础。这项调查涵盖34个国家的医疗保健系统,基于经合组织的卫生数据。使用数据包络分析(DEA)获得医疗保健系统效率得分。基于平均DEA价格计算相对生产率指标。鉴于所涉及的数据限制严重,我们没有对每个医疗保健系统进行全面分析,而是关注每个系统的几个方面,进行了五项局部分析。

结果

对于每个国家,五项局部分析得出的效率差异很大,导致对所考虑的各种医疗保健系统的效率情况呈现出模糊的图景。提供了一份对所分析国家进行综合排名的概要。

结论

对这里所考虑的医疗保健系统的几个方面进行分析,突出了这些系统特定领域的潜在改进之处,从而为政策制定者提供了在旨在改善一个国家的医疗保健系统时应关注哪些方面的信息。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2b57/5691836/202a881a4d59/41669_2017_10_Fig1_HTML.jpg

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