Department of Commerce, School of Entrepreneurship and Management Studies, SRM University-AP, Amaravati, Andhra Pradesh, India.
Department of Economics, SRM University-AP, Amaravati, Andhra Pradesh, India.
Int J Health Plann Manage. 2021 Jul;36(4):1236-1250. doi: 10.1002/hpm.3169. Epub 2021 Apr 14.
This study assesses and compares the productive efficiency of the national healthcare system of the ASEAN region which includes Brunei, Cambodia, Indonesia, Laos, Malaysia, Myanmar, Philippines, Singapore, Thailand and Vietnam amidst rising mortality rate from noncommunicable diseases (NCDs) in the Sustainable Development Goals (SDGs) era. Nonparametric data envelopment analysis technique based on the Malmquist Productivity Index is performed and its components, total factor productivity change, technical change and technological change are compared across the region. Two different models are considered in assessing and comparing the technical efficiency of the national healthcare system across the region with life expectancy at birth and mortality rate from NCDs as parallel health care output for both the models. The mean value of total factor productivity is 0.983 and 0.974 which suggests that national healthcare system productivity efficiency decays by 1.7% for Model I and 2.6% for Model II, respectively. This suggests that the health care system inefficiencies across the ASEAN region have not made life expectancy to improve as much as it should be and curtailed the mortality rate from growing chronic NCDs within a decade. The region is likely to lag behind in achieving SDGs 3 target 4 on reducing by one-third premature mortality from chronic NCDs unless the health care system's technical efficiency is improved across the region. The finding suggests a microlevel study on each country to identify major sources of healthcare system inefficiency in a bid to ameliorate it.
本研究评估并比较了东盟地区（包括文莱、柬埔寨、印度尼西亚、老挝、马来西亚、缅甸、菲律宾、新加坡、泰国和越南）的医疗保健系统的生产效率，因为在可持续发展目标（SDGs）时代，非传染性疾病（NCDs）的死亡率不断上升。本研究采用基于 Malmquist 生产力指数的非参数数据包络分析技术，并比较了该地区的总要素生产率变化、技术变化和技术进步等各个组成部分。在评估和比较该地区各国医疗保健系统的技术效率时，本研究考虑了两种不同的模型，将出生时预期寿命和 NCD 死亡率作为两种模型的平行医疗保健产出。总要素生产率的平均值为 0.983 和 0.974，这表明模型 I 中的国家医疗保健系统生产力效率下降了 1.7%，模型 II 中的效率下降了 2.6%。这表明，东盟地区的医疗保健系统效率低下，导致出生时预期寿命的提高幅度不如预期，在十年内遏制了不断增长的慢性 NCD 的死亡率。除非该地区提高医疗保健系统的技术效率，否则该地区可能难以实现 SDGs 关于将慢性 NCD 导致的过早死亡率减少三分之一的目标 4。该研究结果表明，需要对每个国家进行微观层面的研究，以确定医疗保健系统效率低下的主要原因，并努力加以改善。
