Lupu Dan, Tiganasu Ramona
Alexandru Ioan Cuza University of Iasi, 700483, Carol I Boulevard, 22, Iasi, Romania.
Health Econ Rev. 2022 Feb 12;12(1):14. doi: 10.1186/s13561-022-00358-y.
This study aims at analyzing the efficiency of the health systems of 31 European countries in treating COVID-19, for the period January 1, 2020 - January 1, 2021, by incorporating some factors from a multidimensional perspective.
The methodology used in the research was Data Envelopment Analysis (DEA), through which efficiency scores for health systems have been calculated. The research was performed considering three stages: the first wave (January 1-June 15), the relaxation period (June 15-October 1) and the second wave (October 1-December 31). In evaluating the determinants of the efficiency of health systems, six major fields of influence were taken into account: health care, health status, population, economic, cultural/societal and governmental issues, all covering 15 indicators. After measuring the efficiency, we used the Tobit type regression to establish the influencing elements on it.
The results for the public health systems of European states were determined for each country and period. We evaluated the efficiency of health systems in Europe against COVID-19, starting from health inputs (COVID-19 cases, physicians, nurses, hospital beds, health expenditure) and output (COVID-19 deaths). The obtained outputs show that, especially in the first phase of the pandemic, the inefficiency of the health systems was quite high, mainly in Western countries (Italy, Belgium, Spain, UK). In the relaxation phase and in the second wave, the Western states, severely affected at the beginning of the pandemic, began to take adequate measures and improve the efficiency of their sanitary systems. Instead, Eastern European countries were hit hard by the inefficiency of health systems (Bulgaria, Greece, Hungary, Romania). After Tobit regression, results of the study show that the influencing elements are different for the three stages: concerning the first wave, comobirdities, population age, and population density are important; for relaxation period a great influence have government effectiveness and power distance; with respect to second wave, the relevant factors are education and population density.
The results obtained could serve as starting points for health policymakers to perform comparative analyzes in terms of good practices in the health system and to develop national plans to better deal with health crises. At the same time, they can be used internationally to achieve a coherent and effective community response to the pandemic.
本研究旨在通过从多维度视角纳入一些因素，分析2020年1月1日至2021年1月1日期间31个欧洲国家卫生系统治疗新冠病毒病的效率。
研究采用数据包络分析（DEA）方法，据此计算了卫生系统的效率得分。研究分三个阶段进行：第一波（1月1日至6月15日）、缓和期（6月15日至10月1日）和第二波（10月1日至12月31日）。在评估卫生系统效率的决定因素时，考虑了六个主要影响领域：医疗保健、健康状况、人口、经济、文化/社会和政府问题，共涵盖15项指标。在测量效率后，我们使用托比特类型回归来确定影响效率的因素。
确定了欧洲各国在每个国家和时期的公共卫生系统结果。我们从卫生投入（新冠病毒病病例、医生、护士、医院病床、卫生支出）和产出（新冠病毒病死亡人数）出发，评估了欧洲卫生系统应对新冠病毒病的效率。所得结果表明，尤其是在疫情的第一阶段，卫生系统的低效率相当高，主要集中在西方国家（意大利、比利时、西班牙、英国）。在缓和期和第二波疫情期间，在疫情初期受到严重影响的西方国家开始采取适当措施，提高其卫生系统的效率。相反，东欧国家受到卫生系统低效率的沉重打击（保加利亚、希腊、匈牙利、罗马尼亚）。经过托比特回归分析，研究结果表明三个阶段的影响因素各不相同：在第一波疫情中，合并症、人口年龄和人口密度很重要；在缓和期，政府效能和权力距离有很大影响；在第二波疫情中，相关因素是教育和人口密度。
所得结果可为卫生政策制定者在卫生系统良好实践方面进行比较分析以及制定更好应对卫生危机的国家计划提供起点。同时，这些结果可在国际上用于实现对该疫情的一致且有效的社区应对。
