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.