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BMC Health Services Research
Published in: BMC Health Services Research 1/2015

Open Access 01-06-2015 | Research article

Comparing efficiency of health systems across industrialized countries: a panel analysis

Authors: Bianca K. Frogner, H.E. Frech III, Stephen T. Parente

Published in: BMC Health Services Research | Issue 1/2015

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Abstract

Background

Rankings from the World Health Organization (WHO) place the US health care system as one of the least efficient among Organization for Economic Cooperation and Development (OECD) countries. Researchers have questioned this, noting simplistic or inappropriate methodologies, poor measurement choice, and poor control variables. Our objective is to re-visit this question by using newer modeling techniques and a large panel of OECD data.

Methods

We primarily use the OECD Health Data for 25 OECD countries. We compare results from stochastic frontier analysis (SFA) and fixed effects models. We estimate total life expectancy as well as life expectancy at age 60. We explore a combination of control variables reflecting health care resources, health behaviors, and economic and environmental factors.

Results

The US never ranks higher than fifth out of all 36 models, but is also never the very last ranked country though it was close in several models. The SFA estimation approach produces the most consistent lead country, but the remaining countries did not maintain a steady rank.

Discussion

Our study sheds light on the fragility of health system rankings by using a large panel and applying the latest efficiency modeling techniques. The rankings are not robust to different statistical approaches, nor to variable inclusion decisions.

Conclusions

Future international comparisons should employ a range of methodologies to generate a more nuanced portrait of health care system efficiency.
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Metadata
Title
Comparing efficiency of health systems across industrialized countries: a panel analysis
Authors
Bianca K. Frogner
H.E. Frech III
Stephen T. Parente
Publication date
01-06-2015
Publisher
BioMed Central
Published in
BMC Health Services Research / Issue 1/2015
Electronic ISSN: 1472-6963
DOI
https://doi.org/10.1186/s12913-015-1084-9

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