Assessing the efficiency of countries in making progress towards universal health coverage: a data envelopment analysis of 172 countries
Introduction Maximising efficiency of resources is critical to progressing towards universal health coverage (UHC) and the sustainable development goal (SDG) for health. This study estimates the technical efficiency of national health spending in progressing towards UHC, and the environmental factor...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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BMJ Publishing Group
2020-10-01
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| Series: | BMJ Global Health |
| Online Access: | https://gh.bmj.com/content/5/10/e002992.full |
| _version_ | 1826937552811065344 |
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| author | Hassan Haghparast-Bidgoli Gerard Joseph Abou Jaoude Emma Jordi Caitlin Pley Matthew Jowett |
| author_facet | Hassan Haghparast-Bidgoli Gerard Joseph Abou Jaoude Emma Jordi Caitlin Pley Matthew Jowett |
| author_sort | Hassan Haghparast-Bidgoli |
| collection | DOAJ |
| description | Introduction Maximising efficiency of resources is critical to progressing towards universal health coverage (UHC) and the sustainable development goal (SDG) for health. This study estimates the technical efficiency of national health spending in progressing towards UHC, and the environmental factors associated with efficient UHC service provision.Methods A two-stage efficiency analysis using Simar and Wilson’s double bootstrap data envelopment analysis investigates how efficiently countries convert health spending into UHC outputs (measured by service coverage and financial risk protection) for 172 countries. We use World Bank and WHO data from 2015. Thereafter, the environmental factors associated with efficient progress towards UHC goals are identified.Results The mean bias-corrected technical efficiency score across 172 countries is 85.7% (68.9% for low-income and 95.5% for high-income countries). High-achieving middle-income and low-income countries such as El Salvador, Colombia, Rwanda and Malawi demonstrate that peer-relative efficiency can be attained at all incomes. Governance capacity, income and education are significantly associated with efficiency. Sensitivity analysis suggests that results are robust to changes.Conclusion We provide a 2015 baseline for cross-country UHC technical efficiency scores. If countries wish to improve their UHC outputs within existing budgets, they should identify their current efficiency and try to emulate more efficient peers. Policy-makers should focus on strengthening institutions and implementing known best practices to replicate efficient systems. Using resources more efficiently is likely to positively impact UHC coverage goals and health outcomes, and without addressing gaps in efficiency progress towards achieving the SDGs will be impeded. |
| first_indexed | 2024-12-21T14:13:50Z |
| format | Article |
| id | doaj.art-cbd8165e08514d55ab5909c85e6f18b7 |
| institution | Directory Open Access Journal |
| issn | 2059-7908 |
| language | English |
| last_indexed | 2025-02-17T18:42:14Z |
| publishDate | 2020-10-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Global Health |
| spelling | doaj.art-cbd8165e08514d55ab5909c85e6f18b72024-12-11T17:55:10ZengBMJ Publishing GroupBMJ Global Health2059-79082020-10-0151010.1136/bmjgh-2020-002992Assessing the efficiency of countries in making progress towards universal health coverage: a data envelopment analysis of 172 countriesHassan Haghparast-Bidgoli0Gerard Joseph Abou Jaoude1Emma Jordi2Caitlin Pley3Matthew Jowett4Institute for Global Health, University College London, London, UKInstitute for Global Health, University College London, London, UKInstitute for Global Health, University College London, London, UKSchool of Clinical Medicine, University of Cambridge, Cambridge, Cambridgeshire, UKHealth Financing and Governance, World Health Organization, Geneva, SwitzerlandIntroduction Maximising efficiency of resources is critical to progressing towards universal health coverage (UHC) and the sustainable development goal (SDG) for health. This study estimates the technical efficiency of national health spending in progressing towards UHC, and the environmental factors associated with efficient UHC service provision.Methods A two-stage efficiency analysis using Simar and Wilson’s double bootstrap data envelopment analysis investigates how efficiently countries convert health spending into UHC outputs (measured by service coverage and financial risk protection) for 172 countries. We use World Bank and WHO data from 2015. Thereafter, the environmental factors associated with efficient progress towards UHC goals are identified.Results The mean bias-corrected technical efficiency score across 172 countries is 85.7% (68.9% for low-income and 95.5% for high-income countries). High-achieving middle-income and low-income countries such as El Salvador, Colombia, Rwanda and Malawi demonstrate that peer-relative efficiency can be attained at all incomes. Governance capacity, income and education are significantly associated with efficiency. Sensitivity analysis suggests that results are robust to changes.Conclusion We provide a 2015 baseline for cross-country UHC technical efficiency scores. If countries wish to improve their UHC outputs within existing budgets, they should identify their current efficiency and try to emulate more efficient peers. Policy-makers should focus on strengthening institutions and implementing known best practices to replicate efficient systems. Using resources more efficiently is likely to positively impact UHC coverage goals and health outcomes, and without addressing gaps in efficiency progress towards achieving the SDGs will be impeded.https://gh.bmj.com/content/5/10/e002992.full |
| spellingShingle | Hassan Haghparast-Bidgoli Gerard Joseph Abou Jaoude Emma Jordi Caitlin Pley Matthew Jowett Assessing the efficiency of countries in making progress towards universal health coverage: a data envelopment analysis of 172 countries BMJ Global Health |
| title | Assessing the efficiency of countries in making progress towards universal health coverage: a data envelopment analysis of 172 countries |
| title_full | Assessing the efficiency of countries in making progress towards universal health coverage: a data envelopment analysis of 172 countries |
| title_fullStr | Assessing the efficiency of countries in making progress towards universal health coverage: a data envelopment analysis of 172 countries |
| title_full_unstemmed | Assessing the efficiency of countries in making progress towards universal health coverage: a data envelopment analysis of 172 countries |
| title_short | Assessing the efficiency of countries in making progress towards universal health coverage: a data envelopment analysis of 172 countries |
| title_sort | assessing the efficiency of countries in making progress towards universal health coverage a data envelopment analysis of 172 countries |
| url | https://gh.bmj.com/content/5/10/e002992.full |
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