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Comparative efficiency of national health systems: cross national econometric analysis
D B Evans1, A Tandon, C J Murray
1Global Programme on Evidence for Health Policy, World Health Organization, 1211 Geneva 27, Switzerland. evansd@who.int
Objective:
To improve the evidence base for health policy by devising a method to measure and monitor the performance of health systems.
Design:
Estimation of the relation between levels of population health and the inputs used to produce health.
Setting:
191 countries.
Main Outcome Measure:
Health system efficiency (performance).
Results:
Estimated efficiency varied from nearly fully efficient to nearly fully inefficient. Countries with a history of civil conflict or high prevalence of HIV and AIDS were less efficient. Performance increased with health expenditure per capita.
Conclusions:
Increasing the resources for health systems is critical to improving health in poor countries, but important gains can be made in most countries by using existing resources more efficiently.