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Evaluating health systems' efficiency towards universal health coverage: A data envelopment analysis.
Paul Eze1, Chidumebi Judith Idemili2, Lucky Osaheni Lawani2
1Penn State University, University Park, PA, USA.
Summary
Most countries are inefficient in using health resources to achieve universal health coverage (UHC). Improving health system efficiency, focusing on primary health care (PHC) and governance, can boost UHC progress globally.
Area of Science:
- Health Systems Research
- Global Health Policy
- Health Economics
Background:
- Universal Health Coverage (UHC) is a global priority, aiming for equitable access to health services and financial protection.
- Assessing the technical efficiency of health systems is crucial for optimizing resource allocation towards UHC goals.
- Previous estimates indicate varying levels of UHC achievement across nations.
Purpose of the Study:
- To estimate the technical efficiency of health systems in 191 countries in achieving UHC.
- To identify socioeconomic and environmental factors influencing health system efficiency.
- To quantify the potential UHC improvements achievable through enhanced efficiency.
Main Methods:
- An output-oriented data envelopment analysis (DEA) was employed to assess technical efficiency.
- The UHC index (service coverage and financial protection) was the output, with per capita health expenditure, healthcare workforce, and hospital beds as inputs.
- Tobit regression with bootstrap analysis was used to examine influencing factors.
Main Results:
- The global UHC index averaged 76.9, with significant country-level variation (48.4 to 94.8).
- A substantial majority (78.5%) of countries demonstrated technical inefficiency in resource utilization for UHC.
- Efficiency gains could increase UHC indices by 4.1%–6.8% across income levels using current resources.
Conclusions:
- Health system inefficiency in achieving UHC is prevalent across all income levels and WHO regions.
- Strategic investments in primary health care (PHC), improved governance, and UHC legislation are key drivers of efficiency.
- Optimizing resource use through efficiency improvements offers a viable pathway to accelerate UHC progress globally.
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