Evaluation of COVID-19 policy efficiency in 27 European OECD countries: a data envelopment analysis

BACKGROUND: The COVID-19 pandemic compelled governments worldwide to adopt diverse public health and economic policies. However, the relative efficiency of these interventions across European countries has not been comprehensively evaluated. This study assessed the efficiency of COVID-19 policy responses in 27 European countries of the Organization for Economic Co-operation and Development (OECD), with the aim of identifying factors associated with effective pandemic management. The time period of this study is from January 1, 2020 to December 31, 2022. METHODS: A data envelopment analysis (DEA) framework was applied to evaluate the efficiency of national responses. Policy inputs, including healthcare resources, economic support, and stringency indices, were assessed against outputs reflecting adverse outcomes, namely COVID-19 cases, mortality, and virus transmission. Data were obtained from the Oxford COVID-19 Government Response Tracker and other publicly available international databases. RESULTS: Marked heterogeneity in policy efficiency was observed. Countries that implemented early, stringent, and adaptive measures demonstrated superior efficiency scores. Italy, Greece, and Austria consistently ranked among the most efficient, while nations with delayed or inflexible strategies performed less effectively despite comparable resource availability. Importantly, policy flexibility and dynamic adjustment to epidemiological trends emerged as critical determinants of sustained efficiency. CONCLUSIONS: This study provides a robust comparative evaluation of COVID-19 policy efficiency across European OECD countries. The findings emphasize that timeliness of interventions, adaptability of policy measures, and judicious resource allocation were more influential than absolute resource capacity. Incorporating efficiency assessments into pandemic preparedness strategies may enhance resilience and inform evidence-based decision-making for future global health emergencies.