Healthcare efficiency across GCC countries: an exploratory DEA study

Healthcare systems in the Gulf Cooperation Council (GCC) countries have expanded substantially in recent decades, accompanied by increasing healthcare expenditures. However, higher spending does not necessarily translate into proportionally better population health outcomes, highlighting the importance of evaluating healthcare expenditure efficiency.

This exploratory study assessed the relative efficiency of healthcare expenditure across GCC countries using Data Envelopment Analysis (DEA).

An exploratory cross-sectional comparative analysis was conducted across six GCC countries: Saudi Arabia, United Arab Emirates, Qatar, Kuwait, Bahrain, and Oman. Health expenditure per capita, expressed in purchasing power parity (PPP)-adjusted current international USD, was used as the input variable, while life expectancy at birth was used as the output variable. Data were obtained from the World Bank World Development Indicators and World Health Organization databases. An input-oriented variable returns to scale (VRS) DEA model was applied. Sensitivity analyses were conducted using alternative DEA specifications, including constant returns to scale (CRS), input-oriented, and output-oriented models.

Relative healthcare expenditure efficiency varied across GCC countries. Qatar and Oman were positioned on the efficiency frontier under the primary VRS model, whereas Bahrain and Kuwait showed relatively high efficiency scores. The United Arab Emirates and Saudi Arabia demonstrated comparatively lower scores. Sensitivity analyses produced broadly consistent findings. However, the results should be interpreted cautiously because of the exploratory design, limited number of decision-making units, and dependence of DEA estimates on model specification. DEA efficiency scores represent relative efficiency within the selected framework and should not be interpreted as direct measures of healthcare quality or overall health system performance.

Healthcare expenditure efficiency varied across GCC countries, suggesting that higher spending does not consistently correspond to better population health outcomes. These preliminary findings emphasize the importance of effective resource utilization. Future research using larger datasets, longitudinal designs, and broader health system indicators is needed.