Abstract
■■■In the last decades, demographic change coupled with new and expensive medical innovations have put most health care systems in developed countries under financial pressure. Therefore, ensuring efficient service provision is essential for a sustainable health care system. This paper investigates the performance of regional health care services in six West European countries between 2005 and 2014. We apply a stochastic metafrontier model to capture the different conditions in the health care systems in the countries within the European Union. By means of this approach, it is possible to detect performance differences in the European health care systems subject to different conditions and technologies relative to the potential technology available. The results indicate that regional deprivation plays a key role for the efficiency of health care provision. Furthermore, a pooled model which assumes a similar technology for all countries cannot sufficiently account for differences between countries. Surprisingly, the Scandinavian regions lag behind other regions with respect to the metafrontier.JEL ClassificationC23, D61, I12, I18, R10
Highlights
Demographic and social changes likely rise the burden of chronic diseases, like cancer, cardiovascular diseases, and diabetes
We show that the efficiency scores of the health care systems in a pooled model, which assumes a common technology for all countries, differ from the efficiency scores with respect to the metafrontier
To check the appropriateness of the metafrontier model, we apply a Likelihood Ratio (LR) test to test if technological differences between the countries are statistically significant
Summary
Demographic and social changes likely rise the burden of chronic diseases, like cancer, cardiovascular diseases, and diabetes. The increasing demand for new and innovative treatments and an increasing request for better value for money for patients at constant budgets raised the topic of value based care [31, 32]. In this sense, Porter [31] diagnoses a need to restructure the delivery of care to obtain sustainable health care budgets. Porter [31] diagnoses a need to restructure the delivery of care to obtain sustainable health care budgets Along these lines, the evaluation of the allocation and utilisation of medical resources is likely an important lever for the assessment of the performance of health care systems
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