Efficiency Of Health Care System Research Articles

The Application of Data Envelopment Analysis in Healthcare Performance Evaluation of Rehabilitation Departments in Hungary

Purpose: Performance evaluation is a general problem both in production and service systems. Generally, operation performance is determined based on input resource utilization and on outputs related data. Performance evaluation is especially complicated when both financial and nonfinancial indicators must be considered in the evaluation of the efficiency of healthcare system. The purpose of this paper is to apply data envelopment analysis (DEA) in order to measure the efficiency of rehabilitation departments curing musculoskeletal diseases.Methodology/Approach: The evaluation of the efficiency of rehabilitation departments includes several parameters. Performance evaluation becomes complicated when several evaluation criteria must be taken into consideration at the same time. In these cases, scoring methods are generally used, which transform performance data into a common scale and an aggregate score is calculated with subjective weights. Using DEA the subjective element of evaluation is eliminated when the weights of inputs and outputs are determined.Findings: The applied DEA model evaluates the performance of rehabilitation departments. The presented analysis highlights the differences between the efficiency of the studied departments, and explores inefficiencies related to economies of scale. The slack values directly show the operational shortcomings in specific areas, and indicate the exact amount of the required changes.Research Limitation/implication: The applied DEA model evaluates the performance of rehabilitation departments. The presented analysis highlights the differences between the efficiency of the studied departments, and explores inefficiencies related to economies of scale. The slack values directly show the operational shortcomings in specific areas, and indicate the exact amount of the required changes.Originality/Value of paper: The originality of the paper lies on the identification of inputs and outputs for the applied DEA model as only nonfinancial indicators were taken into consideration. The analysis involves all rehabilitation departments of the Hungarian healthcare system; consequently, conclusions related to the general state of this area can be drawn.

Public and Private Hospital Care Disparities of Ischemic Stroke in Mexico: Results from the Primer Registro Mexicano de Isquemia Cerebral (PREMIER) Study

Mortality and bad outcome by stroke are higher in developing countries than in industrialized countries. Health-care system efficiency could explain these disparities. Our objective was to identify the impact on short- and middle-term outcomes of patients with acute ischemic stroke (AIS) among public and private Mexican medical care. We analyzed data from patients with AIS included in the Primer Registro Mexicano de Isquemia Cerebral (PREMIER) study. Transient ischemic attacks (TIAs) and ambulatory patients were excluded. Mortality and good outcome were assessed by the modified Rankin Scale (mRS) and analyzed at 1, 3, and 12 months of follow-up. From 1246 patients with AIS included in the registry, 1123 were hospitalized, either in public (n = 881) or in private (n = 242) hospitals. There were no significant differences regarding age and gender. In private settings, patients had a higher educational level, a major frequency of dyslipidemia, a previous stroke and TIA, less overweight and obesity, a sedentary lifestyle, and diabetes; stroke severity, the rate of systemic complications, the length of stay, and in-hospital mortality were also lower; a major frequency of thrombolysis was observed when compared with public hospitals. Our study showed a better outcome (mRS score ≤2) in private scenarios and a higher mortality in patients treated in public hospitals at short- and middle-term follow-ups. A polarized medical practice was observed in the AIS care in this large multicenter cohort of Mexico. There is evidence of an advantage for private scenarios, possibly related with an optimal infrastructure or with a strong patient's economic status.

Paving the road to personalized medicine: recommendations on regulatory, intellectual property and reimbursement challenges.

Personalized medicine (PM) aims to harness a wave of ‘omics’ discoveries to facilitate research and discovery of targeted diagnostics and therapies and increase the efficiency of healthcare systems by predicting and treating individual predispositions to diseases or conditions. Despite significant investment, limited progress has been made bringing PM to market. We describe the major perceived regulatory, intellectual property, and reimbursement challenges to the development, translation, adoption, and implementation of PM products into clinical care. We conducted a scoping review to identify (i) primary challenges for the development and implementation of PM identified in the academic literature; (ii) solutions proposed in the academic literature to address these challenges; and (iii) gaps that exist in that literature. We identified regulatory barriers to PM development and recommendations in 344 academic papers. Regulatory uncertainty was a cross-cutting theme that appeared in conjunction with other themes including: reimbursement; clinical trial regulation; regulation of co-development; unclear evidentiary requirements; insufficient incentives for research and development; incompatible information systems; and different regulation of different diagnostics. To fully realize the benefits of PM for healthcare systems and patients, regulatory, intellectual property, and reimbursement challenges need to be addressed in lock step with scientific advances.

Simulation as a tool for evaluating intelligent self-care systems managing chronic disease patients

Introduction: The world is facing an aging population and along with that an increase in the quantity of those with chronic conditions. So a substantial amount of human and material resources in Health Care System(HCS) will be demanded or is caused long waiting times at different stages along the services and at the end the quality of HCS will decrease. Chronic patients need to access HCS very often, so controlling and reducing the visiting time of these patients could help to improve HCS efficiency. Using an intelligent monitoring system can be a well-thought out solution to improve HCS service quality. In this system medical staff and patients constantly interact with various electronic devices. Vital signs and health histories of patient are stored on and being transmitted between these devices, so patient will being monitored by distance and system will be updated by receiving patient’s data periodically. This semi-automatic system can work in three steps, first when the system predicts a problem, sends a recommendation to the patient. Second if first step didn’t work, an on-line expert attempts to assist the patient. Third if system cannot help you, it will advise you to visit the hospital by receiving an appointment through system. Then we can reduce the quantity of unnecessary visits in HCS. The implementation of a system of this nature would imply a strong economic investment and significant resources, however, the use of simulation gives us the possibility to create this semi-automatic system virtually and evaluate its size and be compared its quality to the quality of current HCS. Method: An agent-based model (ABM) is a class of computational models for simulating the actions and interactions of entities. We used ABM to simulate the system from bottom up. In this model the interactions are among patients, healthcare staff and physical resources in HCS. The supposed system can have capacity to save the information of patient, this include the personal data of patients and information and histories about their diseases. Progress report: We have defined a general model of patients and a model of interaction of patients with the system in which the predictions, recommendations, online help or dating are made. We are now working on the simulator and the design of the experimental phase Discussion: The proposed system not only can help us to improve the efficiency of HCS by decreasing number of personal visit by distance managing and online treating but also can prevent people from illness.in this system patient depends on their urgent situation can visit the HCS in best schedule of health care system. Conclusion: A simulation of a HCS using the intelligent model make us able to consider the mentioned system behavior in a virtual setting and can help us to best use of resources in the real world. Although simulation can investigate possibility and capability of system before implementation by analyzing the system, suggested model and behavior of patient and medical staff. This research has been supported by MINECO SPAIN under contract TIN2014-53172-P

Efficiency Analysis of Integrated Public Hospital Networks in Outpatient Internal Medicine.

Healthcare systems are evolving towards a complex network of interconnected services due to the increasing costs and the increasing expectations for high service levels. It is evidenced in the literature the importance of implementing management techniques and sophisticated methods to improve the efficiency of healthcare systems, especially in emerging economies. This paper proposes an integrated collaboration model between two public hospitals to reach the reduction of weighted average lead time in outpatient internal medicine department. A strategic framework based on value stream mapping and collaborative practices has been developed in real case study settled in Colombia.

Technical efficiency of rural primary health care system for diabetes treatment in Iran: a stochastic frontier analysis

BackgroundOur aim was to explore the technical efficiency (TE) of the Iranian rural primary healthcare (PHC) system for diabetes treatment coverage rate using the stochastic frontier analysis (SFA) as well as to examine the strength and significance of the effect of human resources density on diabetes treatment.MethodsIn the SFA model diabetes treatment coverage rate, as a output, is a function of health system inputs (Behvarz worker density, physician density, and rural health center density) and non-health system inputs (urbanization rate, median age of population, and wealth index) as a set of covariates. Data about the rate of self-reported diabetes treatment coverage was obtained from the Non-Communicable Disease Surveillance Survey, data about health system inputs were collected from the health census database and data about non-health system inputs were collected from the census data and household survey.ResultsIn 2008, rate of diabetes treatment coverage was 67% (95% CI: 63%–71%) nationally, and at the provincial level it varied from 44% to 81%. The TE score at the national level was 87.84%, with considerable variation across provinces (from 59.65% to 98.28%).Among health system and non-health system inputs, only the Behvarz density (per 1000 population)was significantly associated with diabetes treatment coverage (β (95%CI): 0.50 (0.29–0.70),p < 0.001).ConclusionOur findings show that although the rural PHC system can considered efficient in diabetes treatment at the national level, a wide variation exists in TE at the provincial level. Because the only variable that is predictor of TE is the Behvarz density, the PHC system may extend the diabetes treatment coverage by using this group of health care workers.

New decision-making processes for the pricing of health technologies in Japan: The FY 2016/2017 pilot phase for the introduction of economic evaluations

Economic evaluation is used for decision-making processes in healthcare technologies in many developed countries. In Japan, no health economic data have been requested for drugs, medical devices, and interventions till date. However, economic evaluation is gradually gaining importance, and a trial implementation of the cost-effectiveness evaluation of drugs and medical devices has begun. Discussions on economic evaluation began in May 2012 within a newly established sub-committee of the Chuikyo, referred to as the "Special Committee on Cost Effectiveness." After four years of discussions, this committee determined that during the trial implementation, the results of the cost-effectiveness evaluation would be used for the re-pricing of drugs and medical devices at the end of fiscal year (FY) 2017. Chuikyo selected 13 products (7 drugs and 6 medical devices) as targets for this evaluation. These products will be evaluated until the end of FY 2017 based on the following process: manufacturers will submit the data of economic evaluation; the National Institute of Public Health will coordinate the review process; academic groups will perform the actual review of the submitted data, and the expert committee will appraise these data. This represents the first step to introducing cost-effectiveness analysis in the Japanese healthcare system. We believe that these efforts will contribute to the efficiency and sustainability of the Japanese healthcare system.

Developing a comprehensive information security framework for mHealth: a detailed analysis

It has been clearly shown that mHealth solutions, which is the use of mobile devices and other wireless technology to provide healthcare services, deliver more patient-focused healthcare, and improve the overall efficiency of healthcare systems. In addition, these solutions can potentially reduce the cost of providing healthcare in the context of the increasing demands of the aging populations in advanced economies. These solutions can also play an important part in intelligent environments, facilitating real-time data collection and input to enable various functionalities. However, there are several challenges regarding the development of mHealth solutions: the most important of these being privacy and data security. Furthermore, the use of cloud computing is becoming an option for the healthcare sector to store healthcare data; but storing data in the cloud raises serious concerns. This paper investigates how data are managed both on mHealth devices as well as in the cloud. Firstly, a detailed analysis of the entire mHealth domain is undertaken to determine domain-specific features and a taxonomy for mHealth, from which a set of security requirements are identified in order to develop a new information security framework. It then examines individual information security frameworks for mHealth devices and the cloud, noting similarities and differences. Furthermore, key mechanisms to implement the new framework are discussed and the new framework is then presented. Finally, the paper presents how the new framework could be implemented in order to develop an Advanced Digital Medical Platform.

The determinants and costs of bypassing small hospitals in a ‘free’ health system: A cross sectional study in Sri Lanka

Background: Rising out-of-pocket health expenditure due to policy issues is a major factor contributing to deterioration of efficiency and equity of healthcare systems. Objective: The objective of this study was to estimate the determinants of bypassing divisional hospitals in Sri Lanka, and to estimate the effect of bypassing behaviour on the direct out of pocket costs of the patients. Methods: The study employed a hospital based cross sectional analytical design. Out patients department of District General Hospital – Gampaha was selected as the referral facility. Out patients departments of the two selected divisional hospitals were selected as the bypassed facilities. The patients who bypassed the two divisional hospitals and attended the out patients department of the general hospital were identified using a screening tool and a map. The reasons for bypassing were evaluated among those who bypassed. Out of pocket costs of the bypassed were assessed using an interviewer administered questionnaire and compared with the patients who did not bypass the divisional hospitals. Bivariate analysis of the out of pocket expenditure was performed using the Mann-Whitney test, placing the level of significance at 0.05. Results: Patients who bypassed the divisional hospitals were more likely to be married, permanently employed, and have monthly incomes above Rs. 20000. The mean out of pocket expenditure for travelling of bypassed patients and their family members was more than four folds higher than those who did not bypass. The out of pocket expenditure on meals and snacks was also higher among the bypassed. However, more patients among the bypassed group had to spend on outside purchase of medicine and investigations. The average out of pocket expenditure among the bypassed group was about 75% greater than (Rs 63/= more) their counterparts who did not bypass. Conclusions: Bypassing increases the out of pocket expenditure of patients. A primary care based model with designated draining areas and proper referral policies would help to address the issue.

Security and privacy for cloud-based data management in the health network service chain: a microservice approach

New and useful tools that facilitate the harmonization and interconnection of health data have become a requirement for monitoring and preventing illness and also for sharing medical knowledge. Nowadays, cloud-based solutions can support collaborative data science platforms and deliver all types of processing operations through the network service chain. In this article we deal with healthcare-related data management and exchange, and we propose security and privacy requirements together with a novel microservices approach. We investigate how cloud computing can be adopted within healthcare systems. The interoperability of existing technologies will improve the quality of life and the efficiency of healthcare systems by making them more personalized and centered on patients, together with reducing operational costs and medical errors. To have a socially acceptable health network service chain, the security and privacy issues need to be analyzed and addressed. We explore the the security and privacy requirements and implications, and also discuss existing methods, and in the end propose an architecture of a secure manager for cloud-based healthcare-related data management and exchange.

Potential Solutions for Sustaining the Costs of Cancer Drugs

The growing burden of cancer urgently requires sustainable solutions to ensure continued access to effective and safe treatments for all patients within Europe. The aim of this article, the third in a series of perspectives, is to discuss potential approaches to sustain cancer care and increase patient access to treatments. Much work remains to ensure the sustainability ceiling (where costs of care exceed the benefits) is not reached. Immediate steps must be taken to avoid this, including patient education to encourage earlier diagnosis, use of treatment-response biomarkers, improving efficiency of healthcare systems, use of managed-entry agreements, introduction of value-based medicines with measurable outcomes and use of less expensive medicines. Here we discuss these potential solutions with a focus on reducing the cost of cancer drugs, using biosimilar medicines as an example. Biosimilar and generic medicines offer a cost-effective treatment option that may help combat the substantially increasing costs of cancer drugs. Competition from biosimilar medicines is expected to drive a decrease in the cost of medicines, resulting in increased affordability and access to therapy, and therefore a greater number of patients could be treated. However, various barriers must be overcome to increase the uptake of biosimilar medicines and education is needed to allay misperceptions and encourage greater use.

Value added medicines: what value repurposed medicines might bring to society?

ABSTRACTBackground & objectives: Despite the wide interest surrounding drug repurposing, no common terminology has been yet agreed for these products and their full potential value is not always recognised and rewarded, creating a disincentive for further development. The objectives of the present study were to assess from a wide perspective which value drug repurposing might bring to society, but also to identify key obstacles for adoption of these medicines and to discuss policy recommendations.Methods: A preliminary comprehensive search was conducted to assess how the concept of drug repurposing was described in the literature. Following completion of the literature review, a primary research was conducted to get perspective of various stakeholders across EU member states on drug repurposing (healthcare professionals, regulatory authorities and Health Technology Assessment (HTA) bodies/payers, patients, and representatives of the pharmaceutical industry developing medicines in this field). Ad hoc literature review was performed to illustrate, when appropriate, statements of the various stakeholders.Results: Various nomenclatures have been used to describe the concept of drug repurposing in the literature, with more or less broad definitions either based on outcomes, processes, or being a mix of both. In this context, Medicines for Europe (http://www.medicinesforeurope.com/value-added-medicines/) established one single terminology for these medicines, known as value added medicines, defined as ‘medicines based on known molecules that address healthcare needs and deliver relevant improvements for patients, healthcare professionals and/or payers’. Stakeholder interviews highlighted three main potential benefits for value added medicines: (1) to address a number of medicine-related healthcare inefficiencies related to irrational use of medicines, non-availability of appropriate treatment options, shortage of mature products, geographical inequity in medicine access; (2) to improve healthcare system efficiency; and (3) to contribute to sustainability of healthcare systems through economic advantages. Current HTA framework, generic stigma, and pricing rules, such as internal reference pricing or tendering processes in place in some countries, were reported as the current key hurdles preventing the full recognition of value added medicines’ benefits, discouraging manufacturers from bringing such products to the market.Discussion & conclusions: There is currently a gap between increasing regulatory authority interest in capturing value added medicines’ benefits and the resistance of HTA bodies/payers, who tend to ignore this important segment of the pharmaceutical field. This situation calls for policy changes to foster appropriate incentives to enhance value recognition of value added medicines and deliver the expected benefit to society. Policy changes from HTA perspective should include: absence of any legislative barriers preventing companies from pursuing HTA; HTA requirements proportionate to potential reward; HTA decision-making framework taking into account the specific characteristics of value added medicines; eligibility for early HTA dialogues; Policy changes from pricing perspective should encompass: tenders/procurement policies allowing differentiation from generic medicines; eligibility for early entry agreement; non-systematic implementation of external and internal reference pricing policies; recognition of indication-specific pricing.At the same time, the pharmaceutical industry should engage all the stakeholders (patients, healthcare providers, HTA bodies/payers) in early dialogues to identify their expectations and to ensure the developed value added medicines address their needs.

The Promotion of Cross-Border Medical Tourism in Developing Countries: Economic Growth at the Expense of Healthcare System Efficiency and Cost Containment?

Background:More and more developing nations are promoting cross-border medical tourism as a way to enhance economic growth. Major destinations for medical tourism in South and Southeast Asia include India, Thailand, Malaysia and wealthy Singapore. Much has been written on the pros and cons of the growth of medical tourism for both destination and source countries. This article uses a different approach.Methodology:Examples from India, Thailand and Malaysia are used to discuss the actual and potential impact of medical tourism on healthcare system efficiency and costs.Results and Conclusions:Based on the experience of these three countries, it is argued that the promotion of cross-border medical tourism to enhance economic growth is likely to be at the expense of national healthcare system efficiency as it goes directly against cost containment strategies and measures.

Microsurgery robots: addressing the needs of high-precision surgical interventions.

Robotics has a significant potential to enhance the overall capacity and efficiency of healthcare systems. Robots can help surgeons perform better quality operations, leading to reductions in the hospitalisation time of patients and in the impact of surgery on their postoperative quality of life. In particular, robotics can have a significant impact on microsurgery, which presents stringent requirements for superhuman precision and control of the surgical tools. Microsurgery is, in fact, expected to gain importance in a growing range of surgical specialties as novel technologies progressively enable the detection, diagnosis and treatment of diseases at earlier stages. Within such scenarios, robotic microsurgery emerges as one of the key components of future surgical interventions, and will be a vital technology for addressing major surgical challenges. Nonetheless, several issues have yet to be overcome in terms of mechatronics, perception and surgeon-robot interfaces before microsurgical robots can achieve their full potential in operating rooms. Research in this direction is progressing quickly and microsurgery robot prototypes are gradually demonstrating significant clinical benefits in challenging applications such as reconstructive plastic surgery, ophthalmology, otology and laryngology. These are reassuring results offering confidence in a brighter future for high-precision surgical interventions.

Time trends of cancer incidence in childhood in Campania region: 25 years of observation.

BackgroundChildhood cancer is relatively uncommon and the European age-standardized rate was 164 new case per million per year among children 0 to 14 years of age (95 % CI 158-170). Aims of our study are to evaluate the cases of these malignant diseases observed between 0 and 15 years of age in the Campania region between 1990 and 2014, the ration between observed and expected cases by disease and province of residence. Also we studied the percentage of extra-regional migration over the time by disease and province of residence.MethodsIn this study we reported the patients with malignant disease observed in 25 years (1990–2014) based on the specialized registry, the Mod. 1.01 of the AIEOP (Association Italian Pediatric Hematology-Oncology). The size of the monitored population also allowed us to systematically examine five time trends: 1990–94: 1995–99; 2000–04; 2005–09; and 2010–14.ResultsBetween 1990 and 2014 a total of 3655 malignant neoplasms were reported: Napoli province (2059 cases), Salerno province (625), Caserta province (589), Avellino province (229), and Benevento province (153). Epidemiological data suggested that about 4100 cases could be expected in Campania region during the same period. The overall ratio between observed (O) and expected (E) numbers of cases in the five periods considered rose gradually from 0.69 in the first period to 0.76, then 0.82, 0.91, and 0.94, in the other periods considered. The extra-regional migration involved 1029 cases (28.1 %), showing a reduction from 33.7 % of the first period to 20.3 % of the last period considered. Considering single province of residence we observed the lowest rate of migration in Napoli and Caserta province, whereas higher levels were observed in the other provinces. For all provinces, except Salerno, the extra-regional migration declined significantly over time.ConclusionsThe present findings showed an increase over time of O/E ratio, probably due to improvement in the organization of centers and greater trust of families in local centers. It is possible to further improve the efficiency of healthcare system of Campania region and migration can be reduced with a more rational use of hospitals throughout region.

Validity analysis of readmissions at seven townships and counties of China

Objective To learn the suitability and validity of readmission service at counties and townships in rural China. Methods Seven pilot counties were randomly selected from the eastern, middle and western areas of China, and five diseases of the respiratory infection and cerebral system were set as the targets, while 600 target inpatient readmitted who had any of the five target diseases from 2012 to 2013 in such counties were selected from the NRCMS database. With expert consultation and empirical evaluation, the fitness of the days of stay at township hospital and necessity of hospitalization at county hospitals were evaluated for such target inpatients. Results 64.7% of the target inpatients were found with unfit days of stay at township hospitals, mostly too short; 59.0% of the target inpatients' hospitalization at county hospitals were found with serious risk factors during their hospitalization; 18.5% of the inpatients were found with unnecessary hospitalization. Conclusions Hierarchical medical system can enhance the efficiency of the healthcare system, but the current validity of readmission is poor, so is the fitness of days of stay at township hospitals, and the quality of the referral pattern. These problems mostly result from poor medical competence at township hospitals and high autonomy of patients in seeking medical service anywhere in the country. Key words: Hierarchical medical system; Integrated health care; Readmission; Validity

Comparison of Efficiency of Healthcare Systems of Countries with Global Competitiveness Using Data Envelopment Analysis

The purpose of this study is to evaluate and compare the efficiency of healthcare systems among 28 countries around the world by applying the data...

Healthcare sector efficiency in Gujarat (India): an exploratory study using data envelopment analysis

The importance of efficiency in resource utilization in healthcare sector has been recognized globally. In this paper we focus on efficiency of healthcare system at sub-state level (&lt;em&gt;i.e.&lt;/em&gt;, district level) in India using Gujarat state and its district level data for 2012-13. In spite of being an economically advanced state, in terms of infant mortality rate (IMR) the state is not the lowest. We explore the reasons for relative performance of different districts with data envelopment analysis (DEA). We used IMR as output variables. Using principal component analysis we tried a sub-set of variables, which had low correlations. Thus, four factor scores relating to medical officer, lady medical officer, Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homoeopathy doctor, pharmacist, were used for DEA. We have focused on Charnes, Cooper, and Rhodes scores (or constant returns to scale technical efficiency score), and discussed efficiency rankings based on these. Thus, our results pertaining to district level health system efficiency in Gujarat State indicate that some of the districts have low efficiency in utilization of inputs like doctors, beds and workload per health institutions. There are also other districts, which need more of these inputs, which may enhance their output and efficiency. Thus, it is suggested that the efficiency in Valsad needs an improvement much more than other districts, whereas districts like Ahmadabad and Surat need more of both medical manpower and facilities. Even in case of Vadodara and Rajkot, the ranking in terms of most of medical manpower and facilities is low and thus these districts may also be benefitted by additional inputs. Hence, there is a mix of both inefficiency and inadequacy of inputs, which is reflected in our results.

EFFICIENCY MEASUREMENT IN HEALTHCARE WORK MANAGEMENT USING MALMQUIST INDICES

Healthcare management is a very complex problem in each country. There are different conditions as well as economic, health and social bonds in the countries, while a constant emphasis on healthcare system efficiency is the common feature in each country. Specific and current field of healthcare is day surgery. It is less costly and its savings are in the most of rationally functioning economic systems used for financing more complex surgeries. The paper reflects on the above-mentioned aspects and its primary aim is to evaluate the day surgery efficiency during 2009 – 2013 by applying Malmquist indices. So the object of our case study is group of day surgery facilities in Slovak regions. The subject is dynamic data envelopment analysis on basis of Malmquist indices. Results of our case study offer valuable information for health and social policies’ managers, and especially for setting up stabilization and regulation mechanisms in a process of healthcare system development in Slovakia.

A Bayesian Approach for Evaluation of Determinants of Health System Efficiency Using Stochastic Frontier Analysis and Beta Regression.

In today's world, Public expenditures on health are one of the most important issues for governments. These increased expenditures are putting pressure on public budgets. Therefore, health policy makers have focused on the performance of their health systems and many countries have introduced reforms to improve the performance of their health systems. This study investigates the most important determinants of healthcare efficiency for OECD countries using second stage approach for Bayesian Stochastic Frontier Analysis (BSFA). There are two steps in this study. First we measure 29 OECD countries' healthcare efficiency by BSFA using the data from the OECD Health Database. At second stage, we expose the multiple relationships between the healthcare efficiency and characteristics of healthcare systems across OECD countries using Bayesian beta regression.