Health care system efficiency and life expectancy: A 140-country study.

Despite the evidence of links between health expenditure and health care efficiency, it is still unclear why countries with similar levels of health expenditures experience different outputs in terms of life expectancy at birth. Health care system efficiency might shed some light on the question. Us...

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Autores principales:	Virginia Zarulli, Elizaveta Sopina, Veronica Toffolutti, Adam Lenart
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/d6504d44c5d14756a7b7cd1c7822d1e0
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spelling	oai:doaj.org-article:d6504d44c5d14756a7b7cd1c7822d1e02021-12-02T20:05:08ZHealth care system efficiency and life expectancy: A 140-country study.1932-620310.1371/journal.pone.0253450https://doaj.org/article/d6504d44c5d14756a7b7cd1c7822d1e02021-01-01T00:00:00Zhttps://doi.org/10.1371/journal.pone.0253450https://doaj.org/toc/1932-6203Despite the evidence of links between health expenditure and health care efficiency, it is still unclear why countries with similar levels of health expenditures experience different outputs in terms of life expectancy at birth. Health care system efficiency might shed some light on the question. Using output-oriented data envelopment analysis, we compared the health systems of 140 countries in terms of attained life expectancy. Efficiency is determined by the distance from the closest country on the best practice frontier, which identifies the highest attainable life expectancy observed for any given level of health care spending. By using national data form the Human Development Data, we built the efficiency frontier and computed the potential life expectancy increase for each country. The potential improvement was, on average, 5.47 years [95%CI: 4.71-6.27 years]. The least efficient countries (10th percentile of the efficiency score) could improve by 11.78 years, while the most efficient countries (90th percentile of the efficiency score) could only improve by 0.83 years. We then analyzed, with regression analysis stratified by average education level, and by the role of health-related variables in differentiating efficient and inefficient countries from each other. The results suggest that, among countries with lower levels of education, decreasing unemployment and income inequality increases average life expectancy, without increasing health expenditure levels.Virginia ZarulliElizaveta SopinaVeronica ToffoluttiAdam LenartPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 16, Iss 7, p e0253450 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Virginia Zarulli Elizaveta Sopina Veronica Toffolutti Adam Lenart Health care system efficiency and life expectancy: A 140-country study.
description	Despite the evidence of links between health expenditure and health care efficiency, it is still unclear why countries with similar levels of health expenditures experience different outputs in terms of life expectancy at birth. Health care system efficiency might shed some light on the question. Using output-oriented data envelopment analysis, we compared the health systems of 140 countries in terms of attained life expectancy. Efficiency is determined by the distance from the closest country on the best practice frontier, which identifies the highest attainable life expectancy observed for any given level of health care spending. By using national data form the Human Development Data, we built the efficiency frontier and computed the potential life expectancy increase for each country. The potential improvement was, on average, 5.47 years [95%CI: 4.71-6.27 years]. The least efficient countries (10th percentile of the efficiency score) could improve by 11.78 years, while the most efficient countries (90th percentile of the efficiency score) could only improve by 0.83 years. We then analyzed, with regression analysis stratified by average education level, and by the role of health-related variables in differentiating efficient and inefficient countries from each other. The results suggest that, among countries with lower levels of education, decreasing unemployment and income inequality increases average life expectancy, without increasing health expenditure levels.
format	article
author	Virginia Zarulli Elizaveta Sopina Veronica Toffolutti Adam Lenart
author_facet	Virginia Zarulli Elizaveta Sopina Veronica Toffolutti Adam Lenart
author_sort	Virginia Zarulli
title	Health care system efficiency and life expectancy: A 140-country study.
title_short	Health care system efficiency and life expectancy: A 140-country study.
title_full	Health care system efficiency and life expectancy: A 140-country study.
title_fullStr	Health care system efficiency and life expectancy: A 140-country study.
title_full_unstemmed	Health care system efficiency and life expectancy: A 140-country study.
title_sort	health care system efficiency and life expectancy: a 140-country study.
publisher	Public Library of Science (PLoS)
publishDate	2021
url	https://doaj.org/article/d6504d44c5d14756a7b7cd1c7822d1e0
work_keys_str_mv	AT virginiazarulli healthcaresystemefficiencyandlifeexpectancya140countrystudy AT elizavetasopina healthcaresystemefficiencyandlifeexpectancya140countrystudy AT veronicatoffolutti healthcaresystemefficiencyandlifeexpectancya140countrystudy AT adamlenart healthcaresystemefficiencyandlifeexpectancya140countrystudy
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Health care system efficiency and life expectancy: A 140-country study.

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