OECD SAĞLIK SİSTEMLERİ ÇOK SAFHALI ETKİNLİK ANALİZİ

Bu makale, 2000 - 2011 yılları arasında, 34 OECD ülkesinin panel veri seti kullanarak ülkeleri çapındaki sağlık sistemlerinin teknik etkinliğini, çevresel faktörleri ve sağlık harcaması seviyelerinin etkilerini de dikkate alarak ölçmektedir. Çalışmada etkinlik seviyelerini, Veri Zarflama Analizi (DEA) tekniğini kullanarak, üretim ve tedarik olmak üzere 2 safhalı süreçte belirtilmiştir. OECD ülkeleri çapındaki % 3.05 düzeyinde bulunan etkinlik kaybı, 1.38 yıllık doğumda beklenen yaşam beklentisi kaybı ve 1000 canlı doğum başına 0.75 bebek ölümü anlamına gelmektedir. Diğer yandan çevresel etkenler ve yetersiz sağlık harcamaları nedeniyle bu kayıplar, neredeyse ikiye katlanıp, % 5.65 etkinlik kaybı ya da 2.4 yıl doğumda yaşam beklentisi ve 1.5 bebek ölümüne ulaşmaktadır. Ölçülen etkinlik kaybı, % 21 üretim ve % 79 tedarik merkezli olmakla beraber, ülkeden ülkeye büyük değişiklik göstermektedir; dolayısıyla da bu kayıpların telafisi için gerekli çözümler ve bunlara ilişkin politikalar da farklı olacaktır.

Anahtar Kelimeler:

Sağlık Sistemleri, Etkinlik, Veri Zarflama Analizi, DEA, OECD

A MULTI-STAGE EFFICIENCY ANALYSIS OF OECD HEALTHCARE SYSTEMS

This paper measures the multi-stage technical efficiency of healthcare systems across OECD Countries between 2000 and 2011, based on a 34 country panel data set, taking into account the impact of environmental variables and health expenditure levels. We measure technical efficiencies in a two-stage process—the production of health services and the subsequent provision of health outcomes—using output-oriented Data Envelopment Analysis (DEA). An overall inefficiency of 3.05% across OECD countries translates into an average loss of 1.38 years of life expectancy at birth and an additional 0.75 infant deaths per 1000 live births, exacerbated by environmental variables and inadequate healthcare spending, almost doubling the total OECD outcome loss to 5.65%, or 2.4 years of life expectancy and 1.5 infant deaths per 1000 live births. Measured inefficiency is split 21%/79% between production and provision. The type of inefficiencies exhibited, the solutions to these, and the resulting policy implications vary greatly.

Keywords:

Healthcare, Efficiency, DATA ENVELOPMENT ANALYSIS, DEA, OECD,

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