Eficiencia del Gasto Total en Salud: Análisis no paramétrico en una muestra amplia de países

GERI MILVA; MONTERUBBIANESI, PABLO DANIEL ; LAGO, FERNANDO PABLO; MOSCOSO NEBEL

Revista de Salud Pública

Facultad de Medicina, Instituto de Salud Pública

Lugar: Bogotá; Año: 2017 vol. 19 p. 79 - 85

0124-0064

Objective: This paper measures the efficiency of 190 countries in producing health results and the factors that determine this efficiency.Methods: A worldwide data set for the year 2009 and a data envelope analysis is used. In the estimation of the production frontier, per capita total health expenditure is considered as input and infant mortality rate and life expectancy at birth are used as outputs. At the same time, an analysis of the determinants of expenditure efficiency through the use of Tobit models is performed.Results: African nations have lower technical and allocative efficiency, but higher scale efficiency. The quality of institutions has a statistically significant impact on the levels of technical and allocative efficiency and on the levels of scale efficiency. The percentage of health expenditure financed by private insurers would impact on technical and allocative efficiency while the rate of urbanization would affect the scale efficiency.Discussion: the fact that most than 70 % of countries show decreasing returns suggest that, once achieved certain minimal standards of life quality, the marginal effect of each additional dollar assigned to health is not substantial. Conversely, in poor countries where the expenditure in health presents increasing returns, the health performance could be substantially better by raising marginally the expenditure. By the other hand, financing structures of health expenditures could be influencing on technical-allocative efficiency, while the urbanization level could be influencing on scale-efficiency.