ArticlePloS one2017
Evaluation of the performance of national health systems in 2004-2011: An analysis of 173 countries.
Article in PloS one, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 28 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
28 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- The state and significant drivers of health systems efficiency in Africa: A systematic review and meta-analysis.Journal of global health · 2023Pooled it
- A Meta-summarization of Qualitative Findings About Health Systems Performance Evaluation Models: Conceptual Problems and Comparability Limitations.Inquiry : a journal of medical care organization, provision and financingPooled it
- Inositol in the MAnaGemENt of abdominal aortic aneurysm (IMAGEN): study protocol for a randomised controlled trial.Trials · 2017Trial
- Panel regression analysis of the relationship between health resources and infant mortality rate in Chinese mainland provinces, 2010-2020.Frontiers in public health · 2026Article
- Association between healthcare resources, healthcare systems, and population health in European countries.BMC health services research · 2025Article
- Statistical Analysis and Forecasts of Performance Indicators in the Romanian Healthcare System.Healthcare (Basel, Switzerland) · 2025Article
- Identifying and prioritizing inefficiency causes in Iran's health system.Cost effectiveness and resource allocation : C/E · 2024Article
- The trade-off between health system resiliency and efficiency: evidence from COVID-19 in European regions.The European journal of health economics : HEPAC : health economics in prevention and care · 2024Article
- Developing a Conceptual Framework for Socioeconomic Impact Research in European Cancer Patients: A 'Best-Fit' Framework Synthesis.The patient · 2023Article
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- Contextual factors in premature non-communicable disease mortality in selected African countries within the sustainable development goals framework: the implication of voice and accountability.Journal of public health in Africa · 2022Article
- Sustainable Health and Wellbeing in the European Union.Frontiers in public health · 2022Article
- Performance evaluation and ranking of regional primary health care and public health Systems in Iran.BMC health services research · 2021Article
- Performance Evaluation of the Chinese Healthcare System.International journal of environmental research and public health · 2021Article
- Portfolio frontier analysis: Applying mean-variance analysis to health technology assessment for health systems under pressure.Social science & medicine (1982) · 2021Article
- National Health Systems and COVID-19 Death Toll Doubling Time.Frontiers in public health · 2021Article
- Socioeconomic Factors Associated With Reports of Domestic Violence in Large Brazilian Cities.Frontiers in public health · 2021Article
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- Article
- Measuring Timeliness of Outbreak Response in the World Health Organization African Region, 2017-2019.Emerging infectious diseases · 2020Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
In an effort to improve health service delivery and achieve better health outcomes, the World Health Organization (WHO) has called for improved efficiency of health care systems to better use the available funding. This study aims to examine the efficiency of national health systems using longitudinal country-level data. Data on health spending per capita, infant mortality rate (IMR), under 5 mortality rate (U5MR), and life expectancy (LE) were collected from or imputed for 173 countries from 2004 through 2011. Data envelopment analyses were used to evaluate the efficiency and regression models were constructed to examine the determinants of efficiency. The average efficiency of the national health system, when examined yearly, was 78.9%, indicating a potential saving of 21.1% of health spending per capita to achieve the same level of health status for children and the entire population, if all countries performed as well as their peers. Additionally, the efficiency of the national health system varied widely among countries. On average, Africa had the lowest efficiency of 67%, while West Pacific countries had the highest efficiency of 86%. National economic status, HIV/AIDS prevalence, health financing mechanisms and governance were found to be statistically associated with the efficiency of national health systems. Taking health financing as an example, a 1% point increase of social security expenses as a percentage of total health expenditure correlated to a 1.9% increase in national health system efficiency. The study underscores the need to enhance efficiency of national health systems to meet population health needs, and highlights the importance of health financing and governance in improving the efficiency of health systems, to ultimately improve health outcomes.
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