ArticleBMJ open2019
Measuring the efficiency of health systems in Asia: a data envelopment analysis.
Article in BMJ open, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 52 papers, 2 of them syntheses that pooled it.
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Who cites it
52 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Analysing the Efficiency of Health Systems: A Systematic Review of the Literature.Applied health economics and health policy · 2023Pooled it
- A systematic review of patient-reported dignity and dignified care during acute hospital admission.Journal of advanced nursing · 2022Pooled it
- Construction of performance score dynamic prediction system for clinical departments using explainable machine learning.Health information science and systems · 2026Article
- Beyond Efficiency Scores: Explaining Health System Performance Using Two-Stage Bootstrap DEA and Machine Learning.Healthcare (Basel, Switzerland) · 2026Article
- Healthcare Expenditure and Health System Efficiency in 25 European Countries: A Multidimensional Data Envelopment Analysis with Bootstrap Correction and Second-Stage Regression.Epidemiologia (Basel, Switzerland) · 2026Article
- Evaluating the Financial Factors Influencing Maternal, Newborn, and Child Health in Africa: Tobit Regression and Data Envelopment Analysis.JMIRx med · 2025Article
- The spatial effects and influencing factors of inter-provincial health resource allocation efficiency in China.BMC health services research · 2025Article
- Evaluation and dynamic evolution of maternal and child health services in township health centers in ethnic minority areas of Guangxi, China.Primary health care research & development · 2025Article
- Three decades in healthcare service efficiency evaluation: a bootstrapping Data Envelopment Analysis (DEA) of Ministry of Health Malaysia.Health economics review · 2025Article
- Segmenting the Global Layers of Malignant Meningioma: A Population-Based Study of Incidence, Risk Factors, and Temporal Trends.Brain and behavior · 2025Article
- Comparative Efficiency Analysis of OECD Health Systems: FDH vs. Machine Learning Approaches with Efficiency Analysis Trees (EAT and RFEAT).Cost effectiveness and resource allocation : C/E · 2025Article
- Evaluation of Health Resource Efficiency and Its Influencing Factors in Ethnic Minority Areas of Guangxi: Data from 2010 to 2022.Risk management and healthcare policy · 2025Article
- Efficiency and equity of resource allocation in healthcare services using DEA and concentration indices: evidence from the traditional medicine hospital in Gansu Province, China.Frontiers in public health · 2025Article
- The impact of the scale and hierarchical structure of health human resources on the level of medical services-based on China's four major economic regions.International journal for equity in health · 2024Article
- Efficiency evaluation of 28 health systems by MCDA and DEA.Health economics review · 2024Article
- Efficiency evaluation and promoter identification of primary health care system in China: an enhanced DEA-Tobit approach.BMC health services research · 2024Article
- Hospital performance evaluation indicators: a scoping review.BMC health services research · 2024Article
- Enhancing pooling levels strengthens the risk resilience of healthcare insurance: a case study of basic medical insurance fund operations data in Gansu, China.BMC public health · 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
- Assessing the Overall Technical Efficiency, Pure Technical Efficiency, and Scale Efficiency of United States Department of Defense Hospitals.Risk management and healthcare policy · 2024Article
Corrections and comments
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Authors and funding
9 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveThis study aims to estimate the technical efficiency of health systems in Asia. SETTINGS: The study was conducted in Asian countries.
methodsWe applied an output-oriented data envelopment analysis (DEA) approach to estimate the technical efficiency of the health systems in Asian countries. The DEA model used per-capita health expenditure (all healthcare resources as a proxy) as input variable and cross-country comparable health outcome indicators (eg, healthy life expectancy at birth and infant mortality per 1000 live births) as output variables. Censored Tobit regression and smoothed bootstrap models were used to observe the associated factors with the efficiency scores. A sensitivity analysis was performed to assess the consistency of these efficiency scores.
resultsThe main findings of this paper demonstrate that about 91.3% (42 of 46 countries) of the studied Asian countries were inefficient with respect to using healthcare system resources. Most of the efficient countries belonged to the high-income group (Cyprus, Japan, and Singapore) and only one country belonged to the lower middle-income group (Bangladesh). Through improving health system efficiency, the studied high-income, upper middle-income, low-income and lower middle-income countries can improve health system outcomes by 6.6%, 8.6% and 8.7%, respectively, using the existing level of resources. Population density, bed density, and primary education completion rate significantly influenced the efficiency score.
conclusionThe results of this analysis showed inefficiency of the health systems in most of the Asian countries and imply that many countries may improve their health system efficiency using the current level of resources. The identified inefficient countries could pay attention to benchmarking their health systems within their income group or other within similar types of health systems.
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