ArticlePloS one2021
Health care system efficiency and life expectancy: A 140-country study.
Article in PloS one, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 2 of them syntheses that pooled it.
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The trial behind it
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Who cites it
20 citing papers in PubMed, 2 syntheses or guidelines pooled it, 45 citations in OpenAlex.
- The state and significant drivers of health systems efficiency in Africa: A systematic review and meta-analysis.Journal of global health · 2023Pooled it
- Analysing the Efficiency of Health Systems: A Systematic Review of the Literature.Applied health economics and health policy · 2023Pooled it
- Beyond Efficiency Scores: Explaining Health System Performance Using Two-Stage Bootstrap DEA and Machine Learning.Healthcare (Basel, Switzerland) · 2026Article
- Associations of multiple evidence-based care strategies with disease mortality, life expectancy, and disparities in the United States.Health affairs scholar · 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
- Enhancing financial stability in healthcare through data-driven risk assessments with machine learning.Scientific reports · 2026Article
- Let Them Talk: Coping with PrEP-Related Stigma and Sustaining PrEP Persistence Among Men Who Have Sex with Men in Tanga, Tanzania.Healthcare (Basel, Switzerland) · 2026Article
- Development of Deep Learning Models for AI-Enhanced Telemedicine in Nursing Home Care.Journal of clinical medicine · 2026Article
- Health insurance coverage in Mexico: progress, inequalities and remaining challenges towards UHC2030.Health research policy and systems · 2025Article
- Association between healthcare resources, healthcare systems, and population health in European countries.BMC health services research · 2025Article
- Restoring life expectancy in low-income countries: the combined impact of COVID-19, health expenditure, GDP, and child mortality.BMC public health · 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
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- Both religious and secular ethics to achieve both happiness and health: Panel data results based on a dynamic theoretical model.PloS one · 2024Article
- Cost-effectiveness of weekly gastro-resistant risedronate 35 mg, compared with weekly alendronate 70 mg tablets, in the treatment of postmenopausal osteoporosis in Spain.Journal of comparative effectiveness research · 2023Article
- Hydrothermal extraction and physicochemical characterization of biogenic hydroxyapatite nanoparticles from buffalo waste bones for in vivo xenograft in experimental rats.Scientific reports · 2023Article
- Country-level predictors of COVID-19 mortality.Scientific reports · 2023Article
- Grape Polyphenols in the Treatment of Human Skeletal Muscle Damage Due to Inflammation and Oxidative Stress during Obesity and Aging: Early Outcomes and Promises.Molecules (Basel, Switzerland) · 2022Review
- The Global Burden of Osteoporosis, Low Bone Mass, and Its Related Fracture in 204 Countries and Territories, 1990-2019.Frontiers in endocrinology · 2022Article
Corrections and comments
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Authors and funding
4 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
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.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.