ArticleThe European journal of health economics : HEPAC : health economics in prevention and care2024
The trade-off between health system resiliency and efficiency: evidence from COVID-19 in European regions.
Article in The European journal of health economics : HEPAC : health economics in prevention and care, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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6 citing papers in PubMed.
- Hospital performance evaluation for UN Sustainable Developmental Goals (SDGs): a practical multi-criteria decision making model based on root assessment method (RAM).The European journal of health economics : HEPAC : health economics in prevention and care · 2026Article
- When supply chains fail: rethinking resilience in intensive care.Critical care (London, England) · 2026Review
- Financing Regimes and Case-Mix Complexity in Psychiatric Hospitals Beyond the Pandemic Shock-Insights from a Regional European Healthcare System.Healthcare (Basel, Switzerland) · 2026Article
- Healthcare Expenditure and COVID-19 in Europe: Correlation, Entropy, and Functional Data Analysis-Based Prediction of Hospitalizations and ICU Admissions.Entropy (Basel, Switzerland) · 2025Article
- Assessment of the efficiency and effectiveness of health care systems in European Union countries before and during the COVID-19 pandemic.Frontiers in public health · 2025Article
- The Israeli health system's rapid responses during the COVID-19 pandemic.Israel journal of health policy research · 2024Article
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Abstract
The objective of this paper was to investigate the existence of a trade-off between health system resilience and the economic efficiency of the health system, using data for 173 regions in the European Union and the European Free Trade Association countries. Data Envelopment Analysis was used to measure the efficiency of regional health systems before the COVID-19 pandemic. Then, a spatial econometrics model was used to estimate whether this measure of efficiency, adjusted for several covariates, has a significant impact on regional health system resilience during the COVID-19 pandemic, measured by the number of COVID-19 deaths per hundred thousand inhabitants. The results show that COVID-19 death rates were significantly higher in regions with higher population density, higher share of employment in industry, and higher share of women in the population. Results also show that regions with higher values of the health system efficiency index in 2017 had significantly higher rates of COVID-19 deaths in 2020 and 2021, suggesting the existence of a trade-off between health system efficiency and health system resilience during the COVID-19 pandemic.
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