Global Healthcare Resource Efficiency in the Management of COVID-19 Death and Infection Prevalence Rates

Breitenbach, Marthinus C and Ngobeni, Victor and Aye, Goodness C (2020): Global Healthcare Resource Efficiency in the Management of COVID-19 Death and Infection Prevalence Rates.

Abstract

In this paper, we use a novel DEA approach, developed by You and Yan (2011), which accounts for both desirable outputs (recovered cases) and undesirable outputs (infections and deaths), to analyse the technical efficiency of the health systems of 36 most infected countries during the first 11 months since the COVID-19 outbreak. The average technical efficiency scores across the 3 Models is 52%. Specifically, 6 of the 36 (17%) countries in our sample largely used tests, doctors and health spending efficiently in managing the COVID-19 case-mortality and prevalence rates. The remaining 30 DMUs used their available resources inefficiently. Developing countries performed better than developed nations who were inefficient. Therefore, most countries literally “threw” resources at fighting the pandemic, thereby probably raising inefficiency through wasted resource use. The study also showed that developed countries could also draw lessons from developing countries in the management of pandemics. The latter countries mostly face pandemics on a daily basis, therefore, have developed strategies to manage them.

• Item Type: MPRA Paper
• Language: English
• Keywords: Pandemic; COVID-19; Death rates; Infection rates; Recoveries; Data Envelopment Analysis, Healthcare systems efficiency; Technical Efficiency; Undesirable outputs
• Subjects: C - Mathematical and Quantitative Methods > C6 - Mathematical Methods ; Programming Models ; Mathematical and Simulation Modeling > C67 - Input-Output Models; D - Microeconomics > D2 - Production and Organizations > D22 - Firm Behavior: Empirical Analysis; H - Public Economics > H3 - Fiscal Policies and Behavior of Economic Agents > H32 - Firm

References

Afonso, A. and St. Aubyn, M. 2006. Relative Efficiency of Health Provision: A DEA Approach with Non-Discretionary Inputs.

Akazili, J. Adjuik, M. Jehu-Appiah, C. and Zere, E. 2008. Using Data Envelopment Analysis to Measure the Extent of Technical Efficiency of Public Health Centres in Ghana. BMC International Health and Human Rights, 8(1), p.11.

Alhassan, R.K., Nketiah-Amponsah, E., Akazili, J., Spieker, N., Arhinful, D.K., and De Wit, T.F.R. 2015. Efficiency of Private and Public Primary Health Facilities Accredited by the National Health Insurance Authority in Ghana. Cost Effectiveness and Resource Allocation, 13(1), p.23.

Aristovnik, A. 2012. The Impact of ICT on Educational Performance and its Efficiency in Selected EU and OECD Countries: A Non-Parametric Analysis.

Bhat, V.N. 2005. Institutional Arrangements and Efficiency of Healthcare Delivery Systems. European Journal of Health Economics, 50, 215-222.

Breitenbach, M.C., Ngobeni, V. and Aye, G., 2020. Efficiency of Healthcare Systems in the First Wave of COVID-19- A Technical Efficiency Analysis. MPRA Paper No. 101440. Online at https://mpra.ub.uni-muenchen.de/101440/

Campanella, P., Azzolini, E., Izzi, A., Pelone, F., De Meo, C., La Milia, C.D., Specchia, M.L., and Ricciardi, W. 2017. Hospital Efficiency: How to Spend Less Maintaining Quality. Ann Ist Super Sanita, 53(1), pp.46-53.

Chowdhury, H., Zelenyuk, V., Wodchis, W., and Laporte, A. 2010. Efficiency and Technological Change in Health Care Services in Ontario (No. WP082010). School of Economics, University of Queensland, Australia.

Cooper, W.W., Seiford. L.M., and Tone, K. 2007. Data Envelopment Analysis: A Comprehensive Text with Models, Applications, References and DEA-Solver Software. Springer, New York, USA.

Correia, S., Luck, S., and Verner, E. 2020. Pandemics Depress the Economy, Public Health Interventions Do Not: Evidence from the 1918 Flu. Draft Paper. This preprint research paper has not been peer reviewed. Electronic copy available at: https://ssrn.com/abstract=3561560

De Cos, P.H., and Moral-Benito, E. 2014. Determinants of Health-System Efficiency: Evidence from OECD Countries. International Journal of Health Care Finance Economics, 14, 69-93.

Dyckhoff, H., and Allen, K. 2001. Measuring ecological efficiency with data envelopment analysis (DEA). European Journal of Operations Research. 132: 312-325.

Färe R., Grosskopf, S., Lovell, C.A.K. and Pasurka, C. 1989. Multilateral productivity comparisons when some outputs are undesirable: A nonparametric approach. Review of Economic Statististics. 71: 90–98.

Gannon, B. 2005. Testing for Variation in Technical Efficiency of Hospitals in Ireland. The Economic and Social Review, Vol. 36 (3), pp. 273-294.

Gavurova, B., Kocisova, K., Belas, L., and Krajcik, V. 2017. Relative Efficiency of Government Expenditure on Secondary Education. Journal of International Studies. 10(2), pp. 329-343.

Golany, B. and Roll, Y. 1989. An application procedure for DEA. Omega 17: 237–250.

González, E., Cárcaba, A., and Ventura, J. 2010. Value Efficiency Analysis of Health Systems: Does Public Financing Play a Role? Journal of Public Health, 18(4), 337-350.

Hadad, S., Hadad, Y., and Simon-Tuval, T. (2013). Determinants of Healthcare System’s Efficiency in OECD Countries. European Journal of Health Economics, 14, 253-265.

Hua, Z. and Bian, Y. 2007. DEA with undesirable factors. In: Zhu, J. and Cook, W.D. (eds). Modelling Data Irregularities and Structural Complexities in Data Envelopment Analysis. Springer Science: Boston, MA, pp 103–121.

Jarjue, G., Nor, N.M., Ghani, J.A., and Jalil, S.H. 2015. Technical Efficiency of Secondary Health Care Service Delivery in the Gambia. International Journal of Economics & Management, 9(1).

Joumard, I., André, C., Nicq, C., and Chatal, O. 2008. "Health Status Determinants: Lifestyle, Environment, Health Care Resources and Efficiency", No. 627.

Kim, Y. and Kang, M. 2014. The Measurement of Health Care System Efficiency: Cross-country Comparison by Geographical Region. Accessed, 01 January 2019. http://s-space.snu.ac.kr/bitstream/10371/91911/1/02_Younhee_Kim.pdf

Kirigia, J.M., Sambo, L.G., and Scheel, H. 2001. Technical Efficiency of Public Clinics in Kwazulu-Natal Province of South Africa. East African Medical Journal, 78(3), pp.1-14.

Kirigia, J.M., Lambo, E., and Sambo, L.G. 2000. Are Public Hospitals in KwaZulu-Natal Province of South Africa Technically Efficient? African Journal of Health Sciences, 7(3-4), p.25.

Liu, J.S., Lu, L.Y.Y., Lu, W.-M., and Lin, B.J.Y. 2013, "A survey of DEA applications", OMEGA, Vol. 41 No. 5, pp. 893-902.

Lo Storto, C. and Goncharuk, A.G. 2017. Efficiency vs. Effectiveness: A Benchmarking Study on European Healthcare Systems. Economics and Sociology, 10(3), 102-115. Accessed, 28 January 2019.

Lu, W.M., and Lo, S.F. 2007a. A benchmark-learning roadmap for regional sustainable development in China. Journal of the Operations Research Society. 58:841–849.

Lu, W.M,. and Lo, S.F. 2007b. A closer look at the economic environmental disparities for regional development in China. European Journal of Operations Research. 183: 882–894.

Marschall, P., and Flessa, S. 2009. Assessing the Efficiency of Rural Health Centres in Burkina Faso: An Application of Data Envelopment Analysis. Journal of Public Health, 17(2), p.87.

Martić, M., Novaković, M., and Baggia, A. 2009. Data Envelopment Analysis-Basic Models and their Utilization. Organizacija, 42(2), pp.37-43. Accessed, 24 January 2019.

Masiye, F. 2007. Investigating Health System Performance: An Application of Data Envelopment Analysis to Zambian Hospitals. BMC Health Services Research, 7(1), p.58.

McWilliams, A., Siegel, D., and Van Fleet, D.D. 2005. Scholarly Journals as Producers of Knowledge: Theory and Empirical Evidence Based on Data Envelopment Analysis. Organisational Research Methods, 8(2), pp.185-201.

Nakashima, K., Nose, T., and Kuriyama, S. 2006. A new approach to environmental-performance evaluation. International Journal of Productivity Research. 44:4137–4143.

Newey S. and Gulland A. 2020. What is Coronavirus, How Did It Start and How Big Could It Get? The Telegraph. 28 April 2020. Available online at https://www.telegraph.co.uk/news/2020/04/28/what-is-coronavirus-covid-19-virus-pandemic/ Date accessed: 28 April.

Ngobeni, V., Breitenbach, M.C., and Aye, G. 2020. Technical Efficiency of Provincial Public Healthcare in South Africa. Cost Effectiveness & Resource Allocation, Vol 18:3. BMC Springer Nature.

Santos, S.P., Amado, C.A.E., and Santos, M.F. 2012, "Assessing the efficiency of mother-to-child HIV prevention in low- and middle-income countries using data envelopment analysis", Health Care Management Science, Vol. 15 No. 3, pp. 206-222.

Seiford, L.M., and Zhu, J. 2002. Modelling undesirable factors inefficiency evaluation. European Journal of Operations Research. 142: 16–20.

Shirouyehzad, H., Jouzdani, J., and Khodadadi-Karimvand, M. 2020. Fight Against COVID-19: A Global Efficiency Evaluation based on Contagion Control and Medical Treatment. Journal of Applied Research on Industrial Engineering. Vol.7, No.2 (2020) 109-120.

Stewart, H., Proctor, K., and Siddique, H. 2020. Johnson: many more people will lose loved ones to coronavirus. Retrieved from https://www.theguardian.com/world/2020/mar/12/uk-moves-to-delay-phase-ofcoronavirus- plan.

Tang, B., Xia, F., Bragazzi, N. L., McCarthy, Z., Wang, X., & He, S. 2020, "Lessons drawn from China and South Korea for managing COVID-19 epidemic: insights from a comparative modelling study", Bulletin of World Health Organisation, Vol. [preprint].

Taylor, B., and Harris, G. 2004. Relative Efficiency among South African Universities: A Data Envelopment Analysis. Higher Education, 47(1), pp.73-89.

The World Bank. 2020a. Current Health Expenditure (% of GDP). The World Bank. Accessed, 08 August 2020. https://data.worldbank.org/indicator/SH.XPD.CHEX.GD.ZS

The World Bank. 2020b. Nurses and Midwives per 1 000 population. The World Bank. Accessed, 08August 2020. https://data.worldbank.org/indicator/SH.MED.NUMW.P3

The World Bank. 2020c. Physicians per 1 000 population. The World Bank. Accessed, 08August 2020. https://data.worldbank.org/indicator/SH.MED.PHYS.ZS

Watts, J. 2020. Delay is deadly: what Covid-19 tells us about tackling the climate crisis. Retrieved from https://www.theguardian.com/commentisfree/2020/mar/24/covid-19-climatecrisis- governments-coronavirus.

Worldometers. 2020. COVID-19 Coronavirus Pandemic. Worldometer. Accessed, 08August 2020. https://www.worldometers.info/coronavirus/

Yang, C., Hsiao, C., and Yu, M. 2008. Technical efficiency and impact of environmental regulations in farrow-to-finish swine production in Taiwan. Agricultural Economics. 39: 51–61.

You, S., and Yan, H. 2011. A new approach in modelling undesirable output in DEA model. Journal of the Operational Research Society. (62). pp. 2146-2156.

Zere, E., Mbeeli, T., Shangula, K., Mandlhate, C., Mutirua, K., Tjivambi, B., and Kapenambili, W. 2006. Technical Efficiency of District Hospitals: Evidence from Namibia Using Data Envelopment Analysis. Cost Effectiveness and Resource Allocation, 4(1), p.1

Zhou, P., Ang, B.W., and Poh, K.L. 2007. A mathematical programming approach to constructing composite indicators. Ecology Economics 62: 291–297.