Comparative, dynamic efficiency of national healthcare systems

Waśniewski, Krzysztof (2012): Comparative, dynamic efficiency of national healthcare systems.

Abstract

The paper is an ex post, critical contribution to the research conducted by the World Health Organisation on healthcare financing. The issue of national healthcare systems’ efficiency is addressed, through building a model of change in healthcare quality, in response to changes in healthcare financing, with the core hypothesis stating that the greater is the change in healthcare expenditures, the lesser is their efficiency in terms of healthcare quality improvement. Then, empirical evidence is provided, with econometric research proving the robustness of the model; further, qualitative research provides strong presumptions to a more general thesis, namely that healthcare systems bear significant transaction costs, proportional to their demographically defined size. Thus, important, and negative effects of scale are to assume in healthcare financing.

• Item Type: MPRA Paper
• Language: English
• Keywords: healthcare; institutions; efficiency
• Subjects: H - Public Economics > H4 - Publicly Provided Goods > H41 - Public Goods; G - Financial Economics > G2 - Financial Institutions and Services > G28 - Government Policy and Regulation; I - Health, Education, and Welfare > I1 - Health

References

1. Agrawal, A., Gibson, C., ed. 2001., Communities and the Environment: Ethnicity, Gender, and the State in Community-Based Conservation. New Brunswick, NJ: Rutgers University Press

2. Aoki, M., 2007, Endogenizing Institutions and Institutional Changes, Stanford University, revised version of an invited lecture at the 2005World Congress of the International Economic Association in Morocco

3. Chisholm, D., Evans D.,B., 2010, Improving health system efficiency as a means of moving towards universal coverage, World Health Report (2010) Background Paper, 28, World Health Organisation

4. Dummer, T., J., B., Cook, I., G., 2007, Exploring China's rural health crises: Processes and policy implications, Health Policy, 83, pp. 1-16

5. Durairaj, V., D'Almeida, S., Kirigia, J., 2010, Ghana's approach to social health protection, World Health Report (2010) Background Paper, 2, World Health Organisation

6. Durairaj, V., Murali Kannan, M., Gopalan, S.S.,, Jayalakshmi C., Clare, A., CSST, Shivalingiah, M., Sankara Sarma, P., 2010, Lessons learned from a community-based medisave experiment among rural women in the Indian state of Karnataka, World Health Report (2010), Background Paper, 1, World Health Organisation

7. Evans, D.,B., Tandon, A., Murray, C., J., M, Lauer, J., A., 2001, The comparative efficiency of national health systems in producing health: and analysis of 191 countries, GPE Discussion Paper No. 29, WHO; Geneva, Switzerland.

8. Falkingham, J., 2004, Poverty, out-of-pocket payments and access to health care: evidence from Tajikistan, Social Science & Medicine, 58(2), pp. 247-258

9. Gakidou, E., Cowling, K., Lozano, R., Murray, C., 2010, Increased educational attainment and its effect on child mortality in 175 countries between 1970 and 2009: a systematic analysis, The Lancet, 2010; 376(9745), pp. 959-74

10. Häkkinen, U., Joumard, I., 2007, Cross-Country Analysis of Efficiency in OECD Health Care Sectors: Options for Research, OECD Economics Department, Working Papers, No. 554, OECD Publishing, 2007

11. Harsanyi, J.C., 1953, Cardinal Utility in Welfare Economics and in the Theory of Risk – Taking, The Journal of Political Economy, vol. 61, issue 5, pp. 434 - 435

12. Harsanyi, J.C., 1966, A General Theory of Rational Behavior in Game Situations, Econometrica, vol. 34, no. 3, pp. 613 – 634

13. Harsanyi, J.C., 1967, Games With Incomplete Information Played by “Bayesian” Players. Part I: The Basic Model, Management Science, vol. 14, no. 3, pp. 159 - 182

14. Harsanyi, J.C., 1968, Games With Incomplete Information Played by “Bayesian” Players. Part II: Bayesian Equilibrium Points – Management Science, vol. 14, no. 5, pp. 320 - 334

15. Hodgson, G.,M., 2000, The Essence of Institutional Economics, Journal of Economic Issues, vol. XXXIV, no. 2, June, pp. 317 - 329

16. Hodgson, G.,M., 2006, Institutional Economics, the Individual Actor and Institutional Change, For the Alexander von Humboldt lecture at the University of Nijmegen, December the 5th

17. James, Ch., Savedoff, W., 2010, Risk Pooling and Redistribution in Healthcare: An Empirical Analysis of Attitudes Toward Solidarity, World Health Report (2010), Background Paper ,5, World Health Organisation

18. Joas, H., 1996, The Creativity of Action, Chicago: University of Chicago Press

19. Kawabata, K., Xu, K., Carrin, G., 2002, Preventing impoverishment through protection against catastrophic health expenditure, Bulletin of the World Health Organization, 2002;80(8):612

20. Ke Xu, Saksena, P., Evans, D., B., 2010, Health Financing and Access to Effective Interventions, World Health Report (2010), Background Paper, 8, World Health Organisation

21. Ke Xu, Saksena, P., Jowett, M., Indikadahena, Ch., Kutzin, J., Evans, D., B., 2010, Exploring the thresholds of health expenditure for protection against financial risk, World Health Report (2010), Background Paper, 19, World Health Organisation

22. Kilpinen, E., 2000, The Enormous Fly-Wheel of Society: Pragmatism’s Habitual Conception of Action and Social Theory, Helsinki: University of Helsinki

23. Le Gargasson, J-B., Salome, B., 2010, The Role of Innovative Financing Mechanisms for Health, World Health Report (2010), Background Paper, 12, World Health Organisation

24. Missoni, E., Solimano, G., 2010, Towards Universal Health Coverage: the Chilean experience, World Health Report (2010) Background Paper, 4

25. Musgrove, P., Zeramdini, R., Carrin, G., 2002, Basic patterns in national health expenditure, Bull World Health Organ;80(2):134-42

26. Nash, J.F., 1950, Equilibrium Points in n – Person Games – Proceedings of the National Academy of Sciences of the United States of America, vol. 36, no.1, pp. 48 - 49

27. Nash, J.F., 1950, The Bargaining Problem, Econometrica, vol. 18, no.2, pp. 155 - 162

28. Nash, J.F., 1951, Non – Cooperative Games, The Annals of Mathematics, Second Series, vol. 54, issue 2, pp. 286 - 295

29. Nash, J.F., 1953, Two – Person Cooperative Games – Econometrica, vol.

21, issue 1, pp. 128 - 140

30. Ostrom, E., 2010, Beyond Markets and States: Polycentric Governance of Complex Economic Systems, American Economic Review, 100, June 2010, pp. 1 - 33

31. Saksena, P., Fernandes Antunes, A., Ke Xu, Musango, L., Carrin, G., 2010, Impact of mutual health insurance on access to health care and financial risk protection in Rwanda, World Health Report (2010), Background Paper, 6.

32. Schlager, E., Ostrom, E.,. 1992, Property-Rights Regimes and Natural Resources: A Conceptual Analysis, Land Economics, 68(3): 249–62

33. Searle, J., R., 1995, The Construction of Social Reality, London: Allen Lane

34. Selten, R., 1975, Reexamination of the perfectness concept for equilibrium points in extensive games - Journal International Journal of Game Theory, Issue Volume 4, Number 1, reprint: Kuhn, H.W.,( ed. ), Classics in Game Theory, Princeton University Press, 1997, pp. 317 – 354

35. Stenberg, K., Elovainio, R., Chisholm, D., Fuhr, D., Perucic, A-M., Rekve, D., Yurekli, A., 2010, Responding to the challenge of resource mobilization - mechanisms for raising additional domestic resources for health, World Health Report (2010) Background Paper, 13, World Health Organisation

36. Twomey, P., 1998, Reviving Veblenian Economic Psychology, Cambridge Journal of Economics, vol. 22, no. 4, July, pp. 433-48

37. Williamson, O.,E., 1975, Markets and hierarchies, Free Press, New York

38. Williamson, O.,E., 1985, The Economic Institutions of Capitalism: firms, markets, relational contracting, Free Press, New York

39. Williamson, O.,E., 1991, Strategizing, economizing and economic organization, Strategic Management Journal, no. 12, pp. 75 - 94

40. World Bank, 2004, The Health Sector in Eritrea, A World Bank Country Study, Report no. 29793

41. World Bank, 2005, International Bank For Reconstruction and Development, Country Assistance Strategy for The Oriental Republic of Uruguay, for The Period FY05 – FY10, May the 10th, Report No. 31804-UY

42. World Bank, 2007, Health Systems Reconstruction in Liberia, Project Information Document

43. World Bank, 2007, Key Issues in Central America Health Reforms Diagnosis and Strategic Implications (In Two Volumes) Volume II: Main Report, March 8, Human Development Sector Management Unit Latin America and the Caribbean Region, Report No. 36426-LAC

44. World Bank, 2008, International Bank for Reconstruction and Development and International Finance Corporation Progress Report on The Country Assistance Strategy for the Republic of El Salvador, February the 1st

45. World Bank, 2010, Project Appraisal Document on a Proposed Credit […] to The Republic of Kenya for A Health Sector Support Project, Report No. 53988-KE

46. World Bank, 2011, International Bank for Reconstruction and Development and International Finance Corporation, Country Patrnership Strategy for The Republic of Colombia, for The Period FY2012 – 2016, Report No. 60620 - CO

47. World Health Organisation, 2010, Health Systems Financing. The path to universal coverage, World Health Report

48. World Health Organisation, 2011, World Health Statistics