G20 Countries and Turkey's Health System Performance: A Comparative Analysis According to Years

Abstract

Performance measurement in health is a process of monitoring and evaluating the effectiveness of the services provided by the health care system to meet the needs and expectations of the patients. Significant and comparable information on health system performance ensures strong health policies at national and international level. A comparable assessment of health performance is possible, especially through comparisons with countries in the same or higher income group, and provides for the elimination of deficiencies or better aspects in the health system. In this study, it is aimed to compare the performance of health care systems of the G20 members (excluding European Union Commission), whose one of members is Turkey.  In this respect, the Malmquist Total Factor Productivity (MTFP) Analysis, which is one of the most frequently used methods in the comparison of health systems in the country, was utilized. The results showed that Turkey’s healthcare system is one of the healthcare systems which show increase in efficiency in 2000-2010, 2010-2015 and 2000-2015 time periods.

Keywords

• Malmquist Total Factor Productivity,Healthcare Systems,G20 Countries

G20 Ülkeleri ve Türkiye’nin Sağlık Sistemi Performansı: Yıllara Göre Karşılaştırmalı Bir Analiz

Öz

Sağlıkta performans ölçümü, sağlık bakım sistemi tarafından sunulan hizmetlerin hastaların ihtiyaç ve beklentilerini karşılama etkililiğini izleme ve değerlendirme işlemidir. Sağlık sistemi performansı hakkında anlamlı ve karşılaştırılabilir bilgiler, ulusal ve uluslararası seviyede güçlü sağlık politikaları oluşturulmasını sağlamaktadır. Sağlık performansının kıyaslanabilir bir şekilde değerlendirilmesi özellikle aynı ya da daha üst gelir grubundaki ülkelerle yapılan kıyaslamalar ile mümkün olup, sağlık sistemindeki eksiklikleri ya da daha iyi yönlerin ortaya çıkarılmasını sağlamaktadır. Bu çalışmada, Türkiye’nin de üyesi bulunduğu 19 (Avrupa Birliği Komisyonu hariç) G20 ülkesinin sağlık sistem performanslarının karşılaştırılması amaçlanmıştır. Bu doğrultuda, ülke sağlık sistemlerinin karşılaştırılmasında sıklıkla başvurulan yöntemlerden olan Malmquist Toplam Faktör Verimliliği (MTFV) Endeksi’nden faydalanılmıştır. Analiz sonuçlarına göre Türkiye; 2000-2010, 2010-2015 ve 2000-2015 dönemlerinde sağlık sisteminde verimlilik artışı gösteren ülkeler arasındadır.

Anahtar Kelimeler

• Malmquist Toplam Faktör Verimliliği,Sağlık Sistemleri,G20 Ülkeleri

References

1. Aslan, H. K., & Aslan, M. (2014). Birleşmiş Milletler Ekokomik ve Sosyal Konseyi: BM Reformu Çerçevesinde Küresel Düzeyde Sosyal ve Ekonomik Adalet Arayışı. İçinde: Doğan, Çakmak, & Aslan (Ed.), BM Sistemi ve BM’de Reform Tartışmaları (s.81-108). Ankara: Siyasal Kitapevi.
2. Ayanoğlu, Y., Murat, A., & Beylik, U. (2010). Hastanelerde veri zarflama analizi (VZA) yöntemiyle finansal performans ölçümü ve değerlendirilmesi. Sağlıkta Performans ve Kalite Dergisi, 2(2), 40-62.
3. Caves, D.W., Christensen, L.R., & Diewert, W.E. (1982a). The Economic Theory of Index Numbers and the Measuremnt of Input, Output, and Productivity.Econometrica, 50, 1393-1414.
4. Caves, D.W., Christensen, L.R., & Diewert, W.E. (1982b). Multilateral comparisons of output, input, and productivity using superlative index numbers.The Economic Journal, 92, 73-86.
5. Chern, J.Y., & Wan, T.T. (2000). The Impact of The Prospective Payment System on The Technical Efficiency of Hospitals.Journal of Medical Systems, 24, 159–172.
6. Chowdhury, H., Wodchis, W. & Laporte, A. (2011). Efficiency and Technological Change in Health Care Services in Ontario: An Application of Malmquist Productivity Index with Bootstrapping. International Journal of Productivity and Performance Management, 60(7), 721–745.
7. De Silva, A. (2000). A framework for measuring responsiveness. Geneva: World Health Organization.
8. Legatum Institute Foundation. (2016). The Legatum Prosperity Index™ 2016: Bringing Prosperity to Life. (Erişim: 1.10 2018), https://lif.blob.core.windows.net/lif/docs/default-source/publications/2016-legatum-prosperity-index-pdf.pdf?sfvrsn=2

9. Malmquist, S. (1953). Index numbers and indifference surfaces. Trabajos de estadística, 4(2), 209-242.
10. Moreno-Serra, R., & Smith, P. (2012). An Exploratory Application of Data Envelopment Analysis to the Efficiency of Health Service Coverage And Access. (Erişim: 10.09.2018), https://www.r4d.org/wp-content/uploads/THF-Efficiency-of-health-service-coverage-and-access.pdf
11. Murray, C. J., & Frenk, J. (2000). A framework for assessing the performance of health systems. Bulletin of the World Health Organization, 78, 717-731.
12. OECD (2018). OECD Health Data.
13. Özcan, Y. A. (2014). Health Care Benchmarking and Performance Evaluation. International Series in Operations Research & Management Science, USA: Springer.
14. Özcan, Y. A., &Khushalani, J. (2017). Assessing efficiency of public health and medical care provision in OECD countries after a decade of reform. Central European Journal of Operations Research, 25(2), 325-343.
15. Pransky, G., Benjamin, K., & Dembe, A. E. (2001). Performance and quality measurement in occupational health services: current status and agenda for further research. American Journal of Industrial Medicine, 40(3), 295-306.
16. Roh, C.Y., Park, C., & Moon, M.J. (2016). Economic Performances of U.S. Non-profit Hospitals Using the Malmquist Productivity Change Index. Journal of Management and Marketing Research, 8(1),1-16.
17. Samut, P.K., & Cafri, R. (2016). Analysis of the Efficiency Determinants of Health Systems in OECD Countries by DEA and Panel Tobit. Soc Indic Res,129, 113–132.
18. Sherman, H., & Zhu, J. (2006). Service Productivity Management: Improving Service Performance Using Data Envelopment Analysis (DEA). USA: Springer.
19. Smith, P. C., Mossialos, E., & Papanicolas, I. (2008). Performance measurement for health system improvement: experiences, challenges and prospects. Copenhagen: WHO Regional Office for Europe.
20. Spinks, J. & Hollingsworth, B. (2009). Cross-Country Comparisons of Technical Efficiency of Health Production: A Demonstration of Pitfalls.Applied Economics, 41(4), 417-427.
21. Tone, K. (2004). Malmquist Productivity Index: Efficiency Change over Time. İçinde: Data Envolopment Analysis, Cooper W.W., Seiford L.M., & Zhu J. (Ed.), Handbook on Data Envelopment Analysis. (s. 203 – 227). USA: Kluwer Academic Publishers.
22. World Bank (2018). World Bank Health Data.