An Investigation About Health Spending Efficiency in Transition Economies

Year 2015, Volume: 15 Issue: 4, 523 - 538, 01.11.2015

Berna Bulğurcu Pınar Özdemir

Abstract

“Efficiency” concept means to have maximum output with given input. IMF and World Bank define ex socialist countries as transitions that transform resource allocation mechanism central planning to market system accompined with prefering private property instead of public property. Measurement of institutional changes in order to build market system -especially for health system- is an important indicator to determine affect of transformations. Aim of this study is to analyze affect of building market system on health expenditure during transitions and post transitions period. Data Envelopment Analysis is applied in order to compare transition countries efficiency level for years 20002013

Keywords

Transition Economies, Health Expenditure, Data Envelopment Analysis

Geçiş Ekonomilerinde Sağlık Harcamalarının Etkinliği Üzerine Bir İnceleme

Abstract

Kaynakların etkin kullanımı, mevcut girdilerle elde edilebilecek en yüksek çıktı düzeyine ulaşmayı ifade eden bir kavramdır. Kaynak tahsis mekanizmasında merkezi planlamacı devletin yerini serbest piyasanın aldığı, kamu mülkiyetinin ise yerini özel mülkiyete bıraktığı eski sosyalist ülkeler, IMF ve Dünya Bankası tarafından geçiş ekonomisi olarak adlandırılmaktır. Bu ülkelerde piyasa sisteminin kurumsallaşması için yapılan düzenlemelerin özellikle sağlık alanında yarattığı etkilerin ölçülmesi, yaşanan dönüşümün etkilerinin belirlenmesinde önemli bir göstergedir. Bu çalışmanın amacı; geçiş süreci boyunca ve sonrasında piyasa sisteminin tesis edilmesinin sağlık harcamalarının etkinliği üzerine etkisini test etmektir. Çalışmada Veri Zarflama Analizi kullanılarak, 2000-2013 yılları arasında ülkelerin etkinlik düzeyleri kıyaslanmıştır

Keywords

Geçiş Ekonomileri, Sağlık Harcamaları, Veri Zarflama Analizi

References

• Adeyi, O., Chellaraj, G. , Goldstein, E., Preker, A. ve Ringold, D. (1997) “Health Status During the Transition in Central and Eastern Europe: Development in Reverse” Health Policy Plan, 12(2):132-45.
• Alam, A., Casero, P. , Khan, F. ve Udomsaph, C. (2008) “Unleashing Prosperity:Productivity Growth in Eastern Europe and the Former Soviet Union” The World Bank Report, 42.
• Arslan, A. (2002) “Kamu Harcamalarında Verimlilik, Etkinlik ve Denetim” Maliye Dergisi,140.
• Boussofiane, A., Dyson, R.G. ve Thanassoulis, E. (1991) “Applied Data Envelopment Analysis” European Journal Of Operational Research, 52(1):1-15.
• Carvalho, A., Nepal, R. ve Jamasb, T. (2013), “Market-Oriented Structural Reforms and Human Development: Evidence from Transition Economies”, School of Economics, University of Queenslands Discussion Paper Series, 593.
• Charnes, A., Cooper, W.W. ve Rhodes, W. (1978) “Measuring Efficiency of Decision Making Units” European Journal of Operational Research, 2: 429-444.
• Charnes, A., Cooper, W.W, Leiwen, A.Y. ve Seiford, L.M. (1994) “Data Envelopment Analysis” USA : Kluwer Academic Publishers .
• Chubarova, T., Grigorieva, N. ve Mkhitaryan, L. (2013) “Health Care Reforms in the CIS: Comparative Analysis of Armenia and Russia” The 1st International Conference on Public Policy, Grenoble, France, 26-28 June.
• Çelebi, K., Cura, S. (2013), “Etkinlik Göstergeleri Açı- sından Sağlık Sistemleri: Karşılaştırmalı Bir Analiz”, Maliye Dergisi, 164: 47-67
• Dyson, R.G., Allen, R., Camanho, A.S, Podinovski, V.V., Sarrico, C.S. ve. Shale, E.A. “Pitfalls and Protocols in DEA” European Journal of Operational Research, 132(2):245-259.
• Ensor, T. (2004), “Informal Payments for Health care in Transition Economies”, Social Science & Medicine 58: 237–246
• Evans, D., Tandon, A., Murray, C. ve Lauer, J. (2001) “Comparative Efficiency of National Health Systems: Cross National Econometric Analysis” BMJ, 323.
• Fakin, B. ve Crombrugghe, A.D. (1997) “Fiscal Adjustments In Transitions Economies Transfers and the Efficiency of Public Spending: A Comparison with OECD Countries” World Bank Policy Research Working Paper, No: 1803.
• Gupta S., Verhoeven, M. ve Tiongson, E. (2001). Public Spending on Health Care and the Poor. IMF Working Papers, No:127.
• Hollingsworth, B., Dawson,  P.J., Maniadakis, N. (1999)“Efficiency measurement of health care: a review of non‐parametric methods and applications” Health Care Management Science,2(3):161-172.
• Jacobs, R., Smith, P.C. ve Street, A. (2006) “ Measuring Efficiency in Health Care” The United States of America: Cambridge University Press.
• Joumard,I., Andre, C. ve Nicq,C. (2010) “Health Care Systems: Efficiency and Institutions”, Working Papers, 25.
• Kayalı, C. A., Kayalı, N. ve Kartal,B. (2004) “Veri Zarflama Analizinin Türk Sağlık Sektöründe Bir Uygulaması”, Celal Bayar Üniversitesi S.B.E., 2(2): 67-89.
• Kirigia, J.M., Asbu, E.Z., Greene, W. ve Emrouznejad, A. (2007) “Technical Efficiency, Efficiency Change, Technical Progress and Productivity Growth in the National Health Systems of Continental African Countries” Eastern Africa Social Science Research Review , 23(2):19- 40.
• Kocaman, A., Mutlu, M., Bayraktar, D. ve Araz, Ö. (2012) “OECD Ülkelerinin Sağlık Sistemlerinin Analizi” Endüstri Mühendisliği Dergisi, 23(4):14-31.
• Korkut, U. ve Buzogány, A. (2013) “Successful Transplants? Reform Governments and Health Care Policy Change in Slovenia, Slovakia & Hungary”, Paper for the ICPP Conference, Grenoble, 26-28 June .
• Kumbhakar, S. (2004) “Efficiency of World Health Systems” http://www. economics.unsw.edu.au/RESEARCH/SEMINAR/Visitor/kumbhaker (07.02.2013)
• Kutzin, J. (2010) “Conceptual Framework For Analysing Health Financing Systems and the Effe Reforms” Implementing Health Financing Reform Lessons from Countries in Transition Observary Studies Series, 21.
• Linna, M., Nordblad,A. ve Koivu,M. (2003)  “Technical and Cost-efficiency of Oral Health Care Provision in Finnish Health Centres” Soc Sci Med , 56(2):343-353.
• Liu, J., Ding, F. ve Lall, V. (2000) “Using Data Envelopment Analysis to Compare Suppliers for Supplier Selection and Performance Improvement” Supply Chain Management An International Journal , 5(3):143-150.
• Mandl, U., Dierx, A., Ilkovitz, F. (2008) The Effectiveness and Efficiency of Public Spending. European Economy Economic Papers, No:31
• Masiye, F. (2007) “Investigating Health System Performance: An Application of Data Envelopment Analysis to Zambia Hospitals” BMC Health Services Research, 7:58.
• Mirmirani, S. (2008) “Health Care Efficiency in Transition Economies: An Application of Data Envelopment Analysis “ International Business & Economics Research Journal, 7(2): 47–56.
• Nguyen, N. ve Frenk, J. (2011) “Health Policies in Transitions, Oxford Textbook of Public Health” https:// medtextfree.wordpress.com/2011/04/06/3-4-healthpolicies-in-transition-economies (02.06.2013)
• Oxley, H. ve MacFarlan, M. (1995) “Health Care Reform: Controlling Spending and Increasing Efficiency” OECD Economic Studies, No: 24.
• Paoli, F. (2012) “Health System Efficiency and Sustainability European Perspective” Eurohealth, 18(3):14-18.
• Popescu, C., Asandului, L. Ve Fatulescu, P. (2014) “A Data Envelopment Analysis for Evaluating Romania’s Health System” Procedia - Social and Behavioral Sciences, 109: 1185–1189.
• Puenpatom, A. ve Rosenman, R. (2006) “Efficiency of Thai Provincial Public Hospitals After the Introduction of National Health Insurance Program” School of Economic Sciences, Washington State University, Working Paper Series, 2-33.
• Retzlaff-Roberts, D., Chang, C.F. ve Rubin, R.M. (2004) “Technical Efficiency in the Use of Health Care Resources: A Comparison of OECD Countries” Health Policy, 69(1):55-72.
• Rudraswamy, S. ve Doggalli, N. (2012) “Health Policies in Transition Economics” Journal of Hospital Administration, 1: 1.
• Safaei, J (2012) “Communist Health Transitions in Central and Eastern Europe” Economics Research International, 2012 (2012).
• Sherman, H.D. (1984) “Data Envelopment Analysis as a New Managerial Audit Methodology-Test and Evaluation” Auditing: A Journal of Practice and Theory, 4: 35- 53.
• Smith, P. (2012) “What is the Scope for Health System, Efficiency Gains and How They can be Achieved”, Eurohealth, 18(3): 3-7.
• Stratmann T., Crivelli, E. ve Leive, A. (2010) “Subnational Health Spending and Soft Budget Constraints in OECD Countries “ IMF Working Paper, 10:147.
• Şenatalar, B. (2003) “Sağlık Ekonomisine Genel Bakış” Cumhuriyet Üniversitesi Tıp Fakültesi Dergisi, 25(4).
• Şahin B. (1999) “Sağlığın Ölçümü ve Kullanım Alanlarına Teorik Bir Bakış” Sağlık ve Toplum Dergisi, 9(3): 3-12.
• Tambori, M., Pavlova, M. Rechel, B., Golinowska, S. , Sowada, C. ve Groot, W. (2013) “The Inability to Pay for Health Services in Central and Eastern Europe: Evidence from Six Countries” European Journal of Public Health, 24(3):378–385.
• United Nation (2013) World Economic Situation and Prospects Reports.
• Wagener, H. (2011) “The Welfare State in Transition Economies and Accession to the EU” West European Politics, 25(2): 152-174
• Yardım, M.S, Çilingiroğlu N ve Yardım, N (2010) “Catastrophic Health Expenditure and Impoverishment in Turkey “ Health Policy, 94: 26–33.
• Zhang, N., Hu, A., Zheng, J. (2007) “Using Data Envelopment Analysis Approach to Estimate the Health Production Efficiencies in China,” Frontiers of Economics in China, 2(1): 1-23.