The Efficiency of Health Systems in European Union (EU) Countries with Undesirable Output: A DEA-Slack-Based Model Approach

Year 2025, Volume: 59 Issue: 4, 893 - 908, 08.10.2025

Gözde Yeşilaydın , Bilal Saraç

https://doi.org/10.51551/verimlilik.1638688

Abstract

Purpose: This study was conducted to evaluate the efficiency of the health system of the EU countries by using DEA-Slack Based Measure (SBM) Model. The study also aimed to determine the healthcare resources that created a statistical difference in the efficiency status of countries.
Methodology: In the study, 27 member countries of the European Union were considered as decision-making units. Health expenditure and workforce were used as input; adult mortality rate was used as an undesirable and health status were used as desired output variables. DEA-SBM method was employed to evaluate efficiency, the Mann-Whitney U test was used to determine healthcare resources that created a statistically significant difference.
Findings: Approximately 40.74 % of countries were efficient. The number of nursing and midwifery personnel created a statistically significant difference in the efficiency status of the countries. It can be said that inefficient countries do not use their healthcare resources efficiently and they consume more health financial, technological, and workforce resources compared to efficient countries.
Originality: In addition to the input and output variables, the undesired output variable was also included in the analysis. This is considered to be the original aspect of the study.

Keywords

Efficiency , Data Envelopment Analysis , European Union , Health Systems , Slack Based Measure Model

Ethical Statement

Ethical approval is not required since the analysis is done with public access secondary data.

Avrupa Birliği (AB) Ülkelerinin Sağlık Sistemlerinin İstenmeyen Çıktıyla Etkinliği: Aylak Tabanlı Veri Zarflama Analizi Yaklaşımı

Abstract

Amaç: Bu çalışma, AB ülkelerinin sağlık sisteminin etkinliğini Aylak Tabanlı Veri Zarflama Analizi Modeli kullanılarak değerlendirmek amacıyla yürütülmüştür. Çalışmada ayrıca ülkelerin etkinlik durumlarında istatistiksel açıdan fark yaratan sağlık kaynaklarının belirlenmesi de amaçlanmıştır.
Yöntem: Çalışmada Avrupa Birliği’ne üye 27 ülke karar verme birimi olarak ele alınmıştır. Sağlık harcamaları ve sağlık insangücü girdi; yetişkin ölüm oranı istenmeyen çıktı ve sağlık durumu ise istenen çıktı değişkenidir. Ülkelerin etkinliğinin değerlendirilmesinde aylak tabanlı veri zarflama analizi yöntemi kullanılmış; ülkelerin etkin olup olmama durumu üzerinde fark yaratan sağlık kaynaklarının belirlenmesi ise MannWhitney U testi ile yapılmıştır.
Bulgular: Ülkelerin yaklaşık %40,74'ü etkindir. Hemşire ve Ebe sayısı ülkelerin etkinlik durumlarında istatistiksel olarak anlamlı bir fark yaratmıştır. Etkin olmayan ülkelerin sağlık kaynaklarını yeterli düzeyde etkin kullanmadıkları ve etkin ülkelere kıyasla daha fazla finansal, teknolojik ve sağlık insangücü kaynağı tükettikleri söylenebilir.
Özgünlük: Çalışmada girdi ve çıktı değişkenlerine ek olarak istenmeyen çıktı değişkeni de analize dahil edilmiştir. Bu durumun çalışmanın özgün yönü olduğu düşünülmektedir.

Keywords

Etkinlik , Veri Zarflama Analizi , Avrupa Birliği , Sağlık Sistemleri , Aylak Tabanlı Ölçüm Modeli

Ethical Statement

Çalışmanın analizi topluma açık ikincil verilerle yapıldığından etik onaya gerek yoktur.

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