Data envelopment analysis for evaluating Serbia's health care system

Abstract

This paper is an attempt to measure and evaluate the efficiency of the health care system of Serbia in comparison with countries in the European region using the data envelopment analysis (DEA), one of the most important methods to model and measure the efficiency of health care systems. The research included the sample of 42 countries representing decision-making units (DMU), divided into two groups of countries with similar levels of development. To assess the performance of those DMUs we used three outputs representing mortality rates and three inputs representing health care expenditure and health care human resources. In the presence of undesirable outputs, the proposed model was Bad Output Model with simple modifications. The analysis showed that 19 out of 42 countries are relatively efficient in providing health services and a close examination of these efficient countries shows that most countries are countries with low input values. On the other hand, Serbia's health system is ranked the 15th out of 21 analyzed systems within its group, with a gap of 37% in comparison with the first ones ranked. The usual explanation is that the health system in Serbia has been affected, during time, by the lack of reforms, by poor funding as well as by the lack of interest of the authorities in establishing a long-term strategy; further analysis, however, are needed to show the reasons for this state and what steps should be done to improve the current state. We find that this paper could be useful to both public health practitioners and researchers especially because due to its complexity in undertaking, the measuring efficiency at the system level has recently been applied only in few studies and this research will be a significant contribution.