Cílem tohoto příspěvku je zhodnotit dlouhodobý vývoj základních zdravotnických vstupů a výstupů a zhodnotit vývoj efektivnosti českého zdravotnictví. Efektivnost zdravotnictví hodnotíme dvěma indexy efektivnosti, které obsahují čtyři vstupy a dva, resp. tři výstupy zdravotnického systému. Váhy vstupů a výstupů byly získány na základě dotazníkového šetření mezi experty. Vytvořené indexy efektivnosti ukazují, že efektivnost českého zdravotnictví má klesající trend.
The objective of this paper is to evaluate the long-term development of main health system inputs and outputs and to evaluate the development of the efficiency of the Czech health system. We evaluate the health system efficiency by two indices of efficiency, which contain 4 inputs and 2, respectively 3 outputs of the health system. The weights of inputs and outputs were obtained by a questionnaire survey among experts. The developed efficiency indices show that the efficiency of the Czech health system has a downward trend.
- MeSH
- efektivita organizační MeSH
- lidé MeSH
- poskytování zdravotní péče * organizace a řízení MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- práce podpořená grantem MeSH
- srovnávací studie MeSH
- Geografické názvy
- Česká republika MeSH
BACKGROUND: Policymakers, who are constantly discussing growing health expenditures, should know whether the health system is efficient. We can provide them with such information through international health system efficiency evaluations. The main objectives of this study are: (a) to evaluate the efficiency of health systems in 28 developed countries by multiple-criteria decision analysis (MCDA) and data envelopment analysis (DEA) and (b) to identify reasonable benchmark countries for the Czech Republic, for which we collect information on the relative importance of health system inputs and outputs. METHODS: We used MCDA and DEA to evaluate the efficiency of the health systems of 28 developed countries. The models included four health system inputs (health expenditure as a relative share of GDP, the number of physicians, nurses, and hospital beds) and three health system outputs (life expectancy at birth, healthy life expectancy, and infant mortality rate). The sample covers 27 OECD countries and Russia, which is also included in the OECD database. To determine the input and output weights, we used a questionnaire sent to health policy experts in the Czech Republic. RESULTS: We obtained subjective information on the relative importance of the health system inputs and outputs from 27 Czech health policy experts. We evaluated health system efficiency using four MCDA and two DEA models. According to the MCDA models, Turkey, Poland, and Israel were found to have efficient health systems. The Czech Republic ranked 16th, 19th, 15th, and 17th. The benchmark countries for the Czech Republic's health system were Israel, Estonia, Luxembourg, Italy, the UK, Spain, Slovenia, and Canada. The DEA model with the constant returns to scale identified four technically efficient health systems: Turkey, the UK, Canada, and Sweden. The Czech Republic was found to be one of the worst-performing health systems. The DEA model with the variable returns to scale identified 15 technically efficient health systems. We found that efficiency results are quite robust. With two exceptions, the Spearman rank correlations between each pair of models were statistically significant at the 0.05 level. CONCLUSIONS: During the model formulation, we investigated the pitfalls of efficiency measurement in health care and used several practical solutions. We consider MCDA and DEA, above all, as exploratory methods, not methods providing definitive answers.
- Publikační typ
- časopisecké články MeSH
Mezinárodní srovnání zdravotnických systémů je velmi využívaný nástroj zdravotní politiky. Vychází z předpokladu, že mezinárodní zkušenosti jsou, alespoň do určité míry, přenositelné z jedné země do druhé. Cílem článku je posouzení vybraných metod mezinárodního srovnání zdravotnických systémů. Přitom si klademe otázku, jak užitečná je každá metoda pro hodnocení českého zdravotnického systému.
The international comparison of health systems is a frequently used tool of health policy. It assumes that international experiences are, at least to some extent, transferable from one country to another. The aim of this article is to review selected methods of international comparison of health systems. At the same time, we ask the question of how useful each method is for the evaluation of the Czech health system.
- MeSH
- lidé MeSH
- zdravotní politika * MeSH
- zdravotnické služby MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- práce podpořená grantem MeSH
- přehledy MeSH
- Geografické názvy
- Evropa MeSH
