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      Análisis de la eficiencia del gasto sanitario de los países de América Latina y el Caribe Translated title: Analysis of health expenditure efficiency in countries of Latin America and the Caribbean

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          Abstract

          Resumen: Objetivo: Comparar los niveles de eficiencia del gasto sanitario para 25 países de América Latina y el Caribe. Material y métodos: Aplicando la metodología del análisis de frontera estocástica se estiman los índices de eficiencia de los países, utilizando datos de los años 1995, 2000, 2005, 2010 y 2012. Se consideran dos variables alternativas de resultado de salud, la esperanza de vida y la mortalidad infantil. Para este último caso, se analizan los determinantes de la ineficiencia. Resultados: La media del nivel de eficiencia de la región considerando la esperanza de vida es mayor que al utilizar la mortalidad infantil. Conclusiones: Los resultados sugieren que los países aún pueden mejorar el uso de los recursos y que orientar una política de gasto hacia programas de inmunización y que garantice que los partos sean atendidos por un personal capacitado es una manera eficiente de salvar la vida de los neonatos.

          Translated abstract

          Abstract: Objective: To compare the efficiency levels of health expenditure in 25 countries in Latin America and the Caribbean. Materials and methods: The methodology of stochastic frontier analysis was applied to estimate the efficiency scores of the countries, using data from years 1995, 2000, 2005, 2010, 2012. Two output variables were considered, life expectancy at birth and infant mortality. In the latter case, determinants of inefficiency were analyzed. Results: The average efficiency level of the region using life expectancy is higher than when using infant mortality. Conclusions: Results suggest that countries can still improve the use of resources. Guiding the expenditure policy towards immunization programs and ensuring births take place in the presence of trained staff are efficient ways to save neonates.

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          The measurement of productive efficiency

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            Distinguishing between heterogeneity and inefficiency: stochastic frontier analysis of the World Health Organization's panel data on national health care systems.

            The most commonly used approaches to parametric (stochastic frontier) analysis of efficiency in panel data, notably the fixed and random effects models, fail to distinguish between cross individual heterogeneity and inefficiency. This blending of effects is particularly problematic in the World Health Organization's (WHO) panel data set on health care delivery, which is a 191 country, 5-year panel. The wide variation in cultural and economic characteristics of the worldwide sample produces a large amount of unmeasured heterogeneity in the data. This study examines several alternative approaches to stochastic frontier analysis with panel data, and applies some of them to the WHO data. A more general, flexible model and several measured indicators of cross country heterogeneity are added to the analysis done by previous researchers. Results suggest that there is considerable heterogeneity that has masqueraded as inefficiency in other studies using the same data. Copyright 2004 John Wiley & Sons, Ltd.
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              Technical efficiency in the use of health care resources: a comparison of OECD countries.

              Our paper analyzes technical efficiency in the production of aggregate health outcomes of reduced infant mortality and increased life expectancy, using Organization for Economic Cooperation and Development (OECD) health data. Application of data envelopment analysis (DEA) reveals that some countries achieve relative efficiency advantages, including those with good health outcomes (Japan, Sweden, Norway, and Canada) and those with modest health outcomes (Mexico and Turkey). We conclude the USA may learn from countries more economical in their allocation of healthcare resources that more is not necessarily better. Specifically, we find that the USA can substantially reduce inputs while maintaining the current level of life expectancy.
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                Author and article information

                Contributors
                Role: ND
                Role: ND
                Journal
                spm
                Salud Pública de México
                Salud pública Méx
                Instituto Nacional de Salud Pública (Cuernavaca, Morelos, Mexico )
                0036-3634
                October 2017
                : 59
                : 5
                : 583-591
                Affiliations
                [1] Santiago orgnameInstituto de Investigación Social para el Desarrollo República Dominicana
                [2] Castilla y León orgnameUniversidad de Valladolid orgdiv1Departamento de Fundamentos del Análisis Económico Spain
                Article
                S0036-36342017000500583
                10.21149/7816
                29267656
                ff473110-a35c-466d-b1af-2a45a235ae73

                This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.

                History
                : 25 February 2016
                : 14 April 2017
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 17, Pages: 9
                Product

                SciELO Public Health


                health care rationing,efficiency,outcome assessment (health care),América Latina,asignación de recursos para la atención de salud,eficiencia,evaluación de resultado (atención de salud),Latin America

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