{"title":"印度的公共医疗效率：使用两阶段 DEA 方法估算和决定因素","authors":"Khursheed Hussain Dar , Shahid Hamid Raina","doi":"10.1016/j.evalprogplan.2024.102472","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><p>Nearly 400 million Indians (30 % of the total population) lack any financial protection for health which leads to very high out of pocket expenditure. In India more than 90 million people spend 10–25 % of household expenses on healthcare. This is a serious threat to Sustainable Development Goal 3, which aims at providing universal health coverage along with protection from catastrophic spending on health.</p></div><div><h3>Aim</h3><p>The aim of this paper is to estimate the efficiency and determinants of public health in India at subnational level.</p></div><div><h3>Methods</h3><p>To estimate the efficiency of public healthcare, input oriented bias corrected DEA model has been used. In this model life expectancy at birth and infant survival rate have been treated as outputs. Public health spending and per capita income are treated as inputs. In the second stage Tobit regression is used to analyse the determinants of efficiency.</p></div><div><h3>Results</h3><p>The mean bias corrected efficiency score across Indian states is 0.60, implying that on average there is a 40 % inefficiency in public healthcare in India. Maharashtra and Mizoram are the most and least efficient states with efficiency score of 0.921 and 0.218, respectively. Fourteen states have efficiency scores less than 0.60, two states have efficiency score of 0.60 and 15 states have the efficiency score greater than 0.60. Socio economic factors outweigh the medical factors in determining the public healthcare efficiency in India.</p></div><div><h3>Conclusion</h3><p>There are 40 % inefficiencies in public health in India implying significant wastages in public health. By improving public health efficiency, there would be savings of 48 % in terms of government expenditure on health per capita. It will also improve infant survival rate by 27.19 % and life expectancy by 20.65 %.</p></div>","PeriodicalId":48046,"journal":{"name":"Evaluation and Program Planning","volume":"106 ","pages":"Article 102472"},"PeriodicalIF":1.5000,"publicationDate":"2024-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Public healthcare efficiency in India: Estimates and determinants using two stage DEA approach\",\"authors\":\"Khursheed Hussain Dar , Shahid Hamid Raina\",\"doi\":\"10.1016/j.evalprogplan.2024.102472\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Background</h3><p>Nearly 400 million Indians (30 % of the total population) lack any financial protection for health which leads to very high out of pocket expenditure. In India more than 90 million people spend 10–25 % of household expenses on healthcare. This is a serious threat to Sustainable Development Goal 3, which aims at providing universal health coverage along with protection from catastrophic spending on health.</p></div><div><h3>Aim</h3><p>The aim of this paper is to estimate the efficiency and determinants of public health in India at subnational level.</p></div><div><h3>Methods</h3><p>To estimate the efficiency of public healthcare, input oriented bias corrected DEA model has been used. In this model life expectancy at birth and infant survival rate have been treated as outputs. Public health spending and per capita income are treated as inputs. In the second stage Tobit regression is used to analyse the determinants of efficiency.</p></div><div><h3>Results</h3><p>The mean bias corrected efficiency score across Indian states is 0.60, implying that on average there is a 40 % inefficiency in public healthcare in India. Maharashtra and Mizoram are the most and least efficient states with efficiency score of 0.921 and 0.218, respectively. Fourteen states have efficiency scores less than 0.60, two states have efficiency score of 0.60 and 15 states have the efficiency score greater than 0.60. Socio economic factors outweigh the medical factors in determining the public healthcare efficiency in India.</p></div><div><h3>Conclusion</h3><p>There are 40 % inefficiencies in public health in India implying significant wastages in public health. By improving public health efficiency, there would be savings of 48 % in terms of government expenditure on health per capita. It will also improve infant survival rate by 27.19 % and life expectancy by 20.65 %.</p></div>\",\"PeriodicalId\":48046,\"journal\":{\"name\":\"Evaluation and Program Planning\",\"volume\":\"106 \",\"pages\":\"Article 102472\"},\"PeriodicalIF\":1.5000,\"publicationDate\":\"2024-08-09\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Evaluation and Program Planning\",\"FirstCategoryId\":\"90\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S0149718924000740\",\"RegionNum\":4,\"RegionCategory\":\"社会学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"SOCIAL SCIENCES, INTERDISCIPLINARY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Evaluation and Program Planning","FirstCategoryId":"90","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0149718924000740","RegionNum":4,"RegionCategory":"社会学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"SOCIAL SCIENCES, INTERDISCIPLINARY","Score":null,"Total":0}
Public healthcare efficiency in India: Estimates and determinants using two stage DEA approach
Background
Nearly 400 million Indians (30 % of the total population) lack any financial protection for health which leads to very high out of pocket expenditure. In India more than 90 million people spend 10–25 % of household expenses on healthcare. This is a serious threat to Sustainable Development Goal 3, which aims at providing universal health coverage along with protection from catastrophic spending on health.
Aim
The aim of this paper is to estimate the efficiency and determinants of public health in India at subnational level.
Methods
To estimate the efficiency of public healthcare, input oriented bias corrected DEA model has been used. In this model life expectancy at birth and infant survival rate have been treated as outputs. Public health spending and per capita income are treated as inputs. In the second stage Tobit regression is used to analyse the determinants of efficiency.
Results
The mean bias corrected efficiency score across Indian states is 0.60, implying that on average there is a 40 % inefficiency in public healthcare in India. Maharashtra and Mizoram are the most and least efficient states with efficiency score of 0.921 and 0.218, respectively. Fourteen states have efficiency scores less than 0.60, two states have efficiency score of 0.60 and 15 states have the efficiency score greater than 0.60. Socio economic factors outweigh the medical factors in determining the public healthcare efficiency in India.
Conclusion
There are 40 % inefficiencies in public health in India implying significant wastages in public health. By improving public health efficiency, there would be savings of 48 % in terms of government expenditure on health per capita. It will also improve infant survival rate by 27.19 % and life expectancy by 20.65 %.
期刊介绍：
Evaluation and Program Planning is based on the principle that the techniques and methods of evaluation and planning transcend the boundaries of specific fields and that relevant contributions to these areas come from people representing many different positions, intellectual traditions, and interests. In order to further the development of evaluation and planning, we publish articles from the private and public sectors in a wide range of areas: organizational development and behavior, training, planning, human resource development, health and mental, social services, mental retardation, corrections, substance abuse, and education.
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