title: Assessing health system performance: a model-based approach.
abstract: It is difficult to assess countries' relative success in addressing issues of public health because countries are subject to very different background conditions. To address this problem we offer a model-based approach for assessing health system performance. Specifically, an index of public health is regressed against a vector of variables intended to capture economic, educational, cultural, geographic, and epidemiological endowments. The residual from this model is regarded as a plausible measure of public health performance at the national level. We argue that a model-based approach to performance is informative for policymakers and academics as it focuses attention on those aspects of a country's health profile that are not constrained by structural factors. This sharpens comparisons across countries and through time, and also allows one to evaluate the degree to which health systems have lived up to their potential.
authors.affiliation: Department of Political Science, Boston University, 232 Bay State Road, Boston, MA 02215, USA. jgerring@bu.edu
authors.forename: John
authors.initials: J
authors.lastname: Gerring
authors.forename: Strom C
authors.initials: SC
authors.lastname: Thacker
authors.forename: Ruben
authors.initials: R
authors.lastname: Enikolopov
authors.forename: Julián
authors.initials: J
authors.lastname: Arévalo
authors.forename: Matthew
authors.initials: M
authors.lastname: Maguire
mesh_terms: D003695:Delivery of Health Care / Q000592:standards*; D014943:Global Health; D006291:Health Policy; D006305:Health Status Indicators; D006801:Humans; D015233:Models, Statistical; D011634:Public Health / Q000706:statistics & numerical data*
keywords: Global health; Health policy assessment; Health policy performance