title: Productivity changes in OECD healthcare systems: bias-corrected Malmquist productivity approach.
abstract: This study evaluates productivity changes in the healthcare systems of 30 Organization for Economic Co-operation and Development (OECD) countries over the 2002-2012 periods. The bootstrapped Malmquist approach is used to estimate bias-corrected indices of healthcare performance in productivity, efficiency and technology by modifying the original distance functions. Two inputs (health expenditure and school life expectancy) and two outputs (life expectancy at birth and infant mortality rate) are used to calculate productivity growth. There are no perceptible trends in productivity changes over the 2002-2012 periods, but positive productivity improvement has been noticed for most OECD countries. The result also informs considerable variations in annual productivity scores across the countries. Average annual productivity growth is evenly yielded by efficiency and technical changes, but both changes run somewhat differently across the years. The results of this study assert that policy reforms in OECD countries have improved productivity growth in healthcare systems over the past decade. Countries that lag behind in productivity growth should benchmark peer countries' practices to increase performance by prioritizing an achievable trajectory based on socioeconomic conditions. For example, relatively inefficient countries in this study indicate higher income inequality, corresponding to inequality and health outcomes studies. Although income inequality and globalization are not direct measures to estimate healthcare productivity in this study, these issues could be latent factors to explain cross-country healthcare productivity for future research. Copyright © 2016 John Wiley & Sons, Ltd.
authors.affiliation: Department of Political Science, East Carolina University, Greenville, North Carolina, USA.
authors.forename: Younhee
authors.initials: Y
authors.lastname: Kim
authors.affiliation: Department of Industrial Engineering, Inha University, Incheon, Korea.
authors.forename: Dong-Hyun
authors.initials: DH
authors.lastname: Oh
authors.affiliation: Department of Public Administration, Ewha Womans University, Seoul, Korea.
authors.forename: Minah
authors.initials: M
authors.lastname: Kang
mesh_terms: D015982:Bias; D003695:Delivery of Health Care / Q000458:organization & administration* / Q000706:statistics & numerical data; D017598:Efficiency, Organizational / Q000706:statistics & numerical data; D005102:Health Expenditures; D006801:Humans; D007223:Infant; D007226:Infant Mortality; D008017:Life Expectancy; D015233:Models, Statistical; D066150:Organisation for Economic Co-Operation and Development / Q000706:statistics & numerical data
keywords: Malmquist; bootstrap; efficiency; healthcare; productivity