title: Achieving value for money in health: a comparative analysis of OECD countries and regional countries.
abstract: OBJECTIVE
  To measure efficiency gains in health sector over the years 1995 to 2013 in OECD, EU, non-member European countries.
  
  
  METHODS
  An output-oriented DEA model with variable return to scale, and residuals estimated by regression equations were used to estimate efficiencies of health systems. Slacks for health care outputs and inputs were calculated by using DEA multistage method of estimating country efficiency scores.
  
  
  RESULTS
  Better health outcomes of countries were related with higher efficiency. Japan, France, or Sweden were found to be peer-efficient countries when compared to other developed countries like Germany and United States. Increasing life expectancy beyond a certain high level becomes very difficult to achieve. Despite declining marginal productivity of inputs on health outcomes, some developed countries and developing countries were found to have lowered their inefficiencies in the use of health inputs. Although there was no systematic relationship between political system of countries and health system efficiency, the objectives of countries on social and health policy and the way of achieving these objectives might be a factor increasing the efficiency of health systems.
  
  
  CONCLUSIONS
  Economic and political stability might be as important as health expenditure in improving health system goals. A better understanding of the value created by health expenditures, especially in developed countries, will require analysis of specific health interventions that can increase value for money in health. Copyright © 2016 John Wiley & Sons, Ltd.
authors: Faculty of Economics and Administrative Sciences, Department of Health Care Management, Ankara, Turkey.
authors: Yusuf
authors: Y
authors: Çelik
authors: Department of Health Services Policy and Management, Arnold School of Public Health, Columbia, South Carolina, USA.
authors: Mahmud
authors: M
authors: Khan
authors: Department of Integrated Information Technology, Columbia, South Carolina, USA.
authors: Neşet
authors: N
authors: Hikmet
mesh_terms: D003695:Delivery of Health Care / Q000191:economics / Q000458:organization & administration*; D019049:Developed Countries / Q000191:economics; D017598:Efficiency, Organizational / Q000191:economics; D005062:European Union / Q000191:economics / Q000706:statistics & numerical data; D005102:Health Expenditures; D006304:Health Status; D006801:Humans; D066150:Organisation for Economic Co-Operation and Development / Q000191:economics / Q000706:statistics & numerical data*
keywords: OECD countries; health system performance; value for money in health