[go: up one dir, main page]
More Web Proxy on the site http://driver.im/
IDEAS home Printed from https://ideas.repec.org/a/gam/jsusta/v10y2018i9p3186-d168093.html
   My bibliography  Save this article

Investigating Health Systems in the European Union: Outcomes and Fiscal Sustainability

Author

Listed:
  • Madalina Ecaterina Popescu

    (National Scientific Research Institute for Labour and Social Protection, 6-8 Povernei Street, 010643 Bucharest, Romania
    The Faculty of Economic Cybernetics, Statistics and Informatics, The Bucharest University of Economic Studies, 15–17 Dorobanti St., Sector 1, 010552 Bucharest, Romania)

  • Eva Militaru

    (National Scientific Research Institute for Labour and Social Protection, 6-8 Povernei Street, 010643 Bucharest, Romania)

  • Amalia Cristescu

    (National Scientific Research Institute for Labour and Social Protection, 6-8 Povernei Street, 010643 Bucharest, Romania
    The Faculty of Theoretical and Applied Economics, The Bucharest University of Economic Studies, 15–17 Dorobanti St., Sector 1, 010552 Bucharest, Romania)

  • Maria Denisa Vasilescu

    (National Scientific Research Institute for Labour and Social Protection, 6-8 Povernei Street, 010643 Bucharest, Romania
    The Faculty of Economic Cybernetics, Statistics and Informatics, The Bucharest University of Economic Studies, 15–17 Dorobanti St., Sector 1, 010552 Bucharest, Romania)

  • Monica Mihaela Maer Matei

    (National Scientific Research Institute for Labour and Social Protection, 6-8 Povernei Street, 010643 Bucharest, Romania
    The Faculty of Economic Cybernetics, Statistics and Informatics, The Bucharest University of Economic Studies, 15–17 Dorobanti St., Sector 1, 010552 Bucharest, Romania)

Abstract
Healthcare systems aim to provide access to good quality care, while ensuring equity and solidarity. The fiscal sustainability of healthcare systems has become a matter of concern in recent European Union (EU) debates, considering the ever increasing need for adequate healthcare determined by factors such as aging population, investments in technology and infrastructure, medical products and wages. Our paper seeks to measure the health system performances of the EU countries by building up a composite index, which will then be used as a tool in investigating the relationship between health performance and the fiscal sustainability of health systems. A principal components analysis (PCA) was applied to build the composite index through the use of the most relevant health indicators provided by Eurostat and the Sustainable Development Knowledge Platform. The composite index offers a comprehensive performance assessment and provides a clear ranking of the EU countries based on their health system performances. Further investigation of the link between health performance and fiscal sustainability revealed that higher ranks are associated with higher shares of health expenditures in gross domestic product (GDP), a large share of employment in the health sector, and higher duration of working life. These patterns are followed by efficient health systems, encountering reduced sustainability risks.

Suggested Citation

  • Madalina Ecaterina Popescu & Eva Militaru & Amalia Cristescu & Maria Denisa Vasilescu & Monica Mihaela Maer Matei, 2018. "Investigating Health Systems in the European Union: Outcomes and Fiscal Sustainability," Sustainability, MDPI, vol. 10(9), pages 1-28, September.
    • Handle: RePEc:gam:jsusta:v:10:y:2018:i:9:p:3186-:d:168093
    as

    Download full text from publisher

    File URL: https://www.mdpi.com/2071-1050/10/9/3186/pdf
    Download Restriction: no
    File URL: https://www.mdpi.com/2071-1050/10/9/3186/
    Download Restriction: no
    ---><---

    References listed on IDEAS

    as
    1. Smith, Stephen M. & Gibson, Cosette M., 1988. "Industrial Diversification In Nonmetropolitan Counties And Its Effect On Economic Stability," Western Journal of Agricultural Economics, Western Agricultural Economics Association, vol. 13(2), pages 1-9, December.
    2. William Greene, 2004. "Distinguishing between heterogeneity and inefficiency: stochastic frontier analysis of the World Health Organization's panel data on national health care systems," Health Economics, John Wiley & Sons, Ltd., vol. 13(10), pages 959-980, October.
    3. Soeren Mattke & Edward Kelley & Peter Scherer & Jeremy Hurst & Maria Luisa Gil Lapetra & HCQI Expert Group Members, 2006. "Health Care Quality Indicators Project: Initial Indicators Report," OECD Health Working Papers 22, OECD Publishing.
    4. Daxin Sun & Haksoon Ahn & Tomas Lievens & Wu Zeng, 2017. "Evaluation of the performance of national health systems in 2004-2011: An analysis of 173 countries," PLOS ONE, Public Library of Science, vol. 12(3), pages 1-13, March.
    5. Adriana Grigorescu & Elena Condrea & Christopher De Freitas Bradley, 2015. "Quality Management in Healthcare Systems," Ovidius University Annals, Economic Sciences Series, Ovidius University of Constantza, Faculty of Economic Sciences, vol. 0(2), pages 246-251, May.
    6. Quan-Hoang Vuong & Tung-Manh Ho & Hong-Kong Nguyen & Thu-Trang Vuong, 2018. "Healthcare consumers’ sensitivity to costs: a reflection on behavioural economics from an emerging market," Palgrave Communications, Palgrave Macmillan, vol. 4(1), pages 1-10, December.
    7. Edward Kelley & Jeremy Hurst, 2006. "Health Care Quality Indicators Project: Conceptual Framework Paper," OECD Health Working Papers 23, OECD Publishing.
    8. Rosa Aísa & Fernando Pueyo, 2004. "Endogenous longevity, health and economic growth: a slow growth for a longer life?," Economics Bulletin, AccessEcon, vol. 9(3), pages 1-10.
    9. Nenadic, Oleg & Greenacre, Michael, 2007. "Correspondence Analysis in R, with Two- and Three-dimensional Graphics: The ca Package," Journal of Statistical Software, Foundation for Open Access Statistics, vol. 20(i03).
    10. Adriana AnaMaria Davidescu & Andreea Maria Vass Paul & Rodica-Manuela Gogonea & Marian Zaharia, 2015. "Evaluating Romanian Eco-Innovation Performances in European Context," Sustainability, MDPI, vol. 7(9), pages 1-35, September.
    11. Merlin M. Hackbart & Donald A. Anderson, 1975. "On Measuring Economic Diversification," Land Economics, University of Wisconsin Press, vol. 51(4), pages 374-378.
    12. Mark Berger & Jodi Messer, 2002. "Public financing of health expenditures, insurance, and health outcomes," Applied Economics, Taylor & Francis Journals, vol. 34(17), pages 2105-2113.
    13. Asandului, Laura & Roman, Monica & Fatulescu, Puiu, 2013. "The Efficiency of Healthcare Systems in Europe: a Data Envelopment Analysis Approach," MPRA Paper 58954, University Library of Munich, Germany, revised Apr 2014.
    14. Michael Freudenberg, 2003. "Composite Indicators of Country Performance: A Critical Assessment," OECD Science, Technology and Industry Working Papers 2003/16, OECD Publishing.
    15. Elisabeta JABA & Ioana-Alexandra CHIRIANU & Christiana Brigitte BALAN & Ioan-Bogdan ROBU & Mihai Daniel ROMAN, 2016. "The Analysis Of The Effect Of Women’S Participation In The Labor Market On Fertility In European Union Countries Using Welfare State Models," ECONOMIC COMPUTATION AND ECONOMIC CYBERNETICS STUDIES AND RESEARCH, Faculty of Economic Cybernetics, Statistics and Informatics, vol. 50(1), pages 69-84.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Hanana Khan & Maran Marimuthu & Fong-Woon Lai, 2020. "Fiscal Deficit and Its Less Inflationary Sources of Borrowing with the Moderating Role of Political Instability: Evidence from Malaysia," Sustainability, MDPI, vol. 12(1), pages 1-16, January.
    2. Roman Lacko & Zuzana Hajduová & Tomáš Bakalár & Henrieta Pavolová, 2022. "Efficiency and Productivity Differences in Healthcare Systems: The Case of the European Union," IJERPH, MDPI, vol. 20(1), pages 1-14, December.
    3. Jaros{l}aw Wk{a}tr'obski & Aleksandra Bk{a}czkiewicz & Iga Rudawska, 2023. "A Strong Sustainability Paradigm Based Analytical Hierarchy Process (SSP-AHP) Method to Evaluate Sustainable Healthcare Systems," Papers 2306.00718, arXiv.org.
    4. Iñigo Calvo-Sotomayor & Jon Paul Laka & Ricardo Aguado, 2019. "Workforce Ageing and Labour Productivity in Europe," Sustainability, MDPI, vol. 11(20), pages 1-16, October.
    5. Sung-Shil Lim & Jin-Ha Yoon & Jeongbae Rhie & Suk Won Bae & Jihyun Kim & Jong-Uk Won, 2018. "The Relationship between Free Press and Under-Reporting of Non-Fatal Occupational Injuries with Data from Representative National Indicators, 2015: Focusing on the Lethality Rate of Occupational Injur," IJERPH, MDPI, vol. 15(12), pages 1-12, December.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Mustapha D. Ibrahim & Sahand Daneshvar & Mevhibe B. Hocaoğlu & Olasehinde-Williams G. Oluseye, 2019. "An Estimation of the Efficiency and Productivity of Healthcare Systems in Sub-Saharan Africa: Health-Centred Millennium Development Goal-Based Evidence," Social Indicators Research: An International and Interdisciplinary Journal for Quality-of-Life Measurement, Springer, vol. 143(1), pages 371-389, May.
    2. Dino Rizzi & Michele Zanette, 2021. "Potential efficiency gains and expenditure savings in the Italian Regional Healthcare Systems," Politica economica, Società editrice il Mulino, issue 2, pages 187-214.
    3. Schwartz, Robert & Deber, Raisa, 2016. "The performance measurement–management divide in public health," Health Policy, Elsevier, vol. 120(3), pages 273-280.
    4. Sam Peltzman, 2014. "Socialized medicine and mortality," International Journal of Health Economics and Management, Springer, vol. 14(3), pages 179-205, September.
    5. Pınar Kaya Samut & Reyhan Cafrı, 2016. "Analysis of the Efficiency Determinants of Health Systems in OECD Countries by DEA and Panel Tobit," Social Indicators Research: An International and Interdisciplinary Journal for Quality-of-Life Measurement, Springer, vol. 129(1), pages 113-132, October.
    6. Kuhn, Michael & Prettner, Klaus, 2016. "Growth and welfare effects of health care in knowledge-based economies," Journal of Health Economics, Elsevier, vol. 46(C), pages 100-119.
    7. Boroch, Wilfried, 2018. "Dimensionen allgemeiner Gesundheitspolitik: Eine modifizierte Anordnung nach Kriterien der engen, weiten und praxisbezogenen Anwendung," ifgs Schriftenreihe, FOM Hochschule für Oekonomie & Management, ifgs Institut für Gesundheit & Soziales, volume 11, number 11 edited by FOM Hochschule für Oekonomie & Management, ifgs Institut für Gesundheit & Soziales.
    8. Milena Vainieri & Francesca Ferrè & Stefania Manetti, 2021. "An Integrated Framework to Measure the Performance of Inter-Organizational Programme on Health Technology Assessment," Sustainability, MDPI, vol. 13(7), pages 1-17, March.
    9. Stöver, Jana & Vöpel, Henning & Manouguian, Maral-Sonja & Verheyen, Frank, 2010. "Qualität und Effizienz der Gesundheitsversorgung im internationalen Vergleich," HWWI Policy Papers 55, Hamburg Institute of International Economics (HWWI).
    10. Puertas, Rosa & Marti, Luisa & Guaita-Martinez, José M., 2020. "Innovation, lifestyle, policy and socioeconomic factors: An analysis of European quality of life," Technological Forecasting and Social Change, Elsevier, vol. 160(C).
    11. Katharina Schley, 2018. "Health care service provision in Europe and regional diversity: a stochastic metafrontier approach," Health Economics Review, Springer, vol. 8(1), pages 1-11, December.
    12. Nadide Halıcı-Tülüce & İbrahim Doğan & Cüneyt Dumrul, 2016. "Is income relevant for health expenditure and economic growth nexus?," International Journal of Health Economics and Management, Springer, vol. 16(1), pages 23-49, March.
    13. Zeynep Or & Laure Com-Ruelle, 2008. "La qualité des soins en France : comment la mesurer pour l'améliorer ?," Working Papers DT19, IRDES institut for research and information in health economics, revised Dec 2008.
    14. Mariola Zalewska, 2015. "Limitations of the set of public health indicators monitored in the context of sustainable development (Ograniczenia wskaznikow zdrowia publicznego monitorowanych w kontekscie zrownowazonego rozwoju )," Problemy Zarzadzania, University of Warsaw, Faculty of Management, vol. 13(53), pages 247-260.
    15. J. C. Dissart, 2003. "Regional Economic Diversity and Regional Economic Stability: Research Results and Agenda," International Regional Science Review, , vol. 26(4), pages 423-446, October.
    16. Rodrigo Moreno-Serra & Misael Anaya-Montes & Peter C Smith, 2019. "Potential determinants of health system efficiency: Evidence from Latin America and the Caribbean," PLOS ONE, Public Library of Science, vol. 14(5), pages 1-21, May.
    17. Greß, Stefan & Maas, Stephanie & Wasem, Jürgen, 2008. "Effektivitäts-, Effizienz- und Qualitätsreserven im deutschen Gesundheitssystem," Arbeitspapiere 154, Hans-Böckler-Stiftung, Düsseldorf.
    18. Iwona Markowicz & Iga Rudawska, 2021. "Struggling with COVID-19—A Framework for Assessing Health System Performance," Sustainability, MDPI, vol. 13(20), pages 1-13, October.
    19. Duško Čučković & Ilija Ćosić & Milan Delić & Miroslav Miškić & Slavica Ranisavljev Kovačev, 2021. "Influence of Interpersonal Processes on the Performance of Primary Health Care Organizations," Sustainability, MDPI, vol. 13(21), pages 1-12, November.
    20. Veillard, Jeremy & Moses McKeag, Alexandra & Tipper, Brenda & Krylova, Olga & Reason, Ben, 2013. "Methods to stimulate national and sub-national benchmarking through international health system performance comparisons: A Canadian approach," Health Policy, Elsevier, vol. 112(1), pages 141-147.

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:gam:jsusta:v:10:y:2018:i:9:p:3186-:d:168093. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: MDPI Indexing Manager (email available below). General contact details of provider: https://www.mdpi.com .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.