Impacts of social determinants on the transient and persistent inefficiency of health systems in OECD countries

Ezgi Önen Efecan and Volkan Efecan

Health Policy, 2025, vol. 161, issue C

Abstract: This study examines the impact of social determinants on the transient and persistent technical inefficiency of health systems in OECD countries between 2010 and 2020. To estimate inefficiency, panel efficiency models—True Random Effects (TRE) and Generalised True Random Effects (GTRE) models—are employed. The results reveal that the overall inefficiency of OECD countries is largely attributable to long-term policies. Furthermore, transient inefficiency increases, on average, by 1.6 % for every 1 % increase in the unemployment rate, while persistent inefficiency increases, on average, by 6.8 % for every 1 % increase in income inequality. To enhance the long-term efficiency of health systems, governments should address unemployment, education and income inequality. This study represents the first cross-country evaluation to consider unemployment, education, income inequality, and population as social determinants of health system efficiency, employing two competing stochastic frontier models at the country level.

Keywords: Social determinants; Health system efficiency; Life expectancy; Cross-country comparison; Stochastic frontier analysis (search for similar items in EconPapers)
Date: 2025
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Persistent link: https://EconPapers.repec.org/RePEc:eee:hepoli:v:161:y:2025:i:c:s0168851025001885

DOI: 10.1016/j.healthpol.2025.105433

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