EconPapers    
Economics at your fingertips  
 

Advancing universal health coverage in the COVID-19 era: an assessment of public health services technical efficiency and applied cost allocation in Cambodia

Robert John Kolesar (), Peter Bogetoft, Vanara Chea, Guido Erreygers () and Sambo Pheakdey
Additional contact information
Robert John Kolesar: Abt Associates
Peter Bogetoft: Copenhagen Business School
Vanara Chea: Cambodian Ministry of Economy and Finance
Sambo Pheakdey: Cambodian Ministry of Economy and Finance

Health Economics Review, 2022, vol. 12, issue 1, 1-20

Abstract: Abstract Background Achieving universal health coverage (UHC) is a global priority and a keystone element of the 2030 Sustainable Development Goals. However, COVID-19 is causing serious impacts on tax revenue and many countries are facing constraints to new investment in health. To advance UHC progress, countries can also focus on improving health system technical efficiency to maximize the service outputs given the current health financing levels. Methods This study assesses Cambodia’s public health services technical efficiency, unit costs, and utilization rates to quantify the extent to which current health financing can accommodate the expansion of social health protection coverage. This study employs Data Envelopment Analysis (DEA), truncated regression, and pioneers the application of DEA Aumann-Shapley applied cost allocation to the health sector, enabling unit cost estimation for the major social health insurance payment categories. Results Overall, for the public health system to be fully efficient output would need to increase by 34 and 73% for hospitals and health centers, respectively. We find public sector service quality, private sector providers, and non-discretionary financing to be statistically significant factors affecting technical efficiency. We estimate there is potential supply-side ‘service space’ to expand population coverage to an additional 4.69 million social health insurance beneficiaries with existing financing if the public health system were fully efficient. Conclusions Public health service efficiency in Cambodia can be improved by increasing utilization of cost-effective services. This can be achieved by enrolling more beneficiaries into the social health insurance schemes with current supply-side financing levels. Other factors that can lead to increased efficiency are improving health service quality, regulating private sector providers, focusing on discretionary health financing, and incentivizing a referral system.

Keywords: Health service efficiency; Social health protection; Costing; Cost allocation; Universal health coverage; Cambodia (search for similar items in EconPapers)
Date: 2022
References: View references in EconPapers View complete reference list from CitEc
Citations: Track citations by RSS feed

Downloads: (external link)
http://link.springer.com/10.1186/s13561-021-00354-8 Abstract (text/html)

Related works:
Working Paper: Advancing Universal Health Coverage in the COVID-19 Era: An Assessment of Public Health Services Technical Efficiency and Applied Cost Allocation in Cambodia (2021) Downloads
This item may be available elsewhere in EconPapers: Search for items with the same title.

Export reference: BibTeX RIS (EndNote, ProCite, RefMan) HTML/Text

Persistent link: https://EconPapers.repec.org/RePEc:spr:hecrev:v:12:y:2022:i:1:d:10.1186_s13561-021-00354-8

Ordering information: This journal article can be ordered from
http://www.springer.com/journal/13561

DOI: 10.1186/s13561-021-00354-8

Access Statistics for this article

Health Economics Review is currently edited by J. Matthias Graf von der Schulenburg

More articles in Health Economics Review from Springer
Bibliographic data for series maintained by Sonal Shukla () and Springer Nature Abstracting and Indexing ().

 
Page updated 2022-08-07
Handle: RePEc:spr:hecrev:v:12:y:2022:i:1:d:10.1186_s13561-021-00354-8