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Value for Money: Health System Efficiency and Preferences for Health Care

Published online by Cambridge University Press:  16 October 2009

Peter Kotzian
Peter Kotzian*
Affiliation:
Technische Universität Darmstadt
*
Peter Kotzian, Technische Universität Darmstadt, Institut für Politikwissenschaft, Residenzschloß, D-64283 Darmstadt, Germany, kotzian@pg.tu-darmstadt.de.
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Abstract

Abstract. Health expenditure is influenced by health system efficiency, but it is also the result of societal decisions and preferences. Existing cross-national efficiency evaluations often do not fully take this into account, misinterpreting differences in preferences as differences in efficiency. This article estimates health system efficiency by taking preferences fully into account. The empirical findings confirm the theoretical argument, that omitting preferences leads to biased efficiency estimates. Countries and health systems differ with regard to health expenditure not so much because their institutional setting affects their efficiency, but because preferences and demands of their “customers” differ.

Résumé. L'efficacité du système de santé influe, certes, sur les dépenses de soins de santé, mais celles-ci sont également le résultat des décisions et des préférences de la société. Souvent, les évaluations transnationales existantes de l'efficacité du système de santé ne tiennent pas pleinement compte de ce facteur et prennent des différences de préférences pour des différences d'efficacité. Cet article évalue l'efficacité des systèmes de santé en tenant pleinement compte des préférences. Les données empiriques confirment l'argument théorique voulant que l'omission des préférences mène à des estimations d'efficacité déformées. Les dépenses de soins de santé varient d'un pays et d'un système à l'autre, non pas tant parce que leur cadre institutionnel influe sur l'efficacité, mais plutôt parce que les préférences et les demandes de leurs «clientèles» varient.

Type
Research Article
Information
Canadian Journal of Political Science/Revue canadienne de science politique , Volume 42 , Issue 3 , September 2009 , pp. 729 - 748
Copyright
Copyright © Canadian Political Science Association 2009

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