The Measurement of Health Care System Efficiency: Cross-country Comparison by Geographical Region*

Performance of health care delivery at the cross-country level has not often been directly evaluated by given inputs and outputs. This study estimates the efficiency of the health care systems of 170 countries by extending recent research using Simar and Wilson’s bootstrap data envelopment analysis with a sensitivity test. The 170 countries are divided into four groups to compute efficiency estimators necessary to attaining a homogeneity requirement. The major finding is that most countries were inefficient to maximize the use of their inputs at the given output level. Countries in the high-income group have a relatively high average efficiency, but only 16.7% of the countries performed efficiently in the management of their health care systems. Notably, Asian countries performed more efficiently among other regions in each group. This study suggests that inefficient countries should pay attention to benchmark health care best practices within their regional peer groups.