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Advancing Universal Health Coverage in the COVID-19 Era : An Assessment of Public Health Services Technical Efficiency and Applied Cost Allocation in Cambodia
- Source :
- Health Economics Review, Health Economics Review, Vol 12, Iss 1, Pp 1-20 (2022), Health economics review
- Publication Year :
- 2021
- Publisher :
- HAL CCSD, 2021.
-
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.
- Subjects :
- Medicine (General)
health service efficiency
cost allocation
Frontier Estimation
costing
Economics
Universal Health Coverage
Social Sciences
Public Health Insurance
03 medical and health sciences
R5-920
0302 clinical medicine
JEL: I - Health, Education, and Welfare/I.I1 - Health
Business & Economics
Universal health coverage
JEL: I - Health, Education, and Welfare/I.I3 - Welfare, Well-Being, and Poverty
PROTECTION
030212 general & internal medicine
[SHS.ECO] Humanities and Social Sciences/Economics and Finance
Policy Making
Developing Countries
health care economics and organizations
JEL: H - Public Economics
social health protection
Science & Technology
Costing
Input Output Models
AUSTERITY
030503 health policy & services
Health Policy
Research
Health service efficiency
[SHS.ECO]Humanities and Social Sciences/Economics and Finance
Cost allocation
Health Care Sciences & Services
Social health protection
[SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie
Health Policy & Services
JEL: I - Health, Education, and Welfare
[SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie
Human medicine
EQUITY
0305 other medical science
Cambodia
Life Sciences & Biomedicine
Health Care Financing
Subjects
Details
- Language :
- English
- ISSN :
- 21911991
- Database :
- OpenAIRE
- Journal :
- Health Economics Review, Health Economics Review, Vol 12, Iss 1, Pp 1-20 (2022), Health economics review
- Accession number :
- edsair.doi.dedup.....70b28d9563ce5724a533288a9f3a3543