Opportunities for Assessment of Health Care System's Effeciency: Three-Levels Evaluation Model

The efficiency of health care systems becomes crucial in circumstances of the
rising costs of health technologies and strictly limited resources allocated from
the public budget. Within the framework of this research, the authors evaluate
the opportunities to assess the efficiency of health care systems. To achieve the
goal of the research, the methods of the theoretical research (literature analysis,
content analysis, and electronic resources analysis) are used alongside the
methods of the empirical research (data collection methods: document analysis
and database statistical analysis). For data processing and analysis, methods of
economic analysis and statistical analysis are used. To perform this research
the authors have created a three-level performance evaluation model based
on macro-level evaluation (policy impact assessment), meso-level evaluation
(system analysis, functional and economic efficiency measuring) and micro-level
evaluation (production function, allocative and technical efficiency measures,
market analysis). The measures of the macro impact results, policy outcomes and
performance outputs are tested to evaluate the efficiency of health care system.
The ex-post pilot-evaluation of the Latvian health care reform leads to conclusion of its temperate low functional effectiveness, but substantial productive efficiency in scores of the reorganisation of institutional framework. The general conclusion concerning to the health care services and reimbursement system of medicines and medical devices shows the tendency to move towards technical efficiency, rather than total economic efficiency (technical and allocative efficiency), as the treatment alternatives (nutrition programs, physician’s time by consultation, complementary therapy etc.) are not sufficiently taken into account. The suggested methodology for efficiency assessment of health care system has substantial theoretical and practical implication for decision-making process on health care organisation and financing.