The aim of the paper is to analyse the indicators of the healthcare system efficiency in Croatia and to assess its effectiveness based on a comparison with other EU countries. The analysis of the efficiency of the healthcare system in Croatia and 21 selected EU countries in the period from 2013 to 2018 was conducted by the application of the dynamic DEA window analysis (WDEA). According to the results of the analysis, the overall efficiency of expenditure on healthcare in relation to average life expectancy is on the lowest level in Croatia, amounting to 57% in 2018. While cost-effectiveness of the Croatian healthcare system is on the maximum level of 100%, systemic effectiveness amounts to only 48%. According to the aforementioned indicator, Croatia has recorded the lowest efficiency in relation to the selected EU countries, the efficiency of which amounted to 88% in 2018. Therefore, inefficiencies of the healthcare system are generated during the transformation of intermediary inputs into treatment outcomes, which means that Croatia could achieve the same health outcomes with a lesser engagement of intermediary resources. According to the results of the panel analysis, smoking and alcohol consumption are the key determinants of the efficiency of healthcare protection in EU countries. Croatia does not invest enough into health promotion measures and prevention of diseases, for which it spends only 3% of the overall expenditure on healthcare. Strengthening of public healthcare policies against smoking and alcohol consumption and the increase of excise duties on tobacco products and alcoholic beverages could indirectly influence the improvement of health outcomes, while maintaining the existing levels of expenditure on healthcare. Key words: healthcare system efficiency, financial sustainability of healthcare system, DEA method.
In this paper we use the panel VAR model with exogenous variables to analyse the effects of various structural characteristics of the economies on the effectiveness of government consumption in the Central Eastern and Southeastern European region (CESEE). More precisely, we analyse the effects of government consumption on economic growth in this region, controlling for the effects of the size of the economy, level of public debt, level of tax burden, openness of the economy, rigidity of the labour market, monetary regime and the phase of the business cycle. Our results indicate that these characteristics have a significant impact on the effectiveness of fiscal policy (in terms of the size of the fiscal multiplier). Also, these effects are in line with the theoretical assumptions as the recessionary phase of the cycle, size of the economy, rigidity of the labour market and the fixed exchange rate regime increase the average size of fiscal multipliers while tax burden, indebtedness and openness of the economies reduce the size of the fiscal multiplier, when compared to the base model.
This paper analyses determinants of public sector efficiency in 15 Central Eastern and South Eastern European (CESEE) countries. Using Data Envelopment Analysis (DEA) and panel Tobit regressions we analyse the efficiency of public expenditure on health care, education, and public administration. This paper represents the first analysis of public expenditure efficiency for this region. The countries in the sample share a similar economic transition background and transition related challenges in terms of government size and efficiency. In this paper we use input-oriented DEA to calculate efficiency scores and apply Tobit regressions to identify the determinants of public expenditure efficiency for each category. According to our results, the health care sector shows the most room for improvement. With an average input efficiency score of 0.87, the analysed countries could attain the same output with an average 13% fewer resources. The results show that Bulgaria, Estonia, and Slovenia are the most efficient, whilst Serbia, Croatia, and Bosnia and Herzegovina are the worst performers. GDP per capita has a positive effect on efficiency in the health care sector, the rising share of the elderly population reduces the efficiency coefficient, whilst a higher level of education has a positive effect on the efficiency score, as recorded in earlier studies. In education, our results suggest that countries waste an average 10% of their resources. The Czech Republic, Estonia, Poland, Romania, and the Slovak Republic represent the frontier, while the worst performers are Slovenia, Lithuania, and Latvia. The results show that GDP per capita has a positive effect on efficiency in the education sector, whilst a higher unemployment rate leads to lower efficiency scores. Regarding public administration, the average efficiency score of the analysed countries is 0.9, which indicates that countries are wasting an average 10% of their resources. Estonia and Romania are fully efficient, whilst Montenegro, Bosnia and Herzegovina, and Hungary are the most inefficient countries in the sample. As expected, GDP per capita and institutional quality have positive effects on the efficiency of public administration. ; Rad se bavi analizom determinanata učinkovitosti javnoga sektora u 15 zemalja središnje i jugoistočne Europe. Analizom omeđivanja podataka (AOMP) i Tobitovom regresijom ocjenjuje se učinkovitost javnih rashoda u sustavu zdravstva, javne uprave i obrazovanja. To je prva znanstvena analiza učinkovitosti javnih rashoda u navedenim državama koje dijele iskustvo ekonomske tranzicije te slične izazove u vezi s veličinom i učinkovitosti javnog sektora. AOMP usmjeren na inpute korišten je za izračun koeficijenata učinkovitosti, dok se Tobitovom regresijom identificiraju determinante učinkovitosti javnih rashoda za svaku od analiziranih kategorija.Prema dobivenim rezultatima, u zdravstvenom sektoru postoji najviše prostora za poboljšanje. Prosječna vrijednost učinkovitosti inputa od 0,87 upućuje na to da bi analizirane države mogle ostvariti isti output uz prosječno 13 % manje resursa. Najučinkovitije su države Bugarska, Estonija i Slovenija, dok su Srbija, Hrvatska i Bosna i Hercegovina ostvarile najlošije rezultate. BDP po stanovniku pozitivno utječe na učinkovitost u zdravstvenom sektoru, dok rastući udio starije populacije umanjuje koeficijent učinkovitosti. Viša razina obrazovanja također pozitivno utječe na učinkovitost, što je u skladu s prethodnim istraživanjima. Rezultati pokazuju prosječan gubitak resursa od 10 % u obrazovnom sektoru. Češka, Estonija, Poljska, Rumunjska i Slovačka nalaze se na granici učinkovitosti, dok su najlošije rezultate ostvarile Slovenija, Latvija i Litva. BDP po stanovniku ima pozitivan učinak na učinkovitost obrazovnog sektora, dok veća stopa nezaposlenosti umanjuje njegovu učinkovitost. U sektoru javne uprave prosječna vrijednost učinkovitosti iznosi 0,9, što znači da analizirane države gube u prosjeku 10 % svojih resursa. Estonija i Rumunjska potpuno su učinkovite, dok su Crna Gora, Bosna i Hercegovina i Mađarska ostvarile najnižu razinu učinkovitosti. U skladu s očekivanjima, BDP po stanovniku i kvaliteta institucija pozitivno utječu na učinkovitost javne uprave.
