Comparing Iran's Healthcare System Efficiency with OECD Countries Using Data Envelopment Analysis

Acinetobacter baumannii is one of the most challenging nosocomial pathogens due to the emergence and widespread of antibiotic resistance. We aimed to provide the first analysis of global prevalence of antibiotic resistance in A. baumannii infections, by synthesizing data and knowledge through a systematic review. We searched studies reporting antibiotic resistance in A. baumannii infections using the Medline, Embase, Web of Science, and Cochrane databases from January 2000 to December 2016. Studies were eligible if they investigated and reported antibiotic resistance in A. baumannii infections with inpatients or outpatients in hospital. Our investigation showed a high prevalence of resistance to the common prescribed antibiotics in A. baumannii infections in both OECD (Organization for Economic Co-operation and Development) and non-OECD countries. Strikingly, though OECD countries have substantially lower pooled prevalence of resistance compared to non-OECD countries based on the data during 2006–2016, a further investigation in a time scale disclosed a faster increase in OECD countries during the past 11 years, and currently both of them have a comparable prevalence of resistance (2011–2016). Tigecycline and colistin are still active but their resistances are expected to become common if the preventative measures are not taken. Antibiotic resistance in A. baumannii infection developed fast and is a crisis for both OECD and non-OECD countries. A “post-antibiotic era” for A. baumannii infection is expected in the next 10–20 years without immediate actions from pharmaceutical companies and governments.

Does economic level similarly matter for injury mortality in the OECD and non-OECD countries?

BackgroundRecently, the demand for care has risen, while in contrast, healthcare resources remain limited. These resources include health expenditure, the number of physicians, nurses, and hospital beds. Many studies have revealed that healthcare resources are one of the most critical factors contributing to a population’s health status. The healthcare system plays a key role in transforming these resources into health outcomes, which are widely used as indicators to measure population health and the performance of healthcare systems. Previous work has primarily investigated the relationship between health expenditure or the number of doctors and population health. However, the association between healthcare resources as a whole has yet to be widely examined.MethodsThis study utilized multilevel regression analysis to explore the association between healthcare resources, healthcare systems, and population health outcomes across 25 European countries. The healthcare systems in these countries are primarily categorized into two types: Beveridge-type and Bismarck-type. In addition to regression analysis, descriptive statistics were used to analyze the allocation patterns of healthcare resources. Welch’s t-test was employed to compare the performance metrics of the Beveridge-type and Bismarck-type healthcare systems, providing a statistical basis for understanding differences in their effectiveness.ResultsThe regression analysis revealed positive correlations between health expenditure per capita, the number of physicians, and nurses, and life expectancy at birth, while the number of hospital beds showed a negative correlation. Conversely, infant mortality was negatively correlated with health expenditure per capita and the number of physicians and nurses, and positively correlated with the number of hospital beds. The models did not find statistical significance in the effects of healthcare system type (Beveridge-type or Bismarck-type) on life expectancy at birth or infant mortality rates. Additionally, Welch’s t-test indicated that the Beveridge-type healthcare system generally showed better performance outcomes compared to the Bismarck-type system.ConclusionsThe findings indicate that higher allocations of certain healthcare resources, such as hospital beds, are associated with poorer health outcomes, which suggests potential inefficiencies in resource utilization. Observations also show that countries using the same healthcare systems tend to have similar patterns of resource allocation, which may influence the performance of these systems. Policymakers should consider these associations when planning resource allocation and when selecting or modifying healthcare system models in their countries.

Improving efficiency of health sector is of particular importance in all countries. To reach this end, it is paramount to measure the efficiency. On the other hand, there are many factors that affect the efficiency of health systems. This study aimed to measure the Technical Efficiency (TE) of health systems in Economic Cooperation Organization (ECO) countries during 2004-10 and to determine the factors affecting their TE. This was a descriptive-analytical and panel study. The required data were gathered using library and field studies, available statistics and international websites through completing data collection forms. In this study, the TE of health systems in 10 ECO countries was measured using their available data and Data Envelopment Analysis (DEA) through two approaches. The first approach used GDP per capita, education and smoking as its inputs and life expectancy and infant mortality rates as the outputs. The second approach, also, used the health expenditures per capita, the number of physicians per thousand people, and the number of hospital beds per thousand people as its inputs and life expectancy and under-5 mortality rates as the outputs. Then, the factors affecting the TE of health systems were determined using the panel data logit model. Excel 2010, Win4Deap 1.1.2 and Stata 11.0 were used to analyze the collected data. According to the first approach, the mean TE of health systems was 0.497 and based on the second one it was 0.563. Turkey and Turkmenistan had, respectively, the highest and lowest mean of efficiency. Also, the results of panel data logit model showed that only GDP per capita and health expenditures per capita had significant relationships with the TE of health systems. In order to maximize the TE of health systems, health policy-makers should pay special attention to the proper use of healthcare resources according to the people's needs, the appropriate management of the health system resources, allocating adequate budgets to the health sector, establishing an appropriate referral system to provide better public access to health services according to their income and needs, among many others.

Context: according to the corruption perceptions index (CPI) 2018, Iran ranked 148 among 183 countries. This position shows the crucial importance of considering corruption and its negative effect on Iran and its health care system. In this review, we aimed to shed the light on corrupt practices in Iran’s health care system and recommend some practical strategies to combat them. Evidence Acquisition: This is a narrative review based on Vian's conceptual model of corruption in the health sector to evaluate and analyze corruption in Iran's health system. Review of the literature and documents without any time limitation were conducted in several databases including PubMed, Scopus, Web of Science, Google Scholar, and Farsi sources including Iran Medex, scientific information database )SID(, and Magiran, and also the official websites of the Ministry of Health and news agencies. Results: Unfortunately, to the best of our review, there is less published evidence about the extent and types of corruption in Iran's health system. Based on Vian’s model, reviewed literature revealed that Iran's health system is prone to corruption. This system is monopolistic and self-authorized, low transparent and accountable, and required law enforcement in many areas. Evidence to clarify the situation of citizen voice was not found. Conclusions: Based on this study, evidence shows corruption in financing, service provision, and resource generation of Iran's health system. It could affect not only performance of this system but also its responsiveness and effectiveness. To combat, Iran should apply multiple strategies such as; improving good governance, strengthening legal system over the health system, reducing monopoly and discretion stepwise and manageable, enhancing community participation, and finally updating ethics codes in the health system.

AimsCritical appraisal of secondary data made available by the OECD for the time frame 2000–2011.MethodsComparison of trends and variation of amputations in people with diabetes across OECD countries. Generalized estimating equations to test the statistical significance of the annual change adjusting for major potential confounders.ResultsA total of 26 OECD countries contributed to the OECD data collection for at least 1 year in the reference time frame, showing a decline in rates of over 40 %, from a mean of 13.2 (median 9.4, range 5.1–28.1) to 7.8 amputations per 100,000 in the general population (9.9, 1.0–18.4). The multivariate model showed an average decrease equal to −0.27 per 100,000 per year (p = 0.015), adjusted by structural characteristics of health systems, showing lower amputation rates for health systems financed by public taxation (−4.55 per 100,000 compared to insurance based, p = 0.002) and non-ICD coding mechanisms (−7.04 per 100,000 compared to ICD-derived, p = 0.001). Twelve-year decrease was stronger among insurance-based financing systems (tax based: −0.16 per 100,000, p = 0.064; insurance based: −0.36 per 100,000; p = 0.046).ConclusionsIn OECD countries, amputation rates in diabetes continuously decreased over 12 years. Still, in 2011, one amputation every 7 min could be directly attributed to diabetes. Although interesting, these results should be taken with extreme caution, until common definitions are improved and data quality issues, e.g., a different ability in capturing diabetes diagnoses, are fully resolved.

This chapter will explore the impact of cognitive skills on education. In the case of OECD (Organisation for Economic Co-operation and Development) countries, it will be examined the relation between the level of education to the economic situation of a state. Case study work is based on a statistical approach of OECD countries ranking, based on The Global Index of Cognitive Skills and Educational Attainment (GICSES) and Ivanovic distance (I-distance). The chapter will be presented to rank these countries based on the value of the global index. Using I-distance method it will be formed a new order, and then it will be carried out a comparative analysis of these two ways of ranking. The aim of the chapter is to present a new approach to the evaluation of a composite indicator based on the multivariate statistical analysis.

The last two decades have witnessed a growth in foreign direct investments (FDI) in the real estate sector in most of the Organization for Economic Co-Operation and Development (OECD) countries. It is argued that FDI in the real estate sector may improve economic growth in recipient economies. On the other hand, property prices have increased considerably in OECD countries in recent years and some argue that FDI in real estate is one of the driving forces of high property prices in these countries. The purpose of this study is to analyze the interrelationship between FDI in the real estate sector, economic growth, and property prices while controlling for interest rate and inflation. We use observations from a set of OECD countries for the period between 1995 and 2008. The dynamic interrelationship is analyzed by applying a panel cointegration technique. Our empirical results show that FDI in real estate do not cause property price appreciations and also do not contribute to economic growth in OECD countries in the short run and the long run.

IntroductionAdolescents are considered the healthiest population of all age groups, yet they are vulnerable to illnesses and deaths from preventable causes. We aimed to investigate the burden of morbidity, mortality and risk factors for mortality among adolescents and young adults (10–24 years) in Australia compared with the Organisation for Economic Co-operation and Development (OECD) countries.MethodsWe accessed the Global Burden of Disease (GBD) Study 2021 data for OECD countries, including Australia, between 2000 and 2021. Country and age-specific estimates with 95% uncertainty intervals were obtained from the GBD Compare and Results Tool for all-cause mortality and disability-adjusted life years (DALYs). The top 15 level 3 risk factors for mortality for adolescents and young adults were investigated, with rates reported per 100 000 population. Annualised rates of change (ARoC) in mortality and DALY rates were estimated using a log-linear model to quantify temporal trends between distinct time periods. Causes of death by age groups, sex and year for other diseases were measured using the Cause of Death Ensemble model.ResultsBetween 2000 and 2021, mortality rates in adolescents and young adults decreased in Australia and across OECD regions, with substantial reductions (47.1 in 2000 vs 27.9 in 2021) in Australia. DALYs decreased slightly (11 850.2 in 2000 vs 10 363.9 in 2021), ranking Australia eighth among OECD countries in 2021. The ARoC in Australia showed a decline in the rate of mortality and DALYs by 2.48% and 0.64%, respectively. Overall, OECD countries experienced a slower decline, with an ARoC of 0.92% for mortality and 0.04% for DALYs from 2000-2021. Young adults (20–24 years) had higher mortality and DALYs than other age groups. In 2021, males in Australia and OECD countries had higher mortality rates, while Australian females had more DALYs than males. Alcohol and drug use were the leading risk factors for death.ConclusionAdolescent and young adult mortality in Australia has declined more than the OECD average, with minimal reduction in disease burden. Disparities in mortality rates and morbidity burden continue to grow across countries, age groups and genders due to the limited focus on males and young adults. This study calls for comprehensive health strategies that address these disparities to reduce the disease burden in young adults, specifically among males.

The study examines the effects of governance quality and religiosity on tax evasion (TE) in the OECD (Organisation for Economic Co-operation and Development) countries. Further, the study investigates which government qualities and religiosities affect TE significantly. Ordinary least squares has been used to analyze the data gathered from 36 OECD countries covering the period of 2002–2015 based on the latest data of TE. The results show the negative impact of governance quality and religiosity on TE; it implies the higher level of governance quality and religiosity, and the lower level of TE across the countries. Among the governance qualities, the higher the government effectiveness (GE), the rule of law (RL), and regulatory quality (RQ), the lower the level of TE as they have a negatively significant impact on TE. On the contrary, the positive impact of the voice of accountability (VA) and political stability (PS) on TE implies that with increasing the VA and PS, TE also increases. Moreover, during the investigation of religiosities on TE, the study found that Catholics (CATH) have a significant and negative effect on TE, while Muslim (MUSL) is found to be positively significant. Overall findings of the study suggest the government of the OECD countries to emphasize enhancing the governance quality and practicing of peoples' religious activities freely, which demotivates people to evade tax.

Health-system determinants of declines in maternal mortality in China between 1996 and 2013: a provincial econometric analysis

The aim of this article is to assess the feasibility to introduce the Organisation for Economic Co-operation and Development (OECD)-BEPS measures to deal with aggressive tax planning in South America and Sub-Saharan Africa. The BEPS and its Action Plan have been developed by the OECD following the G20 mandate and it provides new international tax standards to be applicable to all countries including OECD and non- OECD countries. This article will provide a comparative analysis of the South America and the Sub-Saharan African region taking into account the country’s economic development, tax administration capacity and resources, and the use (or not) of domestic laws and tax treaty rules to tackle aggressive tax planning. The South American and Sub-Saharan African regions have been chosen since they consist mostly of developing (non- OECD) countries. The comparative analysis of the exchange of best practices and challenges in these two regions will be useful for the OECD-BEPS Project and for the BEPS Multilateral Instrument that will be open for adoption by developing and developed countries. This article is structured as follows: Section 2 contains a short introduction to the BEPS Actions dealing with aggressive tax planning and the discussions at OECD and UN level. Section 3 will provide the assessment of feasibility of the BEPS in South America and Sub-Saharan Africa. Finally, in section 4, conclusions and recommendations will be presented.

Background:Health expenditures of countries have an increasing trend in general and identifying variables affecting health expenditure is an important step toward budget planning for financial sustainability. This study aimed to examine the health expenditure of the Organisation for Economic Co-operation and Development (OECD) countries and identify influential variables.Methods:The data for the years 2000–2018 of OECD countries’ current health expenditure (% of GDP) and economic, demographic, and health variables, considered to affect the health expenditure, to include in the analysis were extracted using the World Bank database (World Bank 2021). Data analys using Chi-Squared Automatic Interaction Detection (CHAID) decision tree technique. Fifteen variables in economic, demographic, and health categories are selected to build the CHAID decision tree.Results:As a result of CHAID analysis, five variables are identified as influential on current health expenditure, which are gross domestic product per capita, life expectancy at birth, death rate, out-of-pocket expenditure, and fertility rate. Thirty-seven OECD countries are classified into eleven groups by the decision rules in terms of the current health expenditure. The high value of the correlation coefficient between the predicted values and the actual values of health expenditure of countries indicates good prediction performance. Moreover, the regression models built using the identified influential variables as explanatory variables give good forecast accuracy.Conclusion:As an effective tool, the CHAID decision tree technique provides a rule-based model in the form of a tree with nodes and branches, illustrating the splitting process graphically with identified variables and their cut-off points for classification and prediction.

Climate change is the greatest threat to human health; however, climate change is also impacting the spread of infectious diseases causing contemporaneous burdens on health systems worldwide. The aim of this research was to assess whether Organisation for Economic Co-operation and Development (OECD) South-East Asia (SEA) countries national climate strategies were effective in mitigating infectious diseases impacted by climate change, using Viet Nam as a key case study. To conduct benchmarking between OECD SEA countries, data from the Institute for Health Metrics and Evaluation (IHME), the Climate Watch, and copies of each countries’ climate strategy were analysed using a SMART analysis. Further analysis was done with IHME data to benchmark the prevalence infectious disease group per 100,000 by country and income group, and health expenditure per capita by infectious disease incidence per 100,000 and DALY per 100,000 across OECD SEA countries. This research found that Viet Nam is doing relatively well in addressing infectious diseases through climate change policy mitigation efforts, both individually and in comparison, to OECD SEA countries. Viet Nam was found to have the highest prevalence of respiratory diseases and tuberculosis in comparison to other OECD SEA countries but is ranked comparatively well when looking at overall infectious disease DALY’s and incidence rates compared to OECD SEA neighbours. Viet Nam’s climate strategy clarifies the need to develop the healthcare network and infrastructure required to effectively manage epidemics. Increased health expenditure per capita and greater implementation of One Health frameworks in government strategies are recommended to improve Viet Nam’s ability to mitigate climate susceptible infectious diseases.

The aim of this article is to address the following questions: (1) Which OECD (The Organization for Economic Co-operation and Development) and EU countries guarantee health insurance coverage to the entire population and which, conversely, leave part of the resident population without coverage?, (2) How many people do not have health coverage, and what are their characteristics? and (3) Within the OECD and the EU, is there actually a trend toward universal population coverage? Approximately one third of OECD and European Union countries do not ensure health insurance coverage to the entire population. At present, the uninsured in European Union countries totals more than seven million people. Considering all 36 OECD countries, the uninsured reach almost 48 million. The diachronic analysis shows that, from the 1970s to present day, the percentage of the uninsured in OECD member countries has gradually decreased. Conversely, in EU countries, the tendency toward universalism shows a fluctuating trend. Until the mid-90s, the number of uninsured decreased. However, a trend reversal took place and the number of uninsured started to rise again from the second half of the 1990s. The number of individuals without insurance coverage is currently 2-fold higher than the figure recorded before the outbreak of the great financial crisis.