Modeling the Impact of Short-Term and Long-Term Determinants of European Health Systems’ Performance: A Panel Data Approach
Abstract
:1. Introduction and Background
- How do we stand?
- What is important in the short-run?
- What is important in the long-run?
2. Assessing the Performance of Healthcare Systems from the Patient Point of View
3. How Do We Stand?
4. Data and Methods
- To examine the possible influences of each of the five subscales on the outcomes, we adopted two approaches: the short-run approach and the long-run approach. In the short-run, stepwise regressions were performed for each of the analyzed years.
- To account for the time factor, we had to deal with panel data (both time series and cross-section data) the Pool Object was used [20]. Panel data perform better in detecting and measuring the effects which in pure cross-sectional or time series data could not be observed [21]. This approach allowed us to capture the influences not only in each point of time, but in a time span of five years (2012–2016) [20].
- We were also interested to see if there were any differences among countries/groups of countries with respect to the influence of different determinants on the healthcare system outcomes. Therefore, we first divided the 34 European countries into more homogenous groups by means of Cluster Analysis. Subsequently, for each group of countries, separate panel data regressions were performed, which more accurately captured the specific influences of dependent variables on health outcomes.
5. Results and Discussion
5.1. What Is Important in the Short-Run?
5.2. What Is Important in the Long-Run?
5.3. Are There Any Differences among Countries/Groups of Countries?
6. Discussion and Conclusions
Author Contributions
Conflicts of Interest
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Independent Variables | Single Year Stepwise Multiple Regressions | ||||
---|---|---|---|---|---|
2012 | 2013 | 2014 | 2015 | 2016 | |
C (intercept) | - | −52.571 * (−1.99) | - | - | - |
RRS—Range and reach of services | 1.515 **,a (5.96) b | 0.737 ** (3.60) | - | 0.556 * (2.24) | 0.833 ** (2.85) |
PRE—Prevention | - | 0.869 * (2.47) | - | - | - |
PHA—Pharmaceuticals | - | 1.109 ** (3.00) | 2.669 ** (6.92) | 1.532 ** (3.11) | 1.787 ** (3.92) |
R-squared | 0.526 | 0.778 | 0.599 | 0.652 | 0.705 |
Adjusted R-squared | 0.512 | 0.756 | 0.587 | 0.629 | 0.686 |
F-statistic | 35.568 ** | 35.128 ** | 41.864 ** | 29.005 ** | 37.095 ** |
Independent Variable | Panel Data Regressions | ||||
---|---|---|---|---|---|
Cluster I | Cluster 2 | Cluster 3 | Cluster 4 | Combined | |
C (intercept) | 127.944 **,a (6.030) b | 212.973 ** (3.842) | 336.465 ** (13.859) | 236.098 ** (3.077) | 225.531 ** (9.89) |
PRI—Patient right and information | - | - | −1.071 ** (−3.405) | - | - |
ACC—Accessibility/waiting time for treatment | 0.231 ** (2.816) | 0.464 * (2.221) | - | 1.212 ** (3.177) | 0.291 ** (4.996) |
RRS—Range and reach of services | −1.273 ** (−4.753) | −1.851 ** (−4.510) | −1.030 * (−2.821) | −2.194 ** (−7.463) | −1.657 ** (11.829) |
PRE—Prevention | 0.890 ** (3.586) | 1.057 ** (4.581) | 1.414 ** (9.684) | - | 0.903 ** (9.771) |
PHA—Pharmaceuticals | - | - | - | - | - |
R-squared | 0.753 | 0.696 | 0.916 | 0.744 | 0.927 |
Adjusted R-squared | 0.677 | 0.587 | 0.886 | 0.668 | 0.908 |
F-statistic | 9.837 ** | 6.383 ** | 30.640 ** | 9.721 ** | 47.583 ** |
Variables | Clusters | Combined | Romania | |||
---|---|---|---|---|---|---|
1 | 2 | 3 | 4 | |||
Cluster Size | 35.3% (12) | 23.5% (8) | 20.6% (7) | 20.6% (7) | ||
OUT_mean | 136.366 | 188.285 | 240.914 | 208.925 | 185.652 | 99.000 |
PRI_mean | 92.983 | 111.485 | 133.542 | 109.600 | 109.052 | 87.800 |
ACC_mean | 145.016 | 152.800 | 146.200 | 181.925 | 155.547 | 138.400 |
RRS_mean | 75.150 | 100.600 | 135.885 | 112.850 | 101.764 | 65.800 |
PRE_mean | 79.166 | 85.600 | 111.342 | 101.250 | 92.311 | 70.200 |
PHA_mean | 50.450 | 64.114 | 77.085 | 77.275 | 65.058 | 45.800 |
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Popa, I.; Ștefan, S.C. Modeling the Impact of Short-Term and Long-Term Determinants of European Health Systems’ Performance: A Panel Data Approach. Sustainability 2017, 9, 1595. https://doi.org/10.3390/su9091595
Popa I, Ștefan SC. Modeling the Impact of Short-Term and Long-Term Determinants of European Health Systems’ Performance: A Panel Data Approach. Sustainability. 2017; 9(9):1595. https://doi.org/10.3390/su9091595
Chicago/Turabian StylePopa, Ion, and Simona Cătălina Ștefan. 2017. "Modeling the Impact of Short-Term and Long-Term Determinants of European Health Systems’ Performance: A Panel Data Approach" Sustainability 9, no. 9: 1595. https://doi.org/10.3390/su9091595