Healthcare System Efficiency in Pakistan: An Intra-country and Inter-country Analysis

Background:

Because of the financial constraints limiting increased investment in the health sector, enhancing efficiency through the optimal use of scarce resources through prioritisation, reallocation, and waste reduction is a viable alternative for improving performance. A key challenge in developing countries is achieving improved health outcomes with limited resources. While extensive research has assessed the productive performance of healthcare systems in both developed and developing nations, a notable gap remains in research on efficiency measurement within Pakistan’s healthcare system.

Purpose:

This study addresses the identified gap by evaluating the efficiency of Pakistan’s healthcare system at both inter-country and intra-country levels, as well as examining key factors influencing healthcare system efficiency.

Method:

The analysis is based on secondary data obtained from the World Bank and official government sources in Pakistan. A two-stage Data Envelopment Analysis (DEA) approach was employed to identify inefficiencies and the factors affecting the performance of the healthcare system. In the first stage, DEA analysis assessed the healthcare system efficiency between Pakistan and comparable countries while separately analysing regional disparities across districts within Pakistan’s four provinces. Eight model specifications were utilised for inter-country comparisons, with an additional eight models applied for intra-country assessments to enable an in-depth investigation. The second stage of the analysis examined the explanatory factors influencing efficiency using regression analysis.

Results:

Findings from the first-stage DEA analysis revealed significant efficiency disparities between Pakistan and comparable nations, as well as substantial regional inefficiencies across districts within Pakistan’s four provinces. The second-stage DEA analysis identified population size, access to basic water services, political stability, security conditions, and population density as key factors influencing healthcare efficiency in Pakistan.

Conclusion:

The results provide evidence-based performance targets and policy implications to enhance efficiency at both inter-country and intra-country levels. This new insight can contribute to the process of optimising resource allocation and improving health sector performance in Pakistan.