Determinants of health system efficiency in middle-east countries-DEA and PLS-SEM model approach

This study presented a radically different approach to efficiency evaluation based on the impact of the Socioeconomic and Behavioral health determinants framework on health outcomes for the countries of Middle-East region. The level of education, employment, and the percentage of the population living in the rural area constitutes the socioeconomic framework. The prevalence of tobacco smoking and alcohol consumption formed the behavioral framework. The model considers life expectancy at birth and mortality rate from non-communicable diseases as health outcomes. The econometric models of the PLS-SEM, the DEA, and the Malmquist TFP index are used to analyze the data. The DEA results highlight differences in the impact of socioeconomic and behavioral health determinants on health outcomes across the countries of the Middle-East region. Finally, evidence from the Malmquist TFP index shows an improvement in health production between the periods 2006-2017. Moreover, a substantial gap in efficiency is observed between economically prosperous countries and others who are less well-off. Furthermore, socioeconomic and behavioral frameworks positively impact life expectancy at birth. Similarly, the two frameworks have a negative impact on the mortality rate from chronic non-communicable diseases. A higher impact on health outcomes is observed in the socioeconomic as a behavioral framework in the model. The study's results have contributed to the policymakers, citizens, and the country's government to compare the health system efficiencies across the middle-east region, which would help achieve the health outcome more efficiently.