Health System Efficiency in Iran and Its Influencing Factors

Background: Given the importance of public health, evaluating the performance of the health system and striving to address its shortcomings is a concern for policymakers and health officials. The aim of this study is to examine the health system efficiency in Iran and investigate the impact of economic variables on the health system efficiency. Methods: In this study, the Stochastic Frontier Analysis (SFA) method was used to evaluate the health system efficiency in Iran, using data from Iranian provinces in 2016. The Stata software was used to evaluate the health system efficiency and investigate the impact of economic variables on the health system efficiency. Results: According to findings, the highest level of efficiency belonged to Alborz and Mazandaran provinces, while the lowest level of efficiency belonged to Sistan and Baluchestan and Ilam provinces. Regression estimates using the Tobit method indicated that the coverage of social insurance and the private sector share of healthcare costs have a positive effect on efficiency, while per capita production has a negative effect on the health system efficiency. Also, the coefficients obtained for GDP per capita, the population covered by insurance and the share of the private sector were -0.00049, 0.00602, and 0.00640, respectively. Conclusion: The average health system efficiency in the provinces varies significantly, suggesting that there is a considerable gap from optimal efficiency. It is recommended to expand the coverage of social insurance, which includes healthcare insurance, in order to improve the health system efficiency, so that more people can benefit from its services. The second suggestion is to pay more attention to the private sector in the health sector.