The Efficiency of Health Systems in European Union (EU) Countries with Undesirable Output: A DEA-Slack-Based Model Approach

Purpose: This study was conducted to evaluate the efficiency of the health system of the EU countries by using DEA-Slack Based Measure (SBM) Model. The study also aimed to determine the healthcare resources that created a statistical difference in the efficiency status of countries. Methodology: In the study, 27 member countries of the European Union were considered as decision-making units. Health expenditure and workforce were used as input; adult mortality rate was used as an undesirable and health status were used as desired output variables. DEA-SBM method was employed to evaluate efficiency, the Mann-Whitney U test was used to determine healthcare resources that created a statistically significant difference. Findings: Approximately 40.74 % of countries were efficient. The number of nursing and midwifery personnel created a statistically significant difference in the efficiency status of the countries. It can be said that inefficient countries do not use their healthcare resources efficiently and they consume more health financial, technological, and workforce resources compared to efficient countries. Originality: In addition to the input and output variables, the undesired output variable was also included in the analysis. This is considered to be the original aspect of the study.