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코로나19 전후 OECD 국가 보건의료체계 효율성 비교 분석

Comparative Analysis of Health System Efficiency in OECD Countries Before and After COVID-19

유수연|강민아|양민희
이화사회과학원 (Ewha Institute of Social Sciences(EISS))|2023.10|사회과학연구논총 (Ewha Journal of Social Sciences)|제39권 제2호|pp. 73-119

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키워드

효율성 분석보건의료체계healthcare systemefficiency analysis보건의료투입네트워크 DEA국민보건계정healthcare inputnetwork DEASHA(System of Health Accounts)
주제분류사회과학일반

초록

본 연구는 OECD 33개 국가 코로나19 발생 이전 10년의 보건의료체계 효율성과 코로나19 대응 효율성의 관계를 살펴보았다. 보건의료체계 접근성과 건강 개선 질 측면으로 나누어 효율성 분석 모형 설정하고 윈도우 네트워크 자료포락분석을 실시하였다. 대부분 국가가 코로나19 이전 10년 동안 보건의료 재정의 70%를 치 료서비스 관련 분야에 투입했고, 그 결과 접근성 차원의 효율성이 질 차원 효율성 보다 높게 나타났다. 코로나19 초기 대응 역시 접근성 차원 효율성이 질 차원 효 율성 보다 높았으나, 2차 연도에 다수 국가의 질 차원 효율성이 향상 되어 검사 및 백신 접종 확대와 같은 정책 개입 효과를 확인 할 수 있었다. 또한 공공보건의 료 투입 총량보다 방향성이 효율성과 유의한 상관관계를 나타냈다. 코로나19 발 생 첫해엔 조세방식 재원조달 국가가 이전 10년 대비 낮은 효율성을 보였으나 2 차 연도에는 유사한 수준으로 회복하는 것을 확인했고, 공공병상 수는 일관된 관 계를 보이지 않았다. 보건의료체계 효율화를 위해 보건의료투입의 방향성이 전환 되어야 할 시점임을 분석결과로 확인하고 이를 토대로 정책 제언을 도출하였다.

Abstract

This study explores the correlation between health system efficiency and the effectiveness of the COVID-19 response in 33 OECD countries during the decade leading up to the outbreak. We established an efficiency analysis model that encompasses healthcare system access and health improvement quality aspects and conducted a Windows network data envelopment analysis. In the decade before COVID-19, most countries allocated 70% of their healthcare finances to treatment services, resulting in higher efficiency in the access dimension than in the quality dimension. In the initial response to COVID-19, access efficiency was also higher than quality efficiency, but in the second year, quality efficiency improved in many countries, confirming the effectiveness of policy interventions such as expanded testing and vaccination. We also found that the direction of public health care inputs was significantly more correlated with efficiency than the total amount. In the first year of COVID-19, tax-financed countries showed lower efficiency than in the previous decade, but they recovered to similar levels in the second year, while the number of public beds did not exhibit a consistent relationship. In conclusion, we recommend reevaluating the allocation of healthcare inputs to enhance healthcare system efficiency and offer specific policy recommendations.

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