Health systems performance in health outcomes, health financing and COVID-19 pandemic: Lessons from 31 countries
Pirhossein Kolivand, Jalal Arabloo, Peyman Saberian, Taher Dorooudi, Soheila Rajaie, Fereshte Karimi, Behzad Raei, Masoud Behzadifar, Arash Parvari, Seyed Jafar Ehsanzadeh, Saeid Homayoun, Shahrzad Salehbeigi, Peyman Namdar, Samad Azari, André Luis C Ramalho

TL;DR
This study evaluates health system performance across 31 countries using multiple indicators and finds that high spending does not always ensure better outcomes.
Contribution
The study introduces a novel ranking method using TOPSIS and clustering to assess health system performance across diverse regions.
Findings
Luxembourg was the only high-performing health system, while several high-income countries showed low performance.
Health spending alone does not guarantee better health system performance, as seen during the COVID-19 pandemic.
Countries like the United States and Germany ranked better within the low-performance group.
Abstract
ssssHealth system performance is a multifaceted concept that encompasses various dimensions of a nation’s healthcare infrastructure. This study aims to assess and rank the performance of health systems across different regions of the world. We employed the Technique for Order of Preference by Similarity to Ideal Solution (TOPSIS) method in 2023 to evaluate and rank the health system performance of 31 countries across six geographical regions. Our evaluation included six general categories and twelve indicators related to health, finance, and the COVID-19 pandemic. The final weights for these indicators were determined using the Three-scale method and the Entropy-weighting method. Additionally, we categorized health system performance into three groups: high, moderate, and low. Hierarchical clustering of health system performance scores was conducted using SPSS software (version 26).…
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Taxonomy
TopicsGlobal Maternal and Child Health · Healthcare Systems and Reforms · Global Health Care Issues
