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This study aims at evaluating the technical efficiency (TE) of healthcare systems in the Arab region and exploring the key factors that affect the efficiency performance.

The study applies a two-stage Data Envelopment Analysis (DEA) approach to a sample of 20 Arab countries. In the first stage, a DEA model is used to calculate the TE scores of the examined healthcare systems in 2019 and 2010, following both the output and input orientations of efficiency. In the second stage, a censored Tobit model is estimated to investigate the determinants of healthcare efficiency.

DEA results of 2019 indicate that achievable efficiency gains of the Arab countries range from 0.4% to 16% under the output and input orientations, respectively. Six countries are efficient under both orientations. Although the average efficiency scores of the Arab countries have deteriorated between 2010 and 2019, Djibouti and Sudan had the greatest efficiency improvements between the two years. Bahrain, Mauritania, Morocco and Qatar proved to be efficient in 2010 and 2019 under the two orientations of efficiency and according to the two DEA specifications followed. The Tobit model reveals that corruption and government health expenditure tend to have an adverse impact on healthcare efficiency.

The author evaluates healthcare efficiency and healthcare's efficiency determinants in the Arab countries. Regardless Arab countries' diversity, these countries are facing common health challenges, including diminishing role of governments in healthcare financing; increased out-of-pocket healthcare spending; poor healthcare outputs and prevalence of health inequities resulting from weak governance institutions. Comparing the efficiency of healthcare systems between 2010 and 2019 gives insights on the potential impact of the Arab spring uprisings on healthcare efficiency. Moreover, examining the determinants of healthcare efficiency allows for better understanding of how to improve the efficiency of healthcare systems in the region.

Bipolar and depression disorders are some of the most common mental health disorders affecting millions of people in low-and middle-income countries, including those in Africa. These disorders are therefore major contributors to the burden of diseases and disability. While an enhancement in income is seen as a major approach towards reducing the burden of these disorders, empirical evidence to support this view in the African context is lacking. This study therefore aims to examine the effect of per capita income growth on bipolar and depression disorders across African countries.

The study uses data from secondary sources comprising 42 African countries over the period, 2002–2019, to achieve its objective. The prevalence of bipolar and major depressive disorders (depression) are used as the dependent variables, while per capita income growth is used as the main independent variable. The system Generalised Method of Moments regression is used as the estimation technique.

In the baseline, the authors find per capita income growth to be associated with a reduction in the prevalence of bipolar (coefficient: −0.001, p < 0.01) and depression (coefficient: −0.001, p < 0.1) in the short-term. Similarly, in the long-term, per capita income growth is found to have negative association with the prevalence of bipolar (coefficient: −0.059, p < 0.01) and depression (coefficient: −0.035, p < 0.1). The results are similar after robustness checks.

This study attempts at providing the first empirical evidence of the effect of per capita income growth on bipolar and depression disorders across several African countries.

According to Global Healthcare Security Index 2021, India ranked 66 out of 195 countries, indicating the need and scope for improvement. The Cooperative healthcare system which has been rendering exemplary services is yet to gain visible recognition in India. Given the need for upgrading the health infrastructure in India and providing more affordable health services to the country’s growing population, it would help appreciate the large role that cooperative healthcare can play along with others. This study explores the structure, conduct, and performance of healthcare co-operatives in India, the factors contributing to their success and failure, and the challenges they face. The Health Cooperatives have a strong presence in Kerala and Karnataka and are also coming up in other parts of the country. However, a detailed database of them for public awareness is very limited. The cooperative hospitals can meet the basic requirements of curative treatment in rural and poorly-endowed urban areas. The democratic way in which they function makes them a destination for a financially weaker section. They must retain this feature. The study covers two successful cases which reveal that India needs a more dense healthcare cooperative network. Since cooperative hospitals in tune with the spirit of service run on the principle of being ‘Not-for-Profit’ they need to be supported by the governments more liberally, without however interfering with their governance and administration.

The estimation of the burden of a disease is one of the tasks with the longest tradition in health economics, which allows us to know the volume of resources that a country allocates to a specific health problem, and to compare countries and diseases. Although the fundamental objective of health systems is not to reduce the cost of the disease, but to improve the health of the population, the studies of burden of disease establish the economic seriousness of the problem, orienting the priorities of action.

Government-funded medical expenditure in Uruguay for the last ten years has tripled in US dollars. The increase in the prevalence of overweight and obesity has contributed to this growth. According to the World Health Organization, Uruguay has the highest growing trend in the prevalence of both overweight and obesity in South America. We have previously estimated that economic burden linked to obesity will be more than US$500 million by 2020, a figure close to 1% of the country’s GDP.

In this study, we tried to generate a measure of value to ascertain the cost of inaction in the fight against obesity and its consequences linked to several non-communicable diseases. The cost of inaction is not defined as the cost of not doing, but as the cost of not implementing the right policies (in this case health prevention policies) at the right time.

The aim of this study is to analyze which socioeconomic factors (economic, demographic, and political) most commonly affect the social expenditure of the European Union (EU) and Organization for Economic Co-operation and Development (OECD) countries.

A panel data fixed-effects model is employed for 34 OECD and 23 EU countries between 2000 and 2020.

Results indicate that, in all country groups, economic factors have the most significant influence on social expenditures, with income being the primary determinant, particularly in EU countries. The negative impacts of unemployment and inflation underscore the importance of counter-cyclical measures adopted by countries to maintain stability in their social expenditures. The most influential demographic factor is found as the old-age-dependency ratio. While the rule of law affects social expenditure positively, government effectiveness and female labor force participation affect it negatively. The positive effect of Konjunkturforschungsstelle (KOF) indexes shows the globalization effect, which can be attributable to the compensation hypothesis.

Governments enforce inclusive and sustainable policies to boost economic activities and GDP, thus combating inflation and unemployment and regulating the labor market and socioeconomic problems about aging populations and women’s economic participation to control social expenditures. The rule of law and institutional quality will also boost economic growth.

This study focuses on the effects of social expenditures in a broader view within the framework of the three main factors (economic, demographic, political) and attempts to determine the key factors that account for the differences in social expenditure between the OECD and EU countries.

The peer review history for this article is available at: https://publons.com/publon/10.1108/IJSE-05-2023-0384

This article aims to relate investments in human capital to the United Nations Sustainable Development Goals (UN SDGs), and examine the spending levels necessary to achieve high performance in related SDG sectors for Azerbaijan.

Employing data from the World Bank, the empirical approach undertaken in this study relies on peer analysis by examining spending levels for nations exhibiting similar income levels and geographical proximity to Azerbaijan.

This study estimates that total spending in education would need to increase by 0.4 percentage points of GDP by 2030, while total spending in health would need to increase by 5.9 percentage points of GDP by 2030 for Azerbaijan.

This study contributes to the literature by conducting an empirical analysis in which other nations can emulate in measuring their relative progress on human capital investments and related UN SDGs.

The peer review history for this article is available at: https://publons.com/publon/10.1108/IJSE-02-2023-0137

The present study investigates the nexus between health performance dynamics and economic growth in 43 countries in sub-Saharan Africa for the period 2004–2018.

Four health performance dynamics are used, notably: total life expectancy, male life expectancy, female life expectancy and risk of maternal death. The empirical evidence is based on quantile regressions (QRs) in order to put into perspective the conditional distribution of economic growth.

The following findings are established: (1) total life expectancy and male life expectancy increase economic growth exclusively in the 10th and 90th quantiles of economic growth; (2) female life expectancy boosts economic growth in the 90th quantile of economic growth and (3) the risk of maternal death reduces economic growth in the 75th and 90th quantiles of economic growth. Policy implications are discussed.

The study complements the literature on the nexus between health performance and economic growth by assessing the nexuses throughout the conditional distribution of economic growth.

This case study is designed to enable students to analyze the competitive landscape of a business impacted by technological disruption; evaluate the viability of an organic growth strategy using stakeholder analysis; evaluate the revenue and cost structure of Apollo 24/7 and decide on the future investment strategy; and analyze funding strategies of traditional hospitals versus pure digital players.

To extend its reach, Apollo Hospitals Enterprise (Apollo Hospitals), a leading private sector brick-and-mortar hospital chain in India known for using state-of-the-art technology, launched a unified virtual mobile platform Apollo 24/7 in February 2020, 45 days into the COVID-19 pandemic. The management believed that the digital platform had a unique ecosystem that could not be replicated. The analysts were optimistic about the impact of the decision on the future performance of Apollo Hospitals, as it was expected to lead to higher penetration and increased revenue. They also anticipated the unlocking of value, as and when the venture capitalist (VC) would invest in Apollo Hospitals. However, with increasing operating expenses on account of burgeoning technological and marketing expenses, things did not seem to go going as planned. Three years later, in February 2022 after the Q3 of financial year 2023 results. Suneeta Reddy, the company’s managing director found herself pondering whether the digital platform could boost Apollo Hospitals’ profitability in addition to expanding its reach and increasing affordability when the company missed the analyst estimates. In India, which was then the second most populous country, “incremental access” and “affordability” were what mattered to the patients, However, for the investors and analysts, it was quarter-on-quarter performance. The change in the macroeconomic environment stalled the company’s plan of raising money from VCs.

Furthermore, the financing dilemma also plagued Reddy. She knew there was a difference between financing for conventional businesses that for digital businesses. She also had to take decide between short-term profitability with which investors were obsessed versus long-term sustainability, which involved taking care of stakeholders’ interests.

This case study is basically aimed at postgraduate courses and executive management courses.

Teaching notes are available for educators only.

CSS11: Strategy.

Population ageing will bring economic challenges in the future. The purpose of this paper is to examine whether increased educational level could mitigate the consequences of population ageing on economic sustainability, measured as the gap between labour income and consumption.

Using the National Transfer Accounts (NTA) methodology, the authors decompose labour income and consumption by age and educational level (low, medium and high) and compare obtained age profiles with those calculated conventionally. In addition, using the population projections by age and educational level, the authors project both profiles to 2060 for selected EU countries and assess future economic sustainability.

The results show that the highly educated have a significantly higher surplus for a longer period then those with lower and medium education. Therefore, the improved educational level of individuals will have a substantially positive impact on labour income in the future—on average by about 32% by 2060 for all EU countries included. However, as the better educated also consume more, higher production does not fully translate into improved economic sustainability, but the resulting net effect is still positive at about 19%.

The authors present for the first time an NTA by education for 15 EU countries and show the importance of including education in the analysis of the economic life cycle. The authors also show that increased educational level will mitigate the consequences of population ageing on economic sustainability in the future.