Developing Composite Indicators for Assessing Health System Efficiency

There exist several dimensions along which health system performance might be measured, and numerous indicators of performance have been proposed. Many such indicators do indeed capture important aspects of system behaviour, but each is to some extent partial, and as a result potentially misleading. Given the intense policy interest in system performance, the question therefore arises: can some form of aggregation of indicators yield a more satisfactory insight into performance than the partial view offered by individual indicators? This paper examines the extent to which some sort of aggregation is possible and useful. It starts with a discussion of some of the key economic concepts associated with system performance…