Efficiency of Public Procurement in the Czech and Slovak Health Care Sectors

Abstract

Health systems in most (if not all) countries perpetually struggle with financial problems and search for resources to cover health care needs. Increased efficiency of health procurement has the potential to save a lot of money and to reallocate them to treatments. The aim of our study is to analyze technical efficiency (efficiency/economy dimension) and allocation efficiency (effectiveness) of public procurement in health care facilities in the Czech Republic and Slovakia, countries whose health systems are governed by the principle of universal access to high quality health services. Concerning the technical efficiency, the results show a low rate of competitiveness whereby the potential of competition is not exploited. In terms of allocation efficiency, our research also sufficiently illustrates the criticality of the situation; however, compared to the element of technical efficiency the situation in the evaluated countries is different. In Slovakia, purchases are usually decided by doctors and procurement is prepared without the necessary ex-ante analysis. In the Czech Republic, the ex-ante evaluation of purchasing of medical equipment is regulated, however, the decision-making process is non-transparent and does not guarantee allocative efficiency. The study has critical policy implications – both countries should urgently adopt measures to improve their respective procurement processes.