<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>0124-0064</journal-id>
<journal-title><![CDATA[Revista de Salud Pública]]></journal-title>
<abbrev-journal-title><![CDATA[Rev. salud pública]]></abbrev-journal-title>
<issn>0124-0064</issn>
<publisher>
<publisher-name><![CDATA[Instituto de Salud Publica, Facultad de Medicina - Universidad Nacional de Colombia]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S0124-00642017000100079</article-id>
<article-id pub-id-type="doi">10.15446/rsap.v19n1.44546</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Eficiencia del Gasto Total en Salud: Análisis no paramétrico en una muestra amplia de países]]></article-title>
<article-title xml:lang="en"><![CDATA[Total health expenditure efficiency: non-parametric analysis in a large sample of countries]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Geri]]></surname>
<given-names><![CDATA[Milva]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Monterubbianesi]]></surname>
<given-names><![CDATA[Pablo D.]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Lago]]></surname>
<given-names><![CDATA[Fernando P.]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Moscoso]]></surname>
<given-names><![CDATA[Nebel S.]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Universidad Nacional del Sur (UNS)  ]]></institution>
<addr-line><![CDATA[Bahía Blanca ]]></addr-line>
<country>Argentina</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,Universidad Nacional del Sur (UNS) Departamento de Economía ]]></institution>
<addr-line><![CDATA[Bahía Blanca ]]></addr-line>
<country>Argentina</country>
</aff>
<aff id="Af3">
<institution><![CDATA[,Universidad Nacional del Sur (UNS) Departamento de Economía ]]></institution>
<addr-line><![CDATA[Bahía Blanca ]]></addr-line>
<country>Argentina</country>
</aff>
<aff id="Af4">
<institution><![CDATA[,Universidad Nacional del Sur (UNS)-CONICET Departamento de Economía ]]></institution>
<addr-line><![CDATA[Bahía Blanca ]]></addr-line>
<country>Argentina</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>02</month>
<year>2017</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>02</month>
<year>2017</year>
</pub-date>
<volume>19</volume>
<numero>1</numero>
<fpage>79</fpage>
<lpage>85</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://www.scielo.org.co/scielo.php?script=sci_arttext&amp;pid=S0124-00642017000100079&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.co/scielo.php?script=sci_abstract&amp;pid=S0124-00642017000100079&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.co/scielo.php?script=sci_pdf&amp;pid=S0124-00642017000100079&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[RESUMEN  Objetivo  Mostrar la utilidad de una herramienta estadística no paramétrica para medir la eficiencia de 190 países en la producción de status de salud, así como conocer los determinantes de dicha eficiencia.  Métodos  Con datos de 2009, y utilizando la técnica de Envolvente de Datos, se estima la frontera de eficiencia, utilizando como insumo al gasto total en salud per cápita y como productos la tasa de mortalidad infantil y la esperanza de vida al nacer. Se realiza un análisis de los determinantes de la eficiencia del gasto mediante el uso de modelos Tobit.  Resultados  Las naciones del continente africano presentan menor eficiencia técnico-asignativa, aunque mayor eficiencia de escala. La calidad de las instituciones muestra un impacto estadísticamente significativo sobre los niveles de eficiencia técnico-asignativa y de escala. El porcentaje de financiamiento del gasto por parte de aseguradoras privadas incide sobre la eficiencia técnico-asignativa mientras que el porcentaje de urbanización lo hace sobre la eficiencia de escala.  Discusión  El hecho de que más del 70 % de los países presente rendimientos decrecientes del gasto en salud sugeriría que, una vez alcanzados ciertos estándares mínimos de calidad de vida, el efecto marginal de cada dólar adicional destinado a salud no es sustancial. En países pobres donde el gasto en salud presenta rendimientos crecientes, el desempeño sanitario podría mejorar significativamente con incrementos marginales del gasto. Las estructuras de financiamiento del gasto en salud podrían estar influyendo sobre la eficiencia técnico-asignativa y el grado de urbanización podría hacerlo sobre la eficiencia de escala.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[ABSTRACT  Objective  To measure the efficiency of 190 countries in producing health results and the factors that determine such efficiency.  Methodology  A data envelopment analysis was conducted on worldwide data from the year 2009 in order to estimate the efficient frontier, based on total health expenditure per capita, as well on infant mortality rate and life expectancy at birth. At the same time, an analysis of the determinants of expenditure efficiency was performed through Tobit models.  Results  African nations have lower technical and allocative efficiency, but higher scale efficiency. The quality of institutions has a statistically significant impact on the levels of technical and allocative efficiency and on the levels of scale efficiency. The percentage of health expenditure financed by private insurers has an impact on technical and allocative efficiency, while urbanization rates affect the scale efficiency.  Discussion  the fact that more than 70 % of countries show decreasing returns suggest that, once certain minimal standards of life quality are achieved, the marginal effect of each additional dollar assigned to health is not substantial. Conversely, in poor countries, where the expenditure in health presents increasing returns, the health performance could be substantially better by marginally raising the expenditure. On the other hand, financing structures of health expenditures may influence technical-allocative efficiency, while urbanization levels may impact scale efficiency (source: MeSH, NLM).]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[Eficiencia]]></kwd>
<kwd lng="es"><![CDATA[gastos en salud]]></kwd>
<kwd lng="es"><![CDATA[estado de salud]]></kwd>
<kwd lng="es"><![CDATA[códigos JEL: I119 (fuente: DeCS, BIREME)]]></kwd>
<kwd lng="en"><![CDATA[Efficiency]]></kwd>
<kwd lng="en"><![CDATA[health expenditure]]></kwd>
<kwd lng="en"><![CDATA[health status]]></kwd>
<kwd lng="en"><![CDATA[JEL codes: I119 (source: MeSH, NLM)]]></kwd>
</kwd-group>
</article-meta>
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