Measuring the Efficiency of Health Systems: A Case of Mental Health in Middle East and North Africa Countries

Background: Mental disorders and problems put a heavy burden on communities. Since resources allocated to the mental health systems are finite, it seems necessary to assess the efficiency of mental health systems. In this study, we assess the efficiency of mental health care systems across 12 Middle East and North Africa (MENA) countries in 2014. Methods: We used data envelopment analysis (DEA). The number of psychiatrists and nurses working in the mental health sector, the number of beds in mental hospitals, and the healthcare expenditures were included as inputs. The disability-adjusted life years (DALYs) of mental and substance use disorders was considered as the output. This approach is an input-oriented and a variable returns to scale. Results: Countries such as Egypt, Iraq, Lebanon, and Qatar with the efficiency scores of 1.00 are entirely efficient. However, Bahrain and Iran with the efficiency scores of 0.50 and 0.58 are the most inefficient countries, respectively. After measuring the efficiency model, the radial super-efficiency showed that Egypt and Lebanon with the efficiency scores of 4.73 and 4.09 were ranked as the first and second by far. Qatar and Iraq compared with the previous analysis, and with the efficiency scores of 1.72 and 1.58, were ranked as the third and fourth. Bahrain and Iran were as inefficient as the previous model. Conclusion: This study depicted a general portrait of the performance of mental health systems across MENA countries. Countries performed efficiently, have taken advantage of comprehensive programs in mental health sector. Countries are strongly recommended to complement their datasets of mental health to make future studies able to evaluate mental health systems more accurately and perfectly.