Honors Theses

Date of Award

Spring 5-9-2020

Document Type

Undergraduate Thesis


Croft Institute for International Studies

First Advisor

Katherine Centellas

Second Advisor

William Schenck

Third Advisor

Joshua First

Relational Format



The 19th century epidemiological transition in healthcare caused a major shift in physician focus from curing one-time, deadly illness to managing chronic disease. Now, even the most advanced international healthcare systems must find a way to increase their efficiency in order to compensate for heightened strains on medical systems and swelling costs of healthcare delivery. Fortunately, recent technological innovation and, chiefly, the growth of Electronic Health Records (EHRs) provide a potential solution to this looming threat. EHRs are digital charts with the potential to store and share patient health data among providers to offer the most informed, streamlined care available. Yet, their effectiveness in increasing health system efficiency remains uncertain. Relying on the concept of technical efficiency in the healthcare sector, I explore the efficacy of long-term international EHR implementation. Using OECD data, I performed a Stochastic Frontier Analysis (SFA) and measured the change in hospital subsector efficiency over time for each of the 15 chosen countries within my analysis. Followed by this data is a comprehensive EHR index as well as 5 individual country case studies to better explain the histories, successes, and failures of EHR implementation throughout the world. These measures yielded somewhat inconclusive results pertaining to EHR’s effect on international healthcare efficiency. Nevertheless, the findings of this study strongly support the need for continued international healthcare efficiency analysis. Rather than submit to the difficulties of such nuanced and complex analytical processes, researchers must remain vigilant and steadfast in their pursuit of efficiency in order to provide effective, affordable healthcare to everyone in need.



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