Health Systems Performance in Health Outcomes, Health Financing and Covid-19 Pandemic: Lessons From 31 Countries

Health Systems Performance in Health Outcomes, Health Financing and Covid-19 Pandemic: Lessons From 31 Countries Publisher Pubmed

Kolivand P ; Arabloo J ; Saberian P ; Dorooudi T ; Rajaie S ; Karimi F ; Raei B ; Behzadifar M ; Parvari A ; Ehsanzadeh SJ ; Homayoun S ; Salehbeigi S ; Namdar P ; Azari S

Source: PLOS ONE Published:2025

Abstract

Background ssssHealth system performance is a multifaceted concept that encompasses various dimensions of a nation’s healthcare infrastructure. This study aims to assess and rank the performance of health systems across different regions of the world. Methodology We employed the Technique for Order of Preference by Similarity to Ideal Solution (TOPSIS) method in 2023 to evaluate and rank the health system performance of 31 countries across six geographical regions. Our evaluation included six general categories and twelve indicators related to health, finance, and the COVID-19 pandemic. The final weights for these indicators were determined using the Three-scale method and the Entropy-weighting method. Additionally, we categorized health system performance into three groups: high, moderate, and low. Hierarchical clustering of health system performance scores was conducted using SPSS software (version 26). Results Luxembourg emerged as the only high-performing health system, while Qatar and the Netherlands fell into the moderate-performance group. Other countries exhibited low-performing health systems. Notably, within the low-performance group, the United States of America, Australia, Singapore, Canada, England, and Germany achieved relatively better rankings. Conversely, Yemen, Egypt, Afghanistan, and Bolivia ranked lowest in terms of health system performance. Conclusion Contrary to the assumption that higher health spending guarantees improved performance, the experience of COVID-19 among high-income countries revealed mixed results. Strengthening resilience, investing in public health systems, and ensuring sustainable financial resources are crucial for enhancing health system performance. © 2025 Elsevier B.V., All rights reserved.

Style	Citing Format
MLA	Kolivand P, et al.. "Health Systems Performance in Health Outcomes, Health Financing and Covid-19 Pandemic: Lessons From 31 Countries." PLOS ONE, vol. 20, no. 10 October, 2025, pp. -.
APA	Kolivand P, Arabloo J, Saberian P, Dorooudi T, Rajaie S, Karimi F, Raei B, Behzadifar M, Parvari A, Ehsanzadeh SJ, Homayoun S, Salehbeigi S, Namdar P, Azari S (2025). Health Systems Performance in Health Outcomes, Health Financing and Covid-19 Pandemic: Lessons From 31 Countries. PLOS ONE, 20(10 October), -.
Chicago	Kolivand P, Arabloo J, Saberian P, Dorooudi T, Rajaie S, Karimi F, Raei B, et al.. "Health Systems Performance in Health Outcomes, Health Financing and Covid-19 Pandemic: Lessons From 31 Countries." PLOS ONE 20, no. 10 October (2025): -.
Harvard	Kolivand P et al. (2025) 'Health Systems Performance in Health Outcomes, Health Financing and Covid-19 Pandemic: Lessons From 31 Countries', PLOS ONE, 20(10 October), pp. -.
Vancouver	Kolivand P, Arabloo J, Saberian P, Dorooudi T, Rajaie S, Karimi F, et al.. Health Systems Performance in Health Outcomes, Health Financing and Covid-19 Pandemic: Lessons From 31 Countries. PLOS ONE. 2025;20(10 October):-.
BibTex	@article{ author = {Kolivand P and Arabloo J and Saberian P and Dorooudi T and Rajaie S and Karimi F and Raei B and Behzadifar M and Parvari A and Ehsanzadeh SJ and Homayoun S and Salehbeigi S and Namdar P and Azari S}, title = {Health Systems Performance in Health Outcomes, Health Financing and Covid-19 Pandemic: Lessons From 31 Countries}, journal = {PLOS ONE}, volume = {20}, number = {10 October}, pages = {-}, year = {2025} }
RIS	TY - JOUR AU - Kolivand P AU - Arabloo J AU - Saberian P AU - Dorooudi T AU - Rajaie S AU - Karimi F AU - Raei B AU - Behzadifar M AU - Parvari A AU - Ehsanzadeh SJ AU - Homayoun S AU - Salehbeigi S AU - Namdar P AU - Azari S TI - Health Systems Performance in Health Outcomes, Health Financing and Covid-19 Pandemic: Lessons From 31 Countries JO - PLOS ONE VL - 20 IS - 10 October SP - EP - PY - 2025 ER -

Science Communicator Platform

Authors

Abstract