Data sources
In order to limit the review to current and highly relevant material
inclusion criteria were established. Only full papers available in
English relating to public health systems in developed countries were
included, with OECD countries used to benchmark this criterion. A
timeframe for inclusion of papers published in or after 2011 was
established, as this aligns with significant national health reform
within the country of residence of the research team (Australia). Papers
not available in English were excluded from the study, as were title
matches for which full papers were not available. Papers based in
developing countries were excluded in order to align with the focus of
this work on OECD countries. Papers reviewed in full which held no clear
content relating to efficiency improvement in public health systems were
also excluded. A range of text words, synonyms and subject headings were
developed for the major concepts of health system, efficiency and
improvement. These search terms were used to undertake searches of two
electronic databases (PUBMED, MEDLINE) in February 2019. Search results
were merged with duplicates removed, and screening was managed using
Covidence.