| Summary: | Abstract Background: In this paper healthcare condition of 31 countries that are the members of Organization for Economic and Co-operative Development (OECD) is measured by considering 14 indicators that are relevant to three main pillars of sustainable development. Method: To estimate the efficiency scores, Principle Component Analysis-Data Envelopment Analysis PCA-DEA additive model in both forms of envelopment and multiplier is used to determine efficiency scores and also to define benchmarks and improvement plan for the inefficient countries. Then Decision Tree Analysis is also used to realize that which factors were the most influential ones to make a county an efficient Decision Making Unit (DMU). Results: According to the PCA-DEA additive model, among 31 OECD countries, 16 countries have become inefficient, that USA have taken the lowest efficiency score, and among efficient countries Iceland could be considered as a paragon which has the highest frequency between the countries that are defined as the benchmarks. Decision tree analysis also show that exposure to PM2.5 is an influential factor on the efficiency status of countries. Conclusion: This research gives an insight about the sustainable development and healthcare system and show the impressive effect of environmental and social factors like: exposure to PM2.5 and water quality, population insurance coverage, and AIDS on the healthcare efficiency of OECD countries
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