Abstract
Health system performance assessment (HSPA) is essential for health planning and to improve population health. One of the HSPA domains is related to effectiveness, which can be represented considering different dimensions. Composite indicators can be used to summarize complex constructs involving several indicators. One example of such efforts is the Healthcare Access and Quality Index from the Global Burden of Diseases Study, in which different causes of mortality amenable to health care are summarized in this index through principal component analysis and exploratory factor analysis. While these approaches use the variance of the indicators, marginal improvement is not considered, that is, the distance to the best practice frontier. In this study we propose an innovative benefit-of-the-doubt approach to combine frontier analysis and composite indicators, using amenable mortality estimates for 188 countries. In particular, we include flexible aggregating weighting schemes and a robust and conditional approach. The dual formulation gives information on the peers and the potential mortality rate reduction targets considering the background conditions. In absolute terms, Andorra and high-income countries are the most effective regarding healthcare access and quality, while sub-Saharan African and South Asian countries are the least effective. North African and Middle Eastern countries benefit the most when epidemiological patterns, geographical proximity, and country development status are considered.

Abstract
In 2010, the European Commission set out the development of an economy based on knowledge and innovation as one of the priorities of its Europe 2020 strategy for smart, sustainable, and inclusive growth. This culminated in the 'Youth on the Move' flagship initiative, aimed at enhancing the performance and international attractiveness of Europe's higher education institutions and raising the Union's overall education and training levels. Therefore, it is relevant to assess the performance of the 'Youth on the Move' initiative via the creation of composite indicators (CIs) and, ultimately, monitor the progress made by European countries in creating a positive environment supporting learner mobility. For this reason, we make use of the CI-building 'Benefit-of-the-Doubt' approach, in its robust and conditional setting to account for outliers and the human development of those nations, to exploit the European Commission's Mobility Scoreboard framework between 2015/2016 and 2022/2023. Furthermore, we incorporate the value judgements of experts in the sector to construct utility scales and compute weight restrictions through multi-criteria decision analysis. This enables the conversion of ordinal scales into interval ones based on knowledgeable information about reality in higher education. In the end, the results point to a slight performance improvement, but highlight the need to improve the 'Recognition of learning outcomes', 'Foreign language preparation', and 'Information and guidance'.