Concept Architecture
Concept
Theoretically, the Return on Equity (ROE) is a financial profitability ratio that measures the rate of return generated on shareholders' equity. It represents the efficiency with which an organisation uses owners' invested capital to generate net income and is founded on financial statement analysis and profitability measurement. In health economics, ROE is used to evaluate the financial performance of investor-owned healthcare organisations, insurers and private healthcare providers.
Mathematically, ROE is represented as the ratio of net income to average shareholders' equity, expressed as a percentage. The mathematical framework quantifies the earnings generated for each unit of equity capital employed during a reporting period.
In practice, ROE is calculated from an organisation's income statement and balance sheet using reported net income and average shareholders' equity. It is routinely used to assess financial performance, benchmark organisations, evaluate management effectiveness and support investment and strategic financial decisions.
Purpose
Used to evaluate the profitability of shareholders' investment, assess organisational financial performance, compare healthcare organisations, monitor management effectiveness and support investment and financial decision-making.
Mathematical Formulae
Primary Formula
ROE = (Net Income / Average Shareholders' Equity) ? 100%
Supporting Formulae
Average shareholders' equity:
Average Shareholders' Equity = (Beginning Equity + Ending Equity) / 2
Related Mathematical Methods
- Ratio analysis
- Financial statement analysis
- Profitability analysis
- Trend analysis
- Benchmarking
- DuPont analysis
Example
A private hospital reports net income of �15 million. Shareholders' equity was �140 million at the beginning of the year and �160 million at the end of the year.
Average Shareholders' Equity = (140 + 160) / 2 = 150 million
ROE = (15 / 150) ? 100 = 10.0%
The organisation generates a 10.0% annual return on shareholders' equity.
Excel Implementation
| Function | Example Formula | Health Economics Application |
|---|---|---|
| AVERAGE | =AVERAGE(B2,C2) | Calculates average shareholders' equity. |
| Division | =(D2/AVERAGE(B2,C2))*100 | Calculates return on equity as a percentage. |
| IF | =IF((D2/AVERAGE(B2,C2))>=0.10,""Target Met"",""Below Target"") | Evaluates performance against a target return. |
| RANK | =RANK(E2,E$2:E$20,0) | Benchmarks return on equity across healthcare organisations. |
VBA (Optional)
Automate the calculation of return on equity across multiple healthcare organisations and generate comparative profitability reports.
Sources
- Drummond MF, Sculpher MJ, Claxton K, Stoddart GL, Torrance GW. Methods for the Economic Evaluation of Health Care Programmes. Oxford University Press.
- Briggs A, Claxton K, Sculpher M. Decision Modelling for Health Economic Evaluation. Oxford University Press.
- Penman SH. Financial Statement Analysis and Security Valuation. McGraw-Hill.
- White GI, Sondhi AC, Fried D. The Analysis and Use of Financial Statements.
- Higgins RC. Analysis for Financial Management.
Related Concepts (2)
Frequently Asked Questions (6)
What is return on equity?
A financial ratio calculated as net income divided by owner equity, showing the return generated on capital invested by an organisation's owners.
Source: Brealey, Myers & Allen 2019
How is return on equity calculated?
Return on equity is calculated by dividing net income by owner equity, expressing the profit earned on the funds that owners have committed rather than on total assets. Because equity is only the portion of assets not financed by debt, borrowing can raise the ratio even when underlying performance is unchanged. This is why it is read together with the organisation's level of borrowing. Zelman and colleagues (2020) explain how the ratio reflects returns to invested capital in health organisations.
Source: Zelman et al. 2020
What does return on equity indicate?
Return on equity indicates how much profit an organisation generates from the capital its owners have invested, so a higher figure means a greater return on that capital. It reflects profitability and how the organisation is financed, since using debt as well as equity can raise the return earned on the equity portion. A low return signals that owners' capital is generating little surplus, which bears on the organisation's attractiveness to those who fund it.
Source: Brealey, Myers & Allen 2019
How is return on equity used?
Return on equity is used by owners and investors to judge the return earned on their capital and to compare it with alternatives, and by managers to assess performance. It is applied mainly where organisations have owners with invested capital, such as private providers or insurers. In public health care, which has no equity owners in the usual sense, the measure is less applicable, so it is used chiefly in the private parts of the sector.
Source: Brealey, Myers & Allen 2019
What are the limitations of return on equity?
Return on equity can be raised by using more debt rather than by better performance, since borrowing reduces the equity base against which profit is measured, so a high figure may reflect heavy borrowing and greater risk rather than efficiency. It depends on how profit and equity are measured, and can be distorted by one-off items or by a small equity base. It should therefore be read alongside measures of debt and of the return on assets.
Source: Brealey, Myers & Allen 2019
How does return on equity relate to financial risk?
Return on equity is linked to financial risk through the use of debt: borrowing can raise the return on equity when things go well, because profit is measured against a smaller equity base, but it magnifies losses when they go badly, since the fixed obligations remain. A high return on equity driven by heavy borrowing therefore carries greater risk. Reading it alongside the debt ratio shows how much of the return reflects performance and how much reflects gearing.
Source: Brealey, Myers & Allen 2019
Trust Record
Verified by Dr Darrin Baines
British health economist
Professional identity: darrinbaines.org
Verification date: 22 Aug 2025
Content version: 1.0.0
Canonical Identity
- Persistent URI
- https://healtheconomics.wiki/concept/return-on-equity
- Term code
- HE-EE_EA-048
Stable URI · Machine-readable · Resolvable · CC BY 4.0