This article addresses the need to establish a comprehensive conceptual framework for analysing healthcare systems and their transformations. It begins by offering an overview of the current state of the art in the field, pointing to the literature's absence of conceptual robustness in the definition of system types. By exploring the dimensions 'financing', 'provision' and 'regulation' of healthcare, the article then proceeds deductively in line with the 'Weberian method of ideal-types' to establish a taxonomy of 27 healthcare systems, of which three can be identified as 'ideal-types'. When applying this concept, not only can differences between healthcare systems be analysed, but also changes over time. The article concludes by identifying three forms of healthcare system transformation.
Healthcare systems have been institutionalized to provide healthcare for those in need. Therefore, comparisons should focus in particular on differences in healthcare provision and on how access to healthcare services is regulated. This article presents a typology of healthcare systems which simultaneously takes into account data on expenditures, financing, provision and access to healthcare in 15 European countries. On this basis, three types of healthcare system have been constructed using statistical cluster analysis: a health service provision-oriented type that is characterized by a high number of service providers and free access for patients to medical doctors; a universal coverage — controlled access type where healthcare provision has the status of a social citizenship right and equal access to healthcare is of higher importance than free access and freedom of choice; and a low budget — restricted access type where financial resources for healthcare are limited and patients’ access to healthcare is restricted by high private out-of-pocket payments and the regulation that patients have to sign up on a general practitioner’s list for a longer period of time.
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