Health Care Systems

Abstract

This paper presents a set of indicators to assess health care system performance. It also presents new comparative data on health care policies and institutions for OECD countries. This set of indicators allows the empirical characterisation of health care systems and the identification of groups of countries sharing similar health institutions. It also helps to uncover strengths and weaknesses of each country's health care system and assessing the scope for improving value-for-money. The empirical analysis suggests that there is room in all countries surveyed to improve the effectiveness of health care spending; there is no health care system that performs systematically better in delivering cost-effective health carebig-bang reforms are therefore not warranted; increasing the coherence of policy settings, by adopting best policy practices within a similar system and borrowing the most appropriate elements from other systems will likely be more practical and effective to raise health care spending efficiency.

Healthcare Spending: The Role of Healthcare Institutions from an International Perspective

“…Their regression analysis indicated that it can account for about 90% (R 2 = 0.94) of the variation in spending across the 30 OECD countries in 2001 although the results of this paper appear to be suggest this figure is around 60% (R 2 = 0.97) for the same 30 OECD countries in 2009 (regression 2). However, in their regression Luxembourg and Norway were excluded as "Luxembourg's GDP is unusually high from international financial services, and Norway's is unusually high by virtue of its oil revenues" (Reinhardt, Hussey, & Anderson, 2004) The results show that after controlling for differences in GDP and healthcare quality/outcomes through life expectancy, there are some significant differences between the six groups of OECD countries in 2009 that share similar healthcare institutions identified by Joumard, André, & Nicq (2010). This therefore suggests that healthcare institutions do play a significant role in determining healthcare spending.…”

“…The institutional differences between healthcare systems in terms of market structures, competition levels, and government intervention and their role on healthcare spending can be explored by looking for evidence of differences between the six groups of countries sharing similar healthcare institutions identified by Joumard, André, & Nicq (2010). The specifics of how they grouped the 29 countries being covered earlier in the literature review section.…”

“…There is a lack of existing literature that looks to identify institutional differences across different countries in a reliable and consistent way; however, a recent OECD working paper (Joumard, André, & Nicq, 2010) offers some insights into this area of research. It has developed a comprehensive set of 20 indicators on health policies and institutions that "allows the empirical characterisation of health care systems and the identification of groups of countries sharing similar health institutions".…”

“…The precise groupings are shown in Figure 3 and "sensitivity analysis shows that the clusters identified are fairly robust." (Joumard, André, & Nicq, 2010) The 20 indicators they used to group the countries are developed from the results of a questionnaire of 269 mainly qualitative items collecting information on the healthcare system characteristics and was sent out by the OECD to its members in 2008 with all apart from the United States responding by early 2009. The results of the 29 responded countries were validated by checking for consistency with experts' knowledge and understanding as well as ensuring cross-country consistency (Paris, Devaux, & Wei, 2010).…”

Federal-State Relations in Australia

“…Others (including Denmark, Norway, and Poland) re-centralised responsibilities, citing concerns about heightened equity problems, potentially insufficient local funding to finance future heath care needs, duplication and inefficiency and other reasons (Saltman, 2008). Decentralisation could make the health care system more responsive to local needs and promote innovation, but it may also result in institutional complexity, weakening control over spending and insufficient exploitation of economies of scale (Joumard et al, 2010). A careful assessment is required.…”