How and why do countries differ in their governance and financing‐related administrative expenditure in health care? <scp>An</scp> analysis of <scp>OECD</scp> countries by health care system typology

Hagenaars, Luc; Klazinga, Niek; Mueller, Michael; Morgan, David; Jeurissen, Patrick

doi:10.1002/hpm.2458

Cited by 26 publications

(17 citation statements)

References 35 publications

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“…Finally, all elements that deal with the regulatory and administrative function of the systems were included under the regulation category. Besides regulation, studies use different terms to refer to this function, such as stewardship (Ferreira et al, 2018), governance (Bertin and Pantalone, 2018; Freeman, 2000; Hagenaars et al, 2018) and organisation (Borisova, 2011).…”

Section: Resultsmentioning

confidence: 99%

“…Financing structure and schemes Anderson, 1963;Bambra, 2005;Borisova, 2011;Docteur and Oxley, 2003;European Union, 2012;Ferreira et al, 2018;Field, 1973;Freeman, 2000;Freeman and Schmid, 2008;Frenk and Londoño, 1997;Hagenaars et al, 2018;Hurst, 1991;Jakubowski and Busse, 1998;Kam, 2012;Lee et al, 2008;Organisation for Economic Co-operation and Development, 1987;Saltman and Figueras, 1997;Sam, 2014;Santerre and Neun, 2010;Thomson et al, 2009;Toth, 2010Toth, , 2016Wendt, 2009Wendt, , 2014Mackintosh et al, 2016 Health expenditure Borisova, 2011;European Union, 2012;Fe...…”

Section: Financingmentioning

confidence: 99%

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Classifications of health care systems: Do existing typologies reflect the particularities of the Global South?

Carvalho

Schmid

Fischer

2020

Global Social Policy

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Typologies are a useful and widely employed instrument in comparative research, including the study of health care systems. This study analyses the effectiveness of extant classifications in representing health care systems globally, examining whether existing literature adequately helps to understand health care systems of the Global South. To this end, the study highlights key elements of health care systems in the Global South, in particular limited resources, segmentation and the involvement of non-domestic/international actors. In a further step, we conduct a systematic literature review of typological scholarship on health care systems, in which 42 classifications are identified and analysed regarding regional coverage, methods, as well as the criteria and categories they include. The results point to major limitations: First, there is a general lack of representation and systematic classification of health care systems of the Global South. Second, there is a bias as criteria for classification are developed inductively based upon health care systems of the Global North. Consequently, existing typologies mostly fail to take into account the particularities of the countries beyond high-income economies. The study concludes by putting forth recommendations for developing a more comprehensive, globally applicable typological framework.

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Section: Resultsmentioning

confidence: 99%

Section: Financingmentioning

confidence: 99%

Classifications of health care systems: Do existing typologies reflect the particularities of the Global South?

Carvalho

Schmid

Fischer

2020

Global Social Policy

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“…Cross-national differences range from 1.3% in Iceland to 8.3% in the United States. 58 While developmental support of the healthcare system decreases the GHE, the total medical expenditure increase depends on a country's economic development. In addition, the OOP health payment is strongly affected by a country's revenue mobilization capacity.…”

Section: Factors Affecting the Out-of-pocket Payment Increase In Chinamentioning

confidence: 99%

Government health expenditure, out‐of‐pocket payment and social inequality: A cross‐national analysis of China and OECD countries

Zhang

Rahman

2020

Health Planning & Management

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This study aims to assess the association between Chinese out‐of‐pocket payments and government health spending, investigating their variation ratio in the context of OECD countries. Aggregated time‐series data of 37 countries (from China and official OECD members) were collected from the World Bank Open Data source and analyzed using the multiple linear regression models. Benchmarking approach was applied to evaluate the causes of healthcare expenditure rise per capita. The results showed that China's government health expenditure was positively associated with out‐of‐pocket payment rise, with a higher variation score of 42.70%. The association was statistically significant at 5%. Likewise, the association between government expenditure and out‐of‐pocket payment in the OECD countries was positively significant at 1%, and their variation score was 2.41%. Health financing in OECD countries showed higher stability and equity than that in China. Policy implications for China is to reduce the distributional disparity of government health funds by tax adjustments in health services, universal health coverage, the removal of social health insurance disparities, and a single health payment method.

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“…The studies on AC in health care indicate that AC take up a considerable share of total spending. Costs borne by organisations that finance and govern healthcare alone constitute around 3% of total health expenditure on average in OECD countries (Hagenaars et al, 2018). These macro level AC omit the AC of healthcare delivery organisations and the administrative activities of healthcare professionals (meso and micro levels), and therefore represent an underestimation of the total share of AC in healthcare spending.…”

Section: Introductionmentioning

confidence: 99%

Track and Trace of Administrative Costs in the Dutch Long-Term Care System

Hagenaars¹,

Hilten

Klazinga

et al. 2021

JLTC

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Dutch LTC, but a robust empirical body of evidence on the components, determinants and value of AC in LTC is absent. Neither has the expert consensus of ways to track and trace AC in LTC been sought. Objective(s): We investigated whether it is possible to reach consensus on operationalising AC in Dutch LTC. Successively we also explored whether the Dutch LTC reform in 2015 had the intended effect of reducing AC. Methods: We differentiated between AC for governing and financing LTC (macro), overhead costs of LTC delivery organisations (meso) and AC on the level of professional care delivery activities (micro). We identified possible data sources in grey literature and national accounts. The quality and completeness of identified data and potential determinants of AC were validated by experts via a survey and focus group discussions. Findings: We were able to reach agreement on how to track AC in Dutch LTC, but current research instruments and data systems are not robust and consistent enough to trace differences before and after the 2015 reform. Limitations: We did not investigate AC experienced by patients and self-selected participating experts. Implications: AC concern a considerable share of total LTC spending, but AC are hidden in regular health expenditure statistics. Our study highlights three approaches for a more sophisticated and fact-based policy debate on reducing low-value AC; defining AC on macro, meso and micro levels of the health care system, determining the underlying value/use of activities; and focusing on interactions of AC between system levels.

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How and why do countries differ in their governance and financing‐related administrative expenditure in health care? An analysis of OECD countries by health care system typology

Cited by 26 publications

References 35 publications

Classifications of health care systems: Do existing typologies reflect the particularities of the Global South?

Classifications of health care systems: Do existing typologies reflect the particularities of the Global South?

Government health expenditure, out‐of‐pocket payment and social inequality: A cross‐national analysis of China and OECD countries

Track and Trace of Administrative Costs in the Dutch Long-Term Care System

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