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Five types of OECD healthcare systems: Empirical results of a deductive classification

Listed author(s):
  • Böhm, Katharina
  • Schmid, Achim
  • Götze, Ralf
  • Landwehr, Claudia
  • Rothgang, Heinz
Registered author(s):

    This article classifies 30 OECD healthcare systems according to a deductively generated typology by Rothgang and Wendt [1]. This typology distinguishes three core dimensions of the healthcare system: regulation, financing, and service provision, and three types of actors: state, societal, and private actors. We argue that there is a hierarchical relationship between the three dimensions, led by regulation, followed by financing and finally service provision, where the superior dimension restricts the nature of the subordinate dimensions. This hierarchy rule limits the number of theoretically plausible types to ten. To test our argument, we classify 30 OECD healthcare systems, mainly using OECD Health Data and WHO country reports. The classification results in five system types: the National Health Service, the National Health Insurance, the Social Health Insurance, the Etatist Social Health Insurance, and the Private Health System. All five types belong to the group of healthcare system types considered theoretically plausible. Merely Slovenia does not comply with our assumption of a hierarchy among dimensions and typical actors due to its singular transformation history.

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    File URL: http://www.sciencedirect.com/science/article/pii/S0168851013002285
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    Article provided by Elsevier in its journal Health Policy.

    Volume (Year): 113 (2013)
    Issue (Month): 3 ()
    Pages: 258-269

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    Handle: RePEc:eee:hepoli:v:113:y:2013:i:3:p:258-269
    DOI: 10.1016/j.healthpol.2013.09.003
    Contact details of provider: Web page: http://www.elsevier.com/locate/healthpol

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    1. AfDB AfDB, . "African Statistical Yearbook 2012," African Statistical Yearbook, African Development Bank, number 387.
    2. Rothgang, Heinz & Cacace, Mirella & Grimmeisen, Simone & Wendt, Claus, 2005. "9 The changing role of the state in healthcare systems," European Review, Cambridge University Press, vol. 13(S1), pages 187-212, March.
    3. Adolf Stepan & Margit Sommersguter-Reichmann, 2005. "Monitoring political decision-making and its impact in Austria," Health Economics, John Wiley & Sons, Ltd., vol. 14(S1), pages 7-23.
    4. Lee, Sang-Yi & Chun, Chang-Bae & Lee, Yong-Gab & Seo, Nam Kyu, 2008. "The National Health Insurance system as one type of new typology: The case of South Korea and Taiwan," Health Policy, Elsevier, vol. 85(1), pages 105-113, January.
    5. Elizabeth Docteur & Howard Oxley, 2003. "Health-Care Systems: Lessons from the Reform Experience," OECD Health Working Papers 9, OECD Publishing.
    6. Albreht, Tit & Klazinga, Niek, 2009. "Privatisation of health care in Slovenia in the period 1992-2008," Health Policy, Elsevier, vol. 90(2-3), pages 262-269, May.
    7. Culyer, A J, 1989. "The Normative Economics of Health Care Finance and Provision," Oxford Review of Economic Policy, Oxford University Press, vol. 5(1), pages 34-58, Spring.
    8. Isabelle Joumard & Christophe André & Chantal Nicq, 2010. "Health Care Systems: Efficiency and Institutions," OECD Economics Department Working Papers 769, OECD Publishing.
    9. Wilsford, David, 1994. "Path Dependency, or Why History Makes It Difficult but Not Impossible to Reform Health Care Systems in a Big Way," Journal of Public Policy, Cambridge University Press, vol. 14(03), pages 251-283, July.
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