IDEAS home Printed from https://ideas.repec.org/a/eee/hepoli/v113y2013i3p258-269.html
   My bibliography  Save this article

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

Author

Listed:
  • Böhm, Katharina
  • Schmid, Achim
  • Götze, Ralf
  • Landwehr, Claudia
  • Rothgang, Heinz

Abstract

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.

Suggested Citation

  • Böhm, Katharina & Schmid, Achim & Götze, Ralf & Landwehr, Claudia & Rothgang, Heinz, 2013. "Five types of OECD healthcare systems: Empirical results of a deductive classification," Health Policy, Elsevier, vol. 113(3), pages 258-269.
    • Handle: RePEc:eee:hepoli:v:113:y:2013:i:3:p:258-269
    DOI: 10.1016/j.healthpol.2013.09.003
    as

    Download full text from publisher

    File URL: http://www.sciencedirect.com/science/article/pii/S0168851013002285
    Download Restriction: Full text for ScienceDirect subscribers only
    File URL: https://libkey.io/10.1016/j.healthpol.2013.09.003?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    As the access to this document is restricted, you may want to search for a different version of it.

    References listed on IDEAS

    as
    1. AfDB AfDB, . "African Statistical Yearbook 2012," African Statistical Yearbook, African Development Bank, number 387.
    2. 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, September.
    3. 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.
    4. Isabelle Joumard & Christophe André & Chantal Nicq, 2010. "Health Care Systems: Efficiency and Institutions," OECD Economics Department Working Papers 769, OECD Publishing.
    5. 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(3), pages 251-283, July.
    6. Frisina Doetter, Lorraine & Götze, Ralf, 2011. "The changing role of the state in the Italian healthcare system," TranState Working Papers 150, University of Bremen, Collaborative Research Center 597: Transformations of the State.
    7. 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.
    8. Elizabeth Docteur & Howard Oxley, 2003. "Health-Care Systems: Lessons from the Reform Experience," OECD Health Working Papers 9, OECD Publishing.
    9. 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.
    10. Culyer, A J, 1989. "The Normative Economics of Health Care Finance and Provision," Oxford Review of Economic Policy, Oxford University Press and Oxford Review of Economic Policy Limited, vol. 5(1), pages 34-58, Spring.
    11. Terris, M., 1978. "The three world systems of medical care: Trends and prospects," American Journal of Public Health, American Public Health Association, vol. 68(11), pages 1125-1131.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Böhm, Katharina & Schmid, Achim & Götze, Ralf & Landwehr, Claudia & Rothgang, Heinz, 2012. "Classifying OECD healthcare systems: A deductive approach," TranState Working Papers 165, University of Bremen, Collaborative Research Center 597: Transformations of the State.
    2. Christine André & Philippe Batifoulier & Mariana Jansen-Ferreira, 2016. "Privatisation de la santé en Europe. Un outil de classification des réformes," CEPN Working Papers hal-01256505, HAL.
    3. Bonasia, Mariangela & Kounetas, Konstantinos & Oreste, Napolitano, 2020. "Assessment of regional productive performance of European health systems under a metatechnology framework," Economic Modelling, Elsevier, vol. 84(C), pages 234-248.
    4. Blazej Lyszczarz, 2016. "The effect of health care model on health systems' responses to economic crises," Ekonomia i Prawo, Uniwersytet Mikolaja Kopernika, vol. 15(4), pages 493-501, December.
    5. Nozaki, Masahiro & Kashiwase, Kenichiro & Saito, Ikuo, 2017. "Health spending in Japan: Macro-fiscal implications and reform options," The Journal of the Economics of Ageing, Elsevier, vol. 9(C), pages 156-171.
    6. Cuadrado, Cristóbal & Crispi, Francisca & Libuy, Matías & Marchildon, Gregory & Cid, Camilo, 2019. "National Health Insurance: A conceptual framework from conflicting typologies," Health Policy, Elsevier, vol. 123(7), pages 621-629.
    7. Tony J Culyer & Alan Wagstaff, 1991. "Need, equality and social justice," Working Papers 090chedp, Centre for Health Economics, University of York.
    8. Pablo Gottret & George Schieber, 2006. "Health Financing Revisited : A Practitioner's Guide," World Bank Publications - Books, The World Bank Group, number 7094, December.
    9. Åsa Johansson, 2016. "Public Finance, Economic Growth and Inequality: A Survey of the Evidence," OECD Economics Department Working Papers 1346, OECD Publishing.
    10. Paul Anand & Laurence S. J. Roope & Anthony J. Culyer & Ron Smith, 2020. "Disability and multidimensional quality of life: A capability approach to health status assessment," Health Economics, John Wiley & Sons, Ltd., vol. 29(7), pages 748-765, July.
    11. Andrew McNee, 2012. "Illuminating the local: can non-formal institutions be complementary to health system development in Papua New Guinea?," Development Policy Centre Discussion Papers 1215, Development Policy Centre, Crawford School of Public Policy, The Australian National University.
    12. Adam Oliver, 2005. "The English National Health Service: 1979‐2005," Health Economics, John Wiley & Sons, Ltd., vol. 14(S1), pages 75-99, September.
    13. Mikkers, Misja, 2016. "The Dutch Healthcare System in International Perspective," Other publications TiSEM 800704a0-24ee-4830-8659-2, Tilburg University, School of Economics and Management.
    14. Kevin Haninger & James K. Hammitt, 2011. "Diminishing Willingness to Pay per Quality‐Adjusted Life Year: Valuing Acute Foodborne Illness," Risk Analysis, John Wiley & Sons, vol. 31(9), pages 1363-1380, September.
    15. Fiebig, Denzil G. & Haas, Marion & Hossain, Ishrat & Street, Deborah J. & Viney, Rosalie, 2009. "Decisions about Pap tests: What influences women and providers?," Social Science & Medicine, Elsevier, vol. 68(10), pages 1766-1774, May.
    16. Mæstad, Ottar & Norheim, Ole Frithjof, 2009. "Eliciting people's preferences for the distribution of health: A procedure for a more precise estimation of distributional weights," Journal of Health Economics, Elsevier, vol. 28(3), pages 570-577, May.
    17. Joao Pereira, 1989. "What does equity in health mean?," Working Papers 061chedp, Centre for Health Economics, University of York.
    18. Morton, Alec, 2014. "Aversion to health inequalities in healthcare prioritisation: A multicriteria optimisation perspective," Journal of Health Economics, Elsevier, vol. 36(C), pages 164-173.
    19. Philippe Ulmann, 2004. "Est-il possible (souhaitable) de maîtriser les dépenses de santé ?," Revue d'Économie Financière, Programme National Persée, vol. 76(3), pages 19-37.
    20. repec:eur:ejnmjr:8 is not listed on IDEAS
    21. Adam Wagstaff, 2010. "Social health insurance reexamined," Health Economics, John Wiley & Sons, Ltd., vol. 19(5), pages 503-517, May.

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:eee:hepoli:v:113:y:2013:i:3:p:258-269. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Catherine Liu or the person in charge (email available below). General contact details of provider: http://www.elsevier.com/locate/healthpol .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.