IDEAS home Printed from
MyIDEAS: Log in (now much improved!) to save this paper

Health-Care Systems: Lessons from the Reform Experience

Listed author(s):
  • Elizabeth Docteur
  • Howard Oxley

This study reviews health-system reforms in OECD countries over the past several decades and their impact on the following policy goals: ensuring access to services; improving the quality of care and its outcomes; allocating an “appropriate” level of resources to health care (macroeconomic efficiency); and ensuring microeconomic efficiency in service provision. While nearly all OECD countries have achieved universal insurance coverage, initiatives to address persistent disparities in access are now being undertaken in a number of countries. In light of new evidence of serious problems with health-care quality, many countries have recently introduced reforms, but it is too soon to generalise as to the relative effects of alternative approaches. Instruments aimed at cost control have succeeded in slowing the growth of (particularly public) health-care spending over the 1980s and 1990s but health-care spending continues to rise as a share of GDP in most countries. A few countries have ...This paper is also published under OECD Health Working Papers Series. Cette étude présente les réformes des systèmes de santé des pays de l’OCDE qui se sont opérées au cours des dernières décennies et leur impact sur les objectifs de politique économique suivants: assurer l’accès aux services de santé; améliorer la qualité des soins; allouer un niveau « approprié » de ressources à la santé (efficience macroéconomique) ; et s’assurer que les services soient dispensés de façon à optimiser l’efficience microéconomique. Alors que presque tous les pays de l’OCDE ont mis en place une couverture universelle, les initiatives se multiplient pour résoudre les problèmes de disparités résiduelles d’accès aux soins. Un grand nombre de pays ont introduit des réformes pour tenter de corriger de sérieux problèmes de qualité mais il est encore trop tôt évaluer leurs effets. Les mesures visant à contrôler les coûts ont réussi à réduire la croissance des dépenses de santé au cours des années 80 et 90, mais les dépenses de santé exprimées en pourcentage du GDP ...

If you experience problems downloading a file, check if you have the proper application to view it first. In case of further problems read the IDEAS help page. Note that these files are not on the IDEAS site. Please be patient as the files may be large.

File URL:
Download Restriction: no

Paper provided by OECD Publishing in its series OECD Economics Department Working Papers with number 374.

in new window

Date of creation: 05 Dec 2003
Handle: RePEc:oec:ecoaaa:374-en
Contact details of provider: Postal:
2 rue Andre Pascal, 75775 Paris Cedex 16

Phone: 33-(0)-1-45 24 82 00
Fax: 33-(0)-1-45 24 85 00
Web page:

More information through EDIRC

No references listed on IDEAS
You can help add them by filling out this form.

This item is featured on the following reading lists or Wikipedia pages:

  1. שיחה:הרפורמה בשירותי הבריאות בארצות הברית in Wikipedia Hebrew ne '')

When requesting a correction, please mention this item's handle: RePEc:oec:ecoaaa:374-en. See general information about how to correct material in RePEc.

For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: ()

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 references are entirely missing, you can add them using this form.

If the full references list an item that is present in RePEc, but the system did not link 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 profile, as there may be some citations waiting for confirmation.

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

This information is provided to you by IDEAS at the Research Division of the Federal Reserve Bank of St. Louis using RePEc data.