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Health Care Systems: Efficiency and Institutions


  • Isabelle Joumard


  • Christophe André


  • Chantal Nicq



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 care – big-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. Systèmes de santé : efficacité et institutions Ce document présente un ensemble d’indicateurs afin d’évaluer la performance des systèmes de santé. Il présente aussi de nouvelles données comparatives sur les politiques et les institutions dans le domaine de la santé pour les différents pays de l’OCDE. Cet ensemble d’indicateurs permet de caractériser empiriquement les systèmes de santé en identifiant des groupes de pays ayant des politiques et institutions comparables. Il permet aussi de mettre en valeur les forces et les faiblesses du système de santé de chaque pays et de déterminer les gains potentiels d’efficacité. L’analyse empirique montre que dans chacun des pays étudiés l’efficacité des dépenses de santé peut être améliorée; qu’il n’existe pas de système qui, pour un coût donné, produit systématiquement des meilleurs résultats – des réformes radicales en faveur d’un système de santé ne sont donc pas nécessaires ; accroitre la cohérence des politiques en matière de santé en adoptant les politiques les plus performantes à l’intérieur d’un système similaire et en empruntant les éléments les plus appropriés aux autres systèmes s’avérera vraisemblablement plus réaliste et plus efficace pour améliorer l’efficacité de la dépense en matière de santé.

Suggested Citation

  • Isabelle Joumard & Christophe André & Chantal Nicq, 2010. "Health Care Systems: Efficiency and Institutions," OECD Economics Department Working Papers 769, OECD Publishing.
  • Handle: RePEc:oec:ecoaaa:769-en

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    dépenses publiques; efficacité; efficiency; health care system; health institutions and policies; institutions et politiques de santé; public spending; système de santé;

    JEL classification:

    • H21 - Public Economics - - Taxation, Subsidies, and Revenue - - - Efficiency; Optimal Taxation
    • H51 - Public Economics - - National Government Expenditures and Related Policies - - - Government Expenditures and Health
    • I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets
    • I12 - Health, Education, and Welfare - - Health - - - Health Behavior
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health

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