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Health-Care Systems: Lessons from the Reform Experience


  • Elizabeth Docteur
  • Howard Oxley


This study presents a broad overview of health-system reforms in OECD countries over the past several decades. Reforms are assessed according to their impact on the following policy goals: ensuring access to needed health-care services; improving the quality of health care and its outcomes; allocating an “appropriate” level of pubic sector and economy-wide resources to health care (macroeconomic efficiency); and ensuring that services are provided in a cost-efficient and cost-effective manner (microeconomic efficiency).While nearly all OECD countries have achieved universal coverage of health-care risks, 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 intended to improve this, but it is too soon to generalise as to the relative effects of alternative approaches. A variety of instruments aimed at ...This paper is also published under OECD Economics Department Working Papers Series. Cette étude présente un survol des réformes des systèmes de santé des pays de l’OCDE qui se sont opérées au cours des dernières décennies. Ces réformes sont évaluées en fonction de leur impact sur les objectifs de politique économique suivants : assurer l’accès aux services de santé indispensables; améliorer la qualité des soins et leurs résultats; allouer un niveau « approprié » des ressources du secteur public et de l’ensemble de l’économie à la santé (efficience macroéconomique) ; et s’assurer que les services soient dispensés de façon à optimiser les rapports efficience-coût et efficacité-coût (efficience microéconomique). Alors que presque tous les pays de l’OCDE ont mis en place une couverture universelle des risques santé, les initiatives se multiplient dans un certain nombre de pays pour résoudre les problèmes de disparités résiduelles d’accès aux soins. Confrontés à l’apparition de sérieux problèmes liés à la qualité des soins de santé, un grand nombre de pays ont ...

Suggested Citation

  • Elizabeth Docteur & Howard Oxley, 2003. "Health-Care Systems: Lessons from the Reform Experience," OECD Health Working Papers 9, OECD Publishing.
  • Handle: RePEc:oec:elsaad:9-en

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    JEL classification:

    • I10 - Health, Education, and Welfare - - Health - - - General
    • I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health

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