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Comparing Comparables: An Approach To Accurate Cross-Country Comparisons Of Health Systems For Effective Healthcare Planning And Policy Guidance


  • Mário Amorim Lopes

    () (INESC-TEC and DEIG, Faculdade de Engenharia, Universidade do Porto)

  • Carlos Soares

    () (INESC-TEC and DEI, Faculdade de Engenharia, Universidade do Porto)

  • Álvaro Almeida

    () (CEF.UP and Faculdade de Economia, Universidade do Porto)


With rising healthcare costs, using health personnel and resources efficiently and effectively is critical. International cross-country and simple worker-to-population ratio comparisons are frequently used for improving the efficiency of health systems, planning of health human resources, and guiding policy changes. These comparisons are made between countries typically of the same continental region. However, if used imprudently, inconsistencies arising from frail comparisons of health systems may outweigh the positive benefits brought by new policy insights. In this work, we propose a different approach to international health system comparisons. We present a methodology to group similar countries in terms of mortality, morbidity, utilization levels, and human and physical resources, which are all factors that influence health gains. Instead of constructing an absolute rank or comparing against the average, the method finds countries that share similar ground, upon which more reliable comparisons can then be conducted, including performance analysis. We apply this methodology using data from WHO’s HFA-DB, and we present some interesting empirical relationships between indicators that may provide new insights into how such information can be used to promote better healthcare planning and policy guidance.

Suggested Citation

  • Mário Amorim Lopes & Carlos Soares & Álvaro Almeida, 2015. "Comparing Comparables: An Approach To Accurate Cross-Country Comparisons Of Health Systems For Effective Healthcare Planning And Policy Guidance," FEP Working Papers 563, Universidade do Porto, Faculdade de Economia do Porto.
  • Handle: RePEc:por:fepwps:563

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    References listed on IDEAS

    1. Vasanthakumar Bhat, 2005. "Institutional arrangements and efficiency of health care delivery systems," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 6(3), pages 215-222, September.
    2. Amitabh Chandra & Jonathan Holmes & Jonathan Skinner, 2013. "Is This Time Different? The Slowdown in Healthcare Spending," Brookings Papers on Economic Activity, Economic Studies Program, The Brookings Institution, vol. 44(2 (Fall)), pages 261-323.
    3. Jeff Richardson & John Wildman & Iain K. Robertson, 2003. "A critique of the World Health Organisation's evaluation of health system performance," Health Economics, John Wiley & Sons, Ltd., vol. 12(5), pages 355-366.
    4. Varabyova, Yauheniya & Schreyögg, Jonas, 2013. "International comparisons of the technical efficiency of the hospital sector: Panel data analysis of OECD countries using parametric and non-parametric approaches," Health Policy, Elsevier, vol. 112(1), pages 70-79.
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    More about this item


    health systems; health indicators; health policy;

    JEL classification:

    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
    • I19 - Health, Education, and Welfare - - Health - - - Other


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