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Classifying OECD healthcare systems: A deductive approach

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

Abstract

This paper is a first attempt to classify 30 OECD healthcare systems according to a typology developed by Rothgang et al. (2005) and elaborated by Wendt et al. (2009). The typology follows a deductive approach. It distinguishes three core dimensions of the healthcare system: regulation, financing, and service provision. Moreover, three types of actors are identified based on long-standing concepts in social research: the state, societal actors, and market participants. Uniform or ideal-type combinations unfold if all dimensions are dominated by the same actor, either belonging to the state, society, or the market. Further, we argue, there is a hierarchical relationship between the dimensions of the healthcare system, led by regulation, followed by financing, and last service provision, where the superior dimension restricts the nature of the subordinate dimensions. This hierarchy limits the number of theoretically plausible healthcare system types within the logic of the deductive typology. The classification of 30 countries according to their most recent institutional setting results in five healthcare system types: the National Health Service, the National Health Insurance, the Social Health Insurance, the Etatist Social Health Insurance, and the Private Health System. Of particular relevance are the National Health Insurance and the Etatist Social Health Insurance both of which include countries that have often provoked caveats when allocated to a specific family of healthcare systems. Moreover, Slovenia stands out as a special case. The findings are discussed with respect to alternative taxonomies, explanatory factors for the position of single countries and most likely trends.

Suggested Citation

  • 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.
  • Handle: RePEc:zbw:sfb597:165
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    References listed on IDEAS

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    1. 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.
    2. 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.
    3. Elizabeth Docteur & Howard Oxley, 2003. "Health-Care Systems: Lessons from the Reform Experience," OECD Health Working Papers 9, OECD Publishing.
    4. Imre Boncz & Júlia Nagy & Andor Sebestyén & László Kőrösi, 2004. "Financing of health care services in Hungary," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 5(3), pages 252-258, September.
    5. Culyer, A J, 1989. "The Normative Economics of Health Care Finance and Provision," Oxford Review of Economic Policy, Oxford University Press, vol. 5(1), pages 34-58, Spring.
    6. Isabelle Joumard & Christophe André & Chantal Nicq, 2010. "Health Care Systems: Efficiency and Institutions," OECD Economics Department Working Papers 769, OECD Publishing.
    7. 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(03), pages 251-283, July.
    8. Scharpf, Fritz W., 2000. "The viability of advanced welfare states in the international economy. Vulnerabilities and options," European Review, Cambridge University Press, vol. 8(03), pages 399-425, July.
    9. repec:aph:ajpbhl:1978:68:11:1125-1131_0 is not listed on IDEAS
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    Cited by:

    1. Bazyli Czyżewski & Anna Hnatyszyn-Dzikowska & Jan Polcyn, 2016. "Problems of Quantifying Public Goods in the Healthcare Sector," Gospodarka Narodowa, Warsaw School of Economics, issue 3, pages 105-125.
    2. Katherine Baird, 2016. "The Incidence of High Medical Expenses by Health Status in Seven Developed Countries," LIS Working papers 670, LIS Cross-National Data Center in Luxembourg.

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