From: EU health systems classification: a new proposal from EURO-HEALTHY
Author (year) | Typology (countries) | Criteria |
---|---|---|
Field (1973) [20] | Pluralist healthcare (US) | Stewardship; ownership; doctors autonomy |
Health insurance (Western European countries, Japan) | ||
National health service system (UK) | ||
Socialist healthcare system (USSR, Eastern Europe) | ||
OECD (1987) [21] | Beveridge model (UK, Nordic countries, Southern European countries, Ireland) | Coverage; funding; ownership |
Bismarck model (Austria, Belgium, France, Germany, Luxembourg, Netherlands) | ||
Private insurance (US) | ||
Donalson and Gerard (1993) [22] | Tax funding (Denmark, Norway, Sweden, UK) | Funding |
Social insurance contributions (France, Germany) | ||
Mixed systems (Italy, Spain, Netherlands) | ||
European Parliament (1998) [3] | Main/supplementary system: Public taxation/private VHI and direct payments (Finland, Greece, Ireland, Italy, Sweden, Spain, UK) | Funding |
Public taxation/direct payments (Denmark, Portugal) | ||
Social contributions insurance/private VHI, direct payments, public taxation (Austria, Belgium, France, Germany, Luxembourg) | ||
Mixed compulsory social insurance and private voluntary health insurance/public taxation, direct payments (Netherlands) | ||
WHO (1997) [23] | Beveridge model, mainly taxed based (Denmark, Finland, Iceland, Ireland, Norway, Sweden, UK) | Funding |
Bismarck model, mainly insurance based (Austria, Belgium, France, Germany, Luxembourg, Netherlands, Switzerland) | ||
Mixed system: 3 sub-groups are considered: Systems in transition, mainly Bismarkian type (Israel, Turkey) | ||
Systems in transformation I from insured to taxed system (Greece, Italy, Portugal, Spain) | ||
Systems in transformation II from Semasko to insured system (ex-communist countries) | ||
Tuohy (1999) [24] | National health service (UK) | Modes of social control: hierarchy; ollegiality; market |
Social insurance (Canada) | ||
Private insurance (US) | ||
Moran (2000) [25] | Entrenched command and state control (Scandinavia, UK) | Consumption; provision; technology |
Supply state (US) | ||
Corporatist state (Germany) | ||
Insecure command and control state (Greece, Italy, Portugal) | ||
National health service (Italy, Sweden, UK) | Financing; delivery; regulation | |
Social insurance system (France, Germany) | ||
Docteur and Oxley/ OECD (2003) [28] | Public-integrated model (Nordic countries, Italy, Greece, Portugal) | Relations across providers; payers; users |
Public-contract model (Continental European countries, UK) | ||
Private insurance/provider (Switzerland, US) | ||
Thompson et al. (2009) [6] | Social insurance (Austria, Belgium, Czech Republic, Estonia, France, Germany, Lithuania, Luxembourg, Netherlands, Poland, Romania, Slovakia, Slovenia, Bulgaria) | Funding |
Taxed financed (Denmark, Finland, Ireland, Italy, Malta, Portugal, Spain, Sweden, UK) | ||
Out-of-pocket payments (Cyprus, Greece, Latvia) | ||
Wendt (2009) [9] | Health service provision oriented (Austria, Belgium, France, Germany, Luxembourg) | Healthcare expenditure; financing; provision; institutional characteristics |
Universal coverage controlled access (Denmark, UK, Sweden, Italy, Ireland) | ||
Low budget restricted access (Portugal, Spain, Finland) | ||
Wendt, Frisina and Rothgang (2009) [17], Bohm et al. (2013) [29] | National health service (Denmark, Finland, Norway, Sweden, Portugal, Spain, UK) | Financing; provision, regulation |
National health insurance (Ireland, Italy, Canada) | ||
Social based mixed (Slovenia) | ||
Social Health Insurance (Austria, Germany, Luxembourg, Switzerland) | ||
Private healthcare system (US) | ||
Statist social health insurance (Belgium, Estonia, France, Czech Republic, Hungary, Netherlands, Poland, Slovakia, Israel, Japan) | ||
Northern macro-region (Sweden, Norway, Finland, Denmark, UK, Ireland) | Neighborhood; one common feature | |
Center Western macro-region (France, Germany, Austria, Netherlands, Belgium, Luxembourg) | ||
Center Eastern macro-region (Poland, Czech Republic, Slovakia, Hungary, Slovenia, Estonia, Lithuania) | ||
Southern macro-region (Italy, Spain, Portugal, Greece) | ||
Joumard et al. (2010) [10] | Private provision and private insurance for basic coverage (Germany, Netherlands, Slovakia, Switzerland) | Institutions; regulations; policies |
Private provision, public insurance for basic coverage, private insurance beyond basic coverage and some gate-keeping (Belgium, France) | ||
Private provision, public insurance for basic coverage, little private insurance beyond basic coverage and no gate-keeping (Austria, Czech Republic, Greece, Luxembourg) | ||
Public provision and public insurance, no gate-keeping and ample choice of providers (Iceland, Sweden) | ||
Public provision and public insurance, gate-keeping, limited choice of providers and soft budget constraint (Denmark, Finland, Portugal, Spain) | ||
Public provision and public insurance, gate-keeping, ample choice of providers and strict budget constraint (Hungary, Ireland, Italy, Norway, Poland, UK) | ||
Reibling (2010) [7] | Financial incentives states (Austria, Belgium, France, Sweden, Switzerland) | Gatekeeping; cost-sharing; provider density; medical technology |
Strong gatekeeping and low supply states (Denmark, Netherlands, Poland, Spain, UK) | ||
Weakly regulated and high supply states (Czech Republic, Germany, Greece) | ||
Mixed regulation states (Finland, Italy, Portugal) | ||
EU (2012) [32] | Decentralized (Austria, Italy, Spain) | health funding by Local and Regional Authorities (LRA); power and responsibility by LRA with regard to health-related legislative, planning, and implementation functions; ownership and management of health care facilities by LRA |
Partially decentralized - funding level above EU average (Denmark, Estonia, Finland, Lithuania, Poland, Sweden, Hungary) | ||
Partially decentralized - funding level below EU average (Belgium, Czech Republic, Germany) | ||
Operatively decentralized - funding level below EU average (Bulgaria, Latvia, Luxembourg, Romania, Slovakia, Slovenia) | ||
Operatively decentralized - funding level low or null (Netherlands, UK) | ||
Centralized but structured at territorial level (France, Greece, Portugal) | ||
Centralized (Cyprus, Ireland, Malta) |