Suchergebnisse

The standard classifications of health systems don't allow for the complexity and variety that exists around the world. Federico Toth sets out a new framework for understanding the many ways in which health systems can be organized and systematically analyses the health systems chosen by 27 OECD countries. He provides a great deal of up-to-date data on financing models, healthcare spending, insurance coverage, methods of organizing providers, healthcare personnel, remuneration methods for doctors and hospitals, development trajectories and recent reforms. For each of the major components of the healthcare system, the organizational models and the possible variants from which individual countries can ideally select are defined. Then, based on the organizational solutions actually adopted, the various national systems are grouped into homogeneous families. With its clear, jargon-free language and concrete examples, this is the most accessible comparative study of international healthcare arrangements available.

AbstractIn 2015, the Emilia‐Romagna Regional Government implemented a plan to reduce waiting times for elective outpatient procedures. The objective set by the regional government establishes that at least 90 per cent of specialist services are to be provided within the following maximum waiting times: 30 days for the first specialist consultation, and 60 days for diagnostic tests. The plan adopted by the Emilia‐Romagna Regional Government is of particular interest because it encompasses a combined strategy. Some of the interventions envisaged in the plan aim at increasing the supply of specialist services. Others address the demand side, seeking to reduce inadequate requests and discourage no‐shows by patients. And others focus on combining supply and demand and neutralizing the effects of some perverse incentives. The Emilia‐Romagna plan appears to have had a successful outcome. In the first 4 years of implementation, the 90 per cent target has not only been achieved but also widely exceeded.

This article discusses the main hypotheses generated within the strand of research that focuses on health politics. These hypotheses are subjected to a brief empirical test, presenting data from 15 OECD countries. There seems to be a correspondence between the healthcare models adopted in different national contexts and the ideological orientation of the governments that have instituted them. Most laws instituting a system of social health insurance have been advanced by conservative governments, while those instituting a national health service have been passed -- in the majority of cases -- by social-democratic governments. The resulting clashes between governments and competing interest groups are largely attributable to the institutional setting. Thus, in the period from 1945 to 2000, most of those countries where political power was more concentrated implemented a national health service. Conversely, those countries where political power was more dispersed tended to maintain a system of voluntary or social health insurance. [Reprinted by permission of Sage Publications Ltd., copyright, the International Political Science Association.]

This article discusses the main hypotheses generated within the strand of research that focuses on health politics. These hypotheses are subjected to a brief empirical test, presenting data from 15 OECD countries. There seems to be a correspondence between the healthcare models adopted in different national contexts and the ideological orientation of the governments that have instituted them. Most laws instituting a system of social health insurance have been advanced by conservative governments, while those instituting a national health service have been passed – in the majority of cases – by social-democratic governments. The resulting clashes between governments and competing interest groups are largely attributable to the institutional setting. Thus, in the period from 1945 to 2000, most of those countries where political power was more concentrated implemented a national health service. Conversely, those countries where political power was more dispersed tended to maintain a system of voluntary or social health insurance.