Health Care Financing Systems and Their Effectiveness: An Empirical Study of OECD Countries

医疗保健融资体系及其有效性:经合组织国家的实证研究

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Abstract

Background: The primary aim of the research in the present study was to determine the effectiveness of health care in classifying health care financing systems from a sample of OECD (Organisation for Economic Co-operation and Development) countries (2012-2017). This objective was achieved through several stages of analysis, which aimed to assess the relations between and relation diversity in selected variables, determining the effectiveness of health care and the health expenditure of health care financing systems. The greatest emphasis was placed on the differences between health care financing systems that were due to the impact of health expenditure on selected health outputs, such as life expectancy at birth, perceived health status, the health care index, deaths from acute myocardial infarction and diabetes mellitus. Methods: Methods such as descriptive analysis, effect analysis (η(2)), binomial logistic regression analysis, linear regression analysis, continuity analysis (ρ) and correspondence analysis, were used to meet the above objectives. Results: Based on several stages of statistical processing, it was found that there are deviations in several of the relations between different health care funding systems in terms of their predisposition to certain areas of health outcomes. Thus, where one system proves ineffective (or its effectiveness is questionable), another system (or systems) appears to be effective. From a correspondence analysis that compared the funding system and other outputs (converted to quartiles), it was found that a national health system, covering the country as a whole, and multiple insurance funds or companies would be more effective systems. Conclusions: Based on the findings, it was concluded that, in analyzing issues related to health care and its effectiveness, it is appropriate to take into account the funding system (at least to verify the significance of how research premises affect the systems); otherwise, the results may be distorted.

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