Health systems everywhere face major challenges – demographic pressures, funding constraints, workforce shortages, rising inequalities, increasing patients’ expectations to name a few. In this context, international comparisons can serve as a tool to help policy makers identify policy options to better address these challenges. These comparisons can raise awareness of health systems’ relative strengths and shortcomings, as well as stimulate policy debates that aim to improve health system outcomes.
Health systems differ in all aspects of their design: how they are governed, how they are funded, how they generate and deploy resources, and how they deliver services. While there is widespread agreement that the design of these functions influence health outcomes, limited work has been able to identify how, and to what degree, they do.
This report has two main objectives: to identify groups of countries with similar health system characteristics (health system clusters); and to compare and assess performance between and within health system clusters to assess potential links between system characteristics and performance. This work follows and builds on earlier OECD analysis of health system performance carried out in 2009‑10. It draws heavily on several rounds of the OECD survey on health system characteristics carried out by the OECD Health Committee.
The analysis highlights that health systems with a different mix of institutions characteristics can achieve similar levels of efficiency. In other words, there is no best health system institutional set up that will “automatically” result in higher performance. Rather, health systems with similar institutional arrangements can learn from each other about how specific policy actions can be leveraged to improve health system performance.