Skip to main content

Table 1 Overview of some healthcare system typologies

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)
Freeman (2000) [26], Freeman and Schmidt (2008) [27] 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)
Figueras et al. (1994) [30], Genova (2010) [31] 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)
\