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Brief analytical summaries or syntheses #32

International Profiles of Health Care Systems

Summary

This publication presents overviews of the health care systems of Australia, Canada, Denmark, England, France, Germany, Japan, Italy, the Netherlands, New Zealand, Norway, Sweden, Switzerland, and the U.S. Each overview covers health insurance, public and private financing, health system organization, quality of care, health disparities, efficiency and integration, use of health information technology, use of evidence-based practice, cost containment, and recent reforms and innovations. In addition, summary tables provide data on a number of key health system characteristics and performance indicators, including overall health care spending, hospital spending and utilization, health care access, patient safety, care coordination, chronic care management, disease prevention, capacity for quality improvement, and public views.

Background

The Commonwealth Fund is a private foundation that promotes a high performance health care system providing better access, improved quality, and greater efficiency. The Fund carries out this mandate by supporting independent research on health care issues and making grants to improve health care practice and policy

Analysis and results

Health care system financing and coverage in 14 countries:

The first comparative table looks at health care system financing in the 14 countries. It documents the role of government, public system financing, the role of private insurance, out-of-pocket spending, exemptions and low-income protection. This table reveals that six countries have national health services (England, Denmark, Italy, New Zealand, Norway, Sweden), five countries have statutory health insurance systems (France, Germany, Japan, The Netherlands, Switzerland), two countries (Australia and Canada) have regionally administered universal public insurance programs and, finally, the U.S. has a distinct system that relies largely on private insurance. It is noteworthy that five countries do not impose direct user fees for health services, including Canada, France, The Netherlands, England and the U.S.

Selected health system indicators in 14 countries:

The second comparative table includes health system performance indicators for each country, such as health care spending, number of physicians and number of medical visits, hospital spending, utilization and capacity, medical technology, risk factors and population statistics.

This table reveals that health spending as a percentage of GDP for 2009 varied from 8.5% in Japan to 17.4% in the United States. The number of physicians per 1,000 people varies from 2.2 in Japan to 4.0 in Norway.

Selected health system performance indicators in 14 countries:

The third table presents health system performance indicators such as access to care, patient safety, care coordination and chronic care management, OECD health care quality indicators, avoidable deaths, prevention and public views.

This table shows that mortality amenable to health care per 100,000 population ranges from 55 deaths in France to 96 deaths in the U.S.. The ability to get a same day or next day appointment when sick ranges from 45% in Canada and Norway to 93% in Switzerland.

Provider organization and payment in 14 countries:

This last table documents how providers are organized and paid, including ownership of health care practices and hospitals, payment for primary care and hospitals and the role of primary care.

This table reveals that all countries rely on private practice, save the U.K. and Sweden, which have mixed systems. Seven countries (Sweden, Norway, New Zealand, The Netherlands, Italy, England and Denmark) require that patients register with a family physician to have access to primary care.

The report goes on to present a brief description of each of the 14 countries’ health systems.

Conclusion

The report does not draw any conclusions.

Implications and recommendations

The report does not include recommendations or analysis.

Source

International Profiles of Health Care Systems, 2011