International Differences in Healthcare Systems

Healthcare systems can be distinguished on a number of dimensions and in a number of ways. [Page 630]The need for care can be analyzed in terms of the burden of disease; here, developing countries differ considerably from industrialized nations. Healthcare incorporates a wide variety of types of service, whose delivery may be based on different combinations of providers, arranged in differing organizational structures. Financing these services may incorporate various combinations of public payment, social insurance, private insurance, and out-of-pocket payments. Reimbursement to providers may use various combinations of global budgets, fee-for-service, pay-for-performance, and capitation, which in turn imply differing incentive structures. System outcomes may be evaluated on a number of dimensions, including access, cost, quality, patient satisfaction, provider satisfaction, and health outcomes. No two systems ...