: Following the US experience, activity-based funding has become the most common mechanism for reimbursing hospitals in Europe. Focusing on five European countries (England, Finland, France, Germany and Ireland), this paper reviews the motivation for introducing activity-based funding, together with the empirical evidence available to assess the impact of implementation. Despite differences in the prevailing approaches to reimbursement, the five countries shared several common objectives, albeit with different emphasis, in moving to activity-based funding during the 1990s and 2000s. These include increasing efficiency, improving quality of care and enhancing transparency. There is substantial cross-country variation in how activity-based funding has been implemented and developed. In Finland and Ireland, for instance, activity-based funding is principally used to determine hospital budgets, whereas the models adopted in the other three countries are more similar to the US approach. Assessing the impact of activity-based funding is complicated by a shortage of rigorous empirical evaluations. What evidence is currently available, though, suggests that the introduction of activity-based funding has been associated with an increase in activity, a decline in length of stay and/or a reduction in the rate of growth in hospital expenditure in most of the countries under consideration.

Current levels of youth unemployment need to be understood in the context of increased labor market flexibility, an expansion of higher education, youth migration, and family legacies of long-term unemployment. Compared with previous recessions, European-wide policies and investments have significantly increased with attempts to support national policies. By mapping these developments and debates, we illustrate the different factors shaping the future of European labor markets. We argue that understanding youth unemployment requires a holistic approach that combines an analysis of changes in the economic sphere around labor market flexibility, skills attainment, and employer demand, as well as understanding the impact of family legacies affecting increasingly polarized trajectories for young people today. The success of EU policy initiatives and investments will be shaped by the ability of national actors to implement these effectively.

No abstract

The 2008 crisis had a significant impact on household employment in some European countries. An analysis of the EU Statistics on Income and Living Conditions generated a new cross-national typology of household employment structures and showed how these changed during the crisis and austerity period, capturing the experiences of high and low qualified households. Findings indicate that dual earning households are not always a consequence of gender equality but result from economic necessity or employment opportunities. The re-emergence of traditional male breadwinner households is often the result of female unemployment, especially for lower educated women. An increase in female single earners and workless households is evident in countries hit hardest by the employment crisis. The value of this cross-national typology, rooted in the interaction of educational effects and employment opportunities, is allowing comparison both within and between European countries, going beyond established typologies based on policy frameworks or gender cultures.

No abstract