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In Europe, the reduction of acute care hospital beds has been one of the measures implemented to restrict hospital expenditure. The aim of this study is to gain insight into the effect bed reductions have on the use of the remaining beds within different healthcare systems. We concentrated on two healthcare system elements: hospital financing system (per diem and global budget systems) and physician remuneration system (fee-for-service and salary systems). We also controlled for technological development and demand for healthcare. We used data from the OECD health data files of 10 North-Western European countries on hospital bed supply and use. The hospital bed indicators used were occupancy rate, average length of stay and admission rate. The data were analysed with multilevel analysis. We found some indication that the different financial incentives of hospital financing systems do indeed influence hospital bed use in the case of reductions in acute care hospital bed supply in different ways. However, we found significant effects only for the hospital bed use indicators "occupancy rate" and "admission rate". For physician financing systems, no significant effects were found.

Both the Netherlands and other European countries are involved in the transition from a breadwinner society towards a more individual-oriented society. What is unique in the Dutch case is the strong emphasis on the equal sharing of time, between paid and unpaid work as well as between women and men. Despite the preferences among citizens for a more equal sharing of paid and unpaid work, in practice it appears that general participation in paid labour is being achieved more rapidly than general participation in unpaid labour. The article looks at the obstacles and sticking points which stand in the way of the process of redistribution and investigates how this process can be accelerated. It includes an empirical analysis on survey data for the Netherlands with respect to both actual and preferred working hours for married and co-habitating men and women. The authors conclude that a consistent government policy is lacking. As a consequence neither individuals nor organizations get signals that might contribute to those steps in the area of part-time work, child-care provision and leave facilities that would bring about a redistribution of paid and unpaid work between women and men.

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