Five types of OECD healthcare systems: Empirical results of a deductive classification

Böhm, Katharina; Schmid, Achim; Götze, Ralf; Landwehr, Claudia; Rothgang, Heinz

doi:10.1016/j.healthpol.2013.09.003

Cited by 280 publications

(222 citation statements)

References 29 publications

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“…Our assessment of the for-profit sector should be considered preliminary, and understanding the effects of marketisation on Trusts and non-profit providers is a matter for future research. However, much of what we find may persist due to the well-known path dependency of health systems (Wilsford, 1994), and our findings may resonate in other countries with NHS-style health systems (Böhm et al, 2013). For our private-sector interviewees, profits were difficult to realise partly because of austerity and the extraction of price concessions through efficiencies built into the tariff and through competitive tendering exercises that pit the private sector against low-cost and highquality NHS providers.…”

Section: Resultsmentioning

confidence: 59%

When does marketisation lead to privatisation? Profit-making in English health services after the 2012 Health and Social Care Act

Krachler

Greer

2015

Social Science & Medicine

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Governments world-wide have attempted to use market mechanisms and privatisation to increase the quality and/or reduce the cost of healthcare. England's Health and Social Care Act 2012 is an attempt to promote privatisation through marketisation in the National Health Service (NHS). While the health policy literature tends to assume that privatisation follows from private-sector entry points, we argue that this is more likely if firms expect to make a profit. This paper examines the link between privatisation and marketisation in England drawing on 32 semi-structured interviews with private-sector and public-sector respondents, campaigners, and other experts conducted 6-10 months after the implementation of the 2012 Act.By generating a theoretical framework on the conditions of profitability we seek a better understanding of the conditions under which marketisation leads to privatisation. We find that significant barriers to profit-making remain after the reforms, including a top-down squeeze on prices, uncertainty in market rules, state dominance of funding and provision, and failures to depoliticise the market. These factors restrict privatesector involvement by frustrating profit-making. Where profits are made they are through reduced unit costs and high volumes by a longstanding incumbent in a particular market segment. This, however, restricts marketisation by reinforcing entry barriers Governments world-wide have attempted to use market mechanisms and privatisation to increase the quality and/or reduce the cost of healthcare. 1 England's Health and Social Care Act 2012 is an attempt to promote privatisation through marketisation in the National Health Service (NHS). While the health policy literature tends to assume that privatisation follows from private-sector entry points, we argue that this is more likely if firms expect to make a profit. This paper examines the link between privatisation and marketisation in England drawing on 32 semi-structured interviews with private-sector and public-sector respondents, campaigners, and other experts conducted 6-10 months after the implementation of the 2012 Act. Suggested Citation Krachler, N., & Greer, I. (2015). When does marketisation lead to privatisation? Profit-making in English healthBy generating a theoretical framework on the conditions of profitability we seek a better understanding of the conditions under which marketisation leads to privatisation. We find that significant barriers to profit-making remain after the reforms, including a top-down squeeze on prices, uncertainty in market rules, state dominance of funding and provision, and failures to depoliticise the market. These factors restrict private-sector involvement by frustrating profit-making. Where profits are made they are through reduced unit costs and high volumes by a longstanding incumbent in a particular market segment. This, however, restricts marketisation by reinforcing entry barriers.

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Section: Resultsmentioning

confidence: 59%

When does marketisation lead to privatisation? Profit-making in English health services after the 2012 Health and Social Care Act

Krachler

Greer

2015

Social Science & Medicine

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“…Furthermore, it should be noted that our study took place in Canada, where all medically necessary care is guaranteed without regard to the setting (primary or tertiary). Experiences of cancer survivors in other health care systems, such as private health systems, might be affected by the prevailing payment structure 44 . Although not necessarily a limitation, our switch from the original method of data collection (focus groups) to telephone interviews for non-methodologic reasons, including accrual and convenience for the participants, is worth noting.…”

Section: Discussionmentioning

confidence: 99%

The Experiences of Cancer Survivors While Transitioning from Tertiary to Primary Care

et al. 2016

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PurposeIn current fiscally constrained health care systems, the transition of cancer survivors to primary care from tertiary care settings is becoming more common and necessary. The purpose of our study was to explore the experiences of survivors who are transitioning from tertiary to primary care. MethodsOne focus group and ten individual telephone interviews were conducted. Data saturation was reached with 13 participants. All sessions were audio-recorded, transcribed verbatim, and analyzed using a qualitative descriptive approach.Results Eight categories relating to the main content category of transition readiness were identified in the analysis. Several factors affected participant transition readiness: how the transition was introduced, perceived continuity of care, support from health care providers, clarity of the timeline throughout the transition, and desire for a "roadmap." Although all participants spoke about the effect of their relationships with health care providers (tertiary, transition, and primary care), their relationship with the primary care provider had the most influence on their transition readiness. ConclusionsOur study provided insights into survivor experiences during the transition to primary care. Transition readiness of survivors is affected by many factors, with their relationship with the primary care provider being particularly influential. Understanding transition readiness from the survivor perspective could prove useful in ensuring patient-centred care as transitions from tertiary to primary care become commonplace.

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“…[26][27][28] According to the data from the Korea National Health and Nutritional Examination Survey (K-NHANES) we used, 20.3% of individuals reported that they experienced UMN in 2010, a number that is substantially greater than other countries' (5.1%~13.2%) such as the United States, Canada, Germany, and France. 29) Researchers in the United States and Canada have already examined the associations of stress and depression with UMN. 30,31) However there has been limited research focused on the effects of stress and depression on UMN in South Korea, even though South Korea led the OECD poll in multiple categories related to stress and depression.…”

Section: -25)mentioning

confidence: 99%

The Effect of Stress and Depression on Unmet Medical Needs

Park

et al. 2017

Korean J Clin Pharm

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Five types of OECD healthcare systems: Empirical results of a deductive classification

Cited by 280 publications

References 29 publications

When does marketisation lead to privatisation? Profit-making in English health services after the 2012 Health and Social Care Act

When does marketisation lead to privatisation? Profit-making in English health services after the 2012 Health and Social Care Act

The Experiences of Cancer Survivors While Transitioning from Tertiary to Primary Care

The Effect of Stress and Depression on Unmet Medical Needs

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