Abstract
Introduction. In the European Union three different health systems could be defined according to service delivery, financing, and economic policies: Beveridge, Bismarck and Mixed system. Although health systems are hardly to compare, various organizations are developing methods assessing performance. In the present work we evaluated the performance of the three systems using European Community Health Indicators according to Organization for Economic Cooperation and Development.
Methods. We conducted our study among the 28 states of the European Union using the following indicators: Standardized death rate for diseases of the circulatory system, standardized death rate for malignant neoplasms, road traffic accidents with injury, life expectancy at birth, incidence of Human Immunodeficiency Virus (HIV), infant deaths, pure alcohol consumption, infants vaccinated against Diphtheria Tetanus Pertussis (DTP), public and total expenditure on health over the period 2001-2010.
Results. The variation of health indicators shows similar trend of circulatory system diseases and malignant neoplasms death rates, road accidents with injury, infant deaths, life expectancy at birth, public and total health expenditure. Some differences in the trend of HIV incidence, alcohol intake and DTP vaccination rates arise among systems. Grouping countries by health system paradigm and geographical area, resulted in a relevant heterogeneity (I2≥90%, Pvalue<0.0001). No clear superiority of a given health delivery system was found with respect to other paradigms.
Conclusion. In accordance with the evidence of our study, we can suppose that best performances are more likely to be linked to country specific economic factors. In conclusion, it was not possible to identify the best health system model.