Abstract
In recent research, much attention has been paid to the divergent health outcomes that have emerged across the region of Central and Eastern Europe (CEE). Although rare the focus of research, one important source of variation in health outcomes can possibly be traced to the evolution of health-care systems. In this article, they and their transformations are relocated at the epicentre of the health story. First, the health-care systems in transition are classified into a typology through a combination of qualitative assessment of Health in Transition (HiT) Reports from the World Health Organisation (WHO), and cluster analysis based on the literature-driven framework. This resultant classification is then utilised in a panel regression using the fixed effects and panel-corrected standard errors model on the WHO Health for All data set for 25 transition countries of CEE and Central Asia across transition years 1989–2007. Through this, the research adds an important strand to the HiT and health-care classification literature. First, the study shows that the health-care systems of transition countries can be classified into separate groups. Second, evidence is presented that the structural differences in health care, reflected in the typology, partially explain cross-country health outcomes.
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Notes
Out of all 28 transition countries, Serbia, Kosovo, and Bosnia and Herzegovina were excluded from research on grounds of unavailability of data.
Specifically, they find that only a few quite distinct and amenable mortality indicators (such as SDR ischaemic heart disease, SDR cerebrovascular diseases) have been influenced by the introduction of the patient-based reimbursement method.
All analysis was performed using the software StataSE 10.
Two cluster analysis ‘outliers’, Latvia and Lithuania, were included in this group because their only major differences from the rest of the group are found in physical resources.
‘Successful’ here refers to the best performing health-care models, comparing with the Semashko model of the initial period in terms of explaining LEB in production functions.
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Acknowledgements
Special thanks to Professor Dr Jan Delhey (Jacobs University Bremen) for comments, advice and never ending support; to Professor Dr Christian Welzel (Jacobs University Bremen and Leuphana University) and Dr Christopher J. Gerry (SSEES, UCL) for valuable comments on my early drafts; and to the Bremen International Graduate School of Social Science (BIGSSS), Bremen University, Jacobs University Bremen and the German Excellence Initiative of the German Research Foundation (Deutsche Forschungsgemeinschaft – DFG) for providing the resources for conducting my research.
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Borisova, L. Health care systems as determinants of health outcomes in transition countries: Developing classification. Soc Theory Health 9, 326–354 (2011). https://doi.org/10.1057/sth.2011.14
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DOI: https://doi.org/10.1057/sth.2011.14