Public versus private healthcare systems in the OECD area– a broad evaluation of performance

Per Molander ()
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Per Molander: Arbor AB

The European Journal of Health Economics, 2025, vol. 26, issue 7, No 4, 1163-1173

Abstract: Abstract Healthcare systems can be categorised along the public/private axis into two main types: publicly administered systems and systems based on compulsory health insurance provided by the private sector. Within the OECD area, the latter group has expanded over time, particularly with the inclusion of new member states from Eastern Europe and Central and Latin America. This study compares the efficiency of these two models across the 38 member countries, utilising a broad spectrum of performance indicators developed by the OECD secretariat. Data from the most recent available year, typically 2021, were analysed. On average, performance improves with an increase in healthcare budgets; however, further enhancements come at rising costs. The analysis concludes that there is no evidence supporting the hypothesis that transitioning from a publicly administered system to a privately dominated system will enhance efficiency. By contrast, there is strong evidence that overall efficiency increases with the public share of financing. These conclusions also hold true for the more restricted group of OECD countries in Europe.

Keywords: Healthcare systems; OECD; Efficiency; Performance; Evaluation; Privatisation (search for similar items in EconPapers)
JEL-codes: I13 I18 (search for similar items in EconPapers)
Date: 2025
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DOI: 10.1007/s10198-025-01767-6

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