Background
Methods
Data
(valid obs.) | Mean | SD | Min | Max | |
---|---|---|---|---|---|
Dependent variables
| |||||
Excess mortality rate (%, until Sep 2021), standardized | 40 | 0 | 1 | -1.4 | 3.2 |
Case fatality rate (%, in Sep 2021), standardized | 43 | 0 | 1 | -1.2 | 4.5 |
Health system financing measures
| |||||
Current health expenditure per capita (CHE), /100, standardized | 43 | 0 | 1 | -1.5 | 3.1 |
Domestic general government health expenditure as % of CHE, standardized | 43 | 0 | 1 | -2.9 | 1.3 |
Out-of-pocket expenditure % of CHE, standardized | 43 | 0 | 1 | -1.4 | 2.2 |
Healthcare system types
| |||||
Financing types | 41 | ||||
Type 2 | 19 | 46.3% | |||
Type 3 | 11 | 26.8% | |||
Type 4 | 11 | 26.8% | |||
Provision types | 41 | ||||
Type 1 | 5 | 12.2% | |||
Type 2 | 7 | 17.1% | |||
Type 4 | 17 | 41.5% | |||
Type 5 | 12 | 29.3% | |||
Combined types | 41 | ||||
Type 1 | 20 | 48.8% | |||
Type 3 | 11 | 26.8% | |||
Type 4 | 10 | 24.4% | |||
Control variables
| |||||
Population: 80 years old and over % of total population, standardized | 43 | 0 | 1 | -1.9 | 2.7 |
DALYs (Disability-Adjusted Life Years) - All causes, both sexes, age-standardized, DALYs per 100 000, standardized | 43 | 0 | 1 | -1.1 | 4.8 |
GDP per capita, PPP (current international $), standardized | 43 | 0 | 1 | -1.5 | 3.6 |
Statistical analysis
Dependent variables
Explanatory variables
Types | Current health expenditurea | Public health expenditureb | Private out-of-pocket health expenditurec | Countries |
---|---|---|---|---|
Type 1 | The highest level | The lowest level | Average level | Switzerland, the US |
Type 2 | High level | The highest level | The lowest level | Australia, Austria, Belgium, Canada, Czechia, Denmark, Finland, France, Germany, Iceland, Ireland, Japan, Luxembourg, the Netherlands, New Zealand, Norway, Slovenia, Sweden, the UK |
Type 3 | The lowest level | Low level | The highest level | Brazil, Chile, China, Greece, Indonesia, Latvia, Lithuania, Mexico, Portugal, South Korea, Russia |
Type 4 | Low level | Average level | Average level | Colombia, Costa Rica, Estonia, Hungary, Israel, Italy, Poland, Slovakia, South Africa, Spain, Turkey |
Types | Primary care delivery and gatekeeping | Number of doctorsa and hospital bedsb | Coverage of essential services | Countries |
---|---|---|---|---|
Type 1 | Primary care mainly private, non-existent gatekeeping | Average number of doctors, the highest number of hospital beds | The highest level | Austria, Czechia, Japan, Luxembourg, South Korea |
Type 2 | Primary care public-private mix, non-existent gatekeeping | Average number of doctors, low number of hospital beds | Average level | China, Greece, Iceland, Russia, Sweden, Turkey, the US |
Type 3 | Primary care public-private mix, moderate gatekeeping | The lowest level | The lowest level | Indonesia, South Africa |
Type 4 | Primary care mainly private, strong to moderate gatekeeping | Average level | High level | Australia, Belgium, Canada, Denmark, Estonia, France, Germany, Hungary, Ireland, Latvia, the Netherlands, New Zealand, Norway, Poland, Slovakia, Switzerland, the UK |
Type 5 | Primary care mainly public or public-private mix, strong gatekeeping | The highest number of doctors, low number of hospital beds | Average level | Brazil, Chile, Colombia, Costa Rica, Finland, Israel, Italy, Lithuania, Mexico, Portugal, Slovenia, Spain |
Types | Financing | Provision | Health outcomes | Countries |
---|---|---|---|---|
Type 1 | The highest level of CHE; the highest level of public health expenditure; the lowest level of private health expenditure | Primary care mainly private; strong to low gatekeeping; high number of hospital beds and doctors; high coverage of essential services | The best population health outcomes | Australia, Austria, Belgium, Canada, Czechia, Denmark, France, Germany, Iceland, Ireland, Japan, Luxembourg, Netherlands, New Zealand, Norway, South Korea, Sweden, Switzerland, the UK, the US |
Type 2 | The lowest level of CHE; the lowest level of public health expenditure; low level of private health expenditure | Primary care public-private mix; moderate gatekeeping; low number of hospital beds and doctors; low coverage of essential services | The worst population health outcomes in terms of child and maternal health | Indonesia, South Africa |
Type 3 | Low level of CHE; low level of public health expenditure; high level of private health expenditure | Primary care mainly public or public-private mix; moderate to low gatekeeping; low number of hospital beds; high number of doctors; average to low coverage of essential services | Population health outcomes good expect high maternal mortality | Brazil, Chile, Colombia, Costa Rica, Finland, Israel, Italy, Mexico, Portugal, Spain |
Type 4 | Low level of CHE; average level of public health expenditure; high level of private health expenditure | Primary care mainly private or public-private mix; strong to low gatekeeping; high number of hospital beds; average number of doctors; low coverage of essential services | Population health outcomes average, cancer mortality and differences in life expectancy between men and women the highest | China, Greece, Estonia, Hungary, Latvia, Lithuania, Poland, Slovakia, Slovenia, Russia, Turkey |
Control variables
Results
Model 1a | Model 1b | Model 1c | Model 2a | Model 2b | Model 2c | Model 3a | Model 3b | Model 3c | |
---|---|---|---|---|---|---|---|---|---|
Β (sd) | Β (sd) | Β (sd) | Β (sd) | Β (sd) | Β (sd) | Β (sd) | Β (sd) | Β (sd) | |
(Intercept) | 0.00 | 0.00 | -0.05 | 0.00 | 0.00 | -0.04 | 0.00 | 0.00 | -0.05 |
(0.13) | (0.12) | (0.09) | (0.15) | (0.11) | (0.09) | (0.14) | (0.11) | (0.08) | |
Current health expenditure | -0.55*** | -0.34* | -0.15 | ||||||
(0.14) | (0.13) | (0.10) | |||||||
Out-of-pocket expenditure | 0.37* | 0.17 | -0.00 | ||||||
(0.15) | (0.12) | (0.11) | |||||||
Government health expenditure | -0.45** | -0.16 | -0.11 | ||||||
(0.14) | (0.12) | (0.09) | |||||||
Population 80 years or over | -0.22 | 0.00 | -0.28* | -0.04 | -0.25 | -0.03 | |||
(0.14) | (0.10) | (0.13) | (0.10) | (0.13) | (0.10) | ||||
DALY | 0.33* | 0.77*** | 0.26 | 0.69*** | 0.20 | 0.64*** | |||
(0.15) | (0.17) | (0.14) | (0.18) | (0.15) | (0.17) | ||||
GDP | -0.36* | -0.23* | -0.42** | -0.21* | |||||
(0.14) | (0.11) | (0.13) | (0.10) | ||||||
Mexico | 2.15*** | 2.08** | 2.02*** | ||||||
(0.58) | (0.58) | (0.55) | |||||||
South Africa | -2.53* | -2.38* | -2.19* | ||||||
(0.93) | (1.04) | (0.90) | |||||||
Colombia | 2.23*** | 2.04** | 2.13*** | ||||||
(0.57) | (0.58) | (0.55) | |||||||
R2 | 0.31 | 0.50 | 0.77 | 0.14 | 0.58 | 0.79 | 0.20 | 0.58 | 0.80 |
adj. R2 | 0.29 | 0.45 | 0.73 | 0.11 | 0.53 | 0.75 | 0.18 | 0.53 | 0.76 |
logLik | -48.91 | -42.57 | -26.73 | -53.30 | -38.96 | -24.94 | -51.76 | -39.12 | -23.99 |
AIC | 103.83 | 95.14 | 69.46 | 112.59 | 89.92 | 67.87 | 109.51 | 90.23 | 66.00 |
BIC | 108.90 | 103.58 | 83.00 | 117.66 | 100.05 | 83.07 | 114.56 | 100.37 | 81.19 |
Model 4a | Model 4b | Model 4c | Model 5a | Model 5b | Model 5c | Model 6a | Model 6b | Model 6c | |
---|---|---|---|---|---|---|---|---|---|
Β (sd) | Β (sd) | Β (sd) | Β (sd) | Β (sd) | Β (sd) | Β (sd) | Β (sd) | Β (sd) | |
(Intercept) | 0.00 | 0.00 | -0.16 | 0.00 | 0.00 | -0.15 | 0.00 | 0.00 | -0.15 |
(0.14) | (0.14) | (0.08) | (0.13) | (0.12) | (0.08) | (0.14) | (0.13) | (0.08) | |
Current health expenditure | -0.45** | -0.31 | -0.16 | ||||||
(0.14) | (0.16) | (0.09) | |||||||
Out-of-pocket expenditure | 0.52*** | 0.40** | 0.11 | ||||||
(0.13) | (0.14) | (0.10) | |||||||
Government health expenditure | -0.45** | -0.26 | -0.12 | ||||||
(0.14) | (0.15) | (0.09) | |||||||
Population 80 years or over | -0.04 | 0.17 | -0.09 | 0.13 | -0.06 | 0.15 | |||
(0.17) | (0.10) | (0.15) | (0.10) | (0.16) | (0.10) | ||||
DALY | 0.27 | 0.35** | 0.25 | 0.32*** | 0.14 | 0.28* | |||
(0.17) | (0.10) | (0.16) | (0.10) | (0.18) | (0.11) | ||||
GDP | -0.12 | -0.12 | -0.29 | -0.16 | |||||
(0.17) | (0.10) | (0.16) | (0.09) | ||||||
Mexico | 4.38*** | 4.14*** | 4.25*** | ||||||
(0.53) | (0.56) | (0.53) | |||||||
China | 2.49*** | 2.30*** | 2.35*** | ||||||
(0.54) | (0.55) | (0.54) | |||||||
R2 | 0.21 | 0.27 | 0.78 | 0.27 | 0.41 | 0.79 | 0.20 | 0.34 | 0.79 |
adj. R2 | 0.19 | 0.22 | 0.75 | 0.25 | 0.33 | 0.75 | 0.18 | 0.27 | 0.75 |
logLik | -55.55 | -53.71 | -28.39 | -53.74 | -49.27 | -27.25 | -55.63 | -51.61 | -26.99 |
AIC | 117.11 | 117.41 | 70.78 | 113.49 | 110.54 | 70.50 | 117.25 | 115.22 | 69.97 |
BIC | 122.39 | 126.22 | 83.11 | 118.77 | 121.11 | 84.59 | 122.54 | 125.78 | 84.06 |
Model 7a | Model 7b | Model 8a | Model 8b | Model 9a | Model 9b | |
---|---|---|---|---|---|---|
Β (sd) | Β (sd) | Β (sd) | Β (sd) | Β (sd) | Β (sd) | |
(Intercept) | -0.60** | -0.60** | -0.58 | -0.58 | -0.57** | -0.57*** |
(0.19) | (0.15) | (0.39) | (0.30) | (0.18) | (0.14) | |
Financing type 3 | 1.25*** | 0.94** | ||||
(0.34) | (0.27) | |||||
Financing type 4 | 1.15** | 0.92** | ||||
(0.33) | (0.26) | |||||
Provision type 2 | 0.65 | 0.65 | ||||
(0.55) | (0.43) | |||||
Provision type 4 | 0.17 | 0.17 | ||||
(0.44) | (0.34) | |||||
Provision type 5 | 1.26* | 0.83* | ||||
(0.47) | (0.37) | |||||
Combined type 3 | 1.26*** | 0.77** | ||||
(0.31) | (0.25) | |||||
Combined type 4 | 0.89* | 0.89** | ||||
(0.34) | (0.26) | |||||
Mexico | 2.82*** | 2.91*** | 2.95*** | |||
(0.68) | (0.71) | (0.64) | ||||
Colombia | 2.26** | 2.33** | 2.37*** | |||
(0.67) | (0.71) | (0.64) | ||||
N | 38 | 38 | 39 | 39 | 39 | 39 |
R2 | 0.35 | 0.65 | 0.28 | 0.59 | 0.34 | 0.66 |
adj. R2 | 0.32 | 0.61 | 0.21 | 0.53 | 0.30 | 0.62 |
logLik | -46.01 | -34.16 | -47.99 | -36.93 | -46.26 | -33.48 |
AIC | 100.02 | 80.32 | 106.00 | 87.85 | 100.52 | 78.96 |
BIC | 106.57 | 90.14 | 114.31 | 99.50 | 107.18 | 88.94 |
Model 10a | Model 10b | Model 11a | Model 11b | Model 12a | Model 12b | |
---|---|---|---|---|---|---|
Β (sd) | Β (sd) | Β (sd) | Β (sd) | Β (sd) | Β (sd) | |
(Intercept) | -0.43* | -0.43** | -0.48 | -0.48 | -0.43* | -0.43** |
(0.21) | (0.13) | (0.45) | (0.26) | (0.21) | (0.12) | |
Financing type 3 | 1.20** | 0.61* | ||||
(0.35) | (0.24) | |||||
Financing type 4 | 0.48 | 0.48* | ||||
(0.35) | (0.22) | |||||
Provision type 2 | 0.55 | 0.18 | ||||
(0.59) | (0.36) | |||||
Provision type 4 | 0.28 | 0.28 | ||||
(0.51) | (0.30) | |||||
Provision type 5 | 0.77 | 0.39 | ||||
(0.53) | (0.32) | |||||
Combined type 3 | 0.78* | 0.36 | ||||
(0.36) | (0.21) | |||||
Combined type 4 | 0.73 | 0.50* | ||||
(0.37) | (0.22) | |||||
Mexico | 4.33*** | 4.60*** | 4.58*** | |||
(0.62) | (0.61) | (0.58) | ||||
China | 2.13** | 2.61*** | 2.23*** | |||
(0.62) | (0.64) | (0.58) | ||||
N | 41 | 41 | 41 | 41 | 41 | 41 |
R2 | 0.24 | 0.71 | 0.07 | 0.70 | 0.14 | 0.73 |
adj. R2 | 0.2 | 0.67 | -0.01 | 0.65 | 0.10 | 0.70 |
logLik | -52.97 | -33.48 | -56.26 | -33.20 | -54.55 | -30.87 |
AIC | 113.94 | 78.96 | 122.51 | 80.40 | 117.09 | 73.73 |
BIC | 120.79 | 89.24 | 131.08 | 92.39 | 123.95 | 84.02 |