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01/06/2007 - Submitted by: Argyro Kazaki

There are a number of factors supporting this interest:

  • the perceived high cost of hospital care (although in many cases the same care provided outside the hospital can be as expensive, or more so, because of the loss of economies of scale);
  • the challenges of delivering hospital care in the future, especially where there are dispersed populations;
  •  the belief that moving services out of hospitals will make them more accessible, thus increasing responsiveness and, perhaps, patient choice.

Despite this interest, there is surprisingly little information currently available about how different countries deliver care outside hospitals. This is in contrast to the extensive information on topics such as the numbers of hospital beds. In this policy brief we aim to describe a broad spectrum of models by exploring the arrangements that are in place in eight countries. This is intended to provide a basis for a more informed discussion on the future of health care outside the hospital. The countries were selected to include a variation: those where health care financing is based predominantly on social health insurance (France and the Netherlands) and those whose systems are mainly funded through taxation (Australia, Denmark, England,* Finland, New Zealand and Sweden).  

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Ettelt S., Nolte E., Mays N., Thomson S., McKee M., & International Healthcare Comparisons Network


WHO on behalf of the European Observatory on Health Systems and Policies
World Health Organisation