There are notable challenges to assessing relative health system performance. Other work has taken a country-level case study approach to identify national health system strengths, and then drawn together the findings from 30, 60 and then 152 countries into a strategic overview of performance. The latest advances include those of the Commonwealth Fund, ranking up to 19 countries across measures such as quality of care, spending, utilisation and governance, the World Health Organisation’s (WHO’s) data on all countries via its and the Organisation for Economic Co-operation and Development’s (OECD’s) Health at a Glance indicators data framework. Recent work has attempted to benchmark countries by ranking them according to aggregated measures of national health system performance.
Health systems are complex, multi-faceted entities with many internal and external variables. It is a considerable challenge to assess the performance of entire health systems and judge their relative contributions to the health of populations. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.Ĭompeting interests: The authors have declared that no competing interests exist. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.ĭata Availability: All relevant data are within the manuscript.įunding: JB and JW are recipients of the Australian National Health and Medical Research Council (NHMRC) grants: Partnership Grant for Health Systems Sustainability (ID: 9100002) and Centre of Research Excellence grant (ID: 1135048). Received: JAccepted: SeptemPublished: September 28, 2020Ĭopyright: © 2020 Braithwaite et al. PLoS ONE 15(9):Įditor: Tomáš Želinský, Technical University of Kosice, SLOVAKIA The Collaborative-Networked Cluster was characterized by low power distance (e.g., greater levels of equity), low uncertainty avoidance (e.g., toleration of others’ opinions), individualism (e.g., self-reliance) and indulgence (e.g., drives and norms to enjoy life and have fun).Ĭitation: Braithwaite J, Tran Y, Ellis LA, Westbrook J (2020) Inside the black box of comparative national healthcare performance in 35 OECD countries: Issues of culture, systems performance and sustainability. The Collaborative-Networked cluster had significantly better performing health systems measured by both the Health at a Glance and SDG performance data, followed by the Orderly-Future Orientated cluster, followed by the Collective-Pyramidal cluster. Three country clusters emerged: Collective-Pyramidal (n = 9: comprising Slovak Republic, Mexico, Poland, Greece, Spain, Turkey, Portugal, Chile, and Slovenia) Collaborative-Networked (n = 12: UK, Canada, Australia, USA, Ireland, New Zealand, Netherlands, Finland, Iceland, Norway, Denmark, and Sweden) and Orderly-Future Orientated (n = 14: Korea, Estonia, Latvia, Austria, Israel, Japan, Czech Republic, Hungary, Italy, Belgium, France, Germany, Luxembourg and Switzerland). Performance was measured by the Organisation for Economic Co-operation and Development’s (OECD’s) Health at a Glance indicators data framework (five dimensions with 57 indicators) and the United Nations’ (UNs’) Sustainability Development Goals (SDG) data set (15 indicators). Hierarchical cluster analysis identified best-matched groupings of countries.
The European Social Survey runs a programme of research to support and enhance the methodology that underpins the high standards it pursues in every aspect of survey design, data collection and archiving.We compared Hofstede’s six cultural dimensions against relative health systems performance of 35 countries.
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