Health Disparities in Europe: Insights from a Cluster Analysis of Healthcare Systems

Healthcare typologies are valuable instruments for comparing the similarities and discrepancies in how nations finance, deliver, and structure their healthcare systems. This study concentrates on three distinct aspects of healthcare systems: (1) the overall level of healthcare expenditure; (2) the distribution between public and private funding; (3) the emphasis on primary care versus secondary care. We examine 25 European countries to investigate empirically how these nations cluster based on these three features. To accomplish this goal, we undertake a cluster analysis combining data on healthcare expenditure with metrics on the public-private funding mix and indicators of healthcare sectional orientation, predominantly utilizing OECD Health Data and WHO country reports. The results suggest the identification of at least five distinct healthcare system types. Subsequently, we employ these typologies to examine cross-national differences in health outcomes and health inequalities. Consistent with expectations, our findings show a robust association between healthcare expenditure, particularly public expenditure, and health outcome metrics, alongside a negative correlation with socio-economic health disparities. Primary care emphasis does not appear to correlate with improved health outcomes, nor with reduced health disparities. Finally, our findings challenge the purported decongestion effect associated with voluntary health insurance.