Paul W. Thurner, Peter Kotzian
Comparative Health Care Systems. Outline for an empirical application of New Institutional Economics approaches


In this paper we provide an outline for a theory-guided comparison of health care systems, based on institutional economics. Following positive principal agency theory, we propose to decompose health care systems into all relevant exchange relationships constituting the system. We discuss the inherent incentive problems and consider possible and implemented controlling mechanisms. Preliminary hypotheses are derived with regard to expenditure dynamics and reformability. Operationalizations and first results of several identified institutional features are presented. A preliminary analytical description of two health care systems illustrates future strategies of qualitative and quantitative comparisons.