Institutional Structures of European Health Care Systems: an Institutional-economic Typology

Health care systems differ extremely in the way the provision of health care is organized. For a comparative analysis of health care systems, this raises the problem of high institutional variation in a large number of features while the number of cases is limited. Based on the approach of ‘theory guided comparisons’, the project chooses the institutional economics approach, in particular the agency-relationship approach, as a basis for the selection of features on which the comparison is based. To achieve this, an inventory of potential delegation relationships and possible control mechanisms in health care shall be developed in a first step, which will be applicable to all health care systems. In a second step, the inventory will be filled for the health care systems of the EU member states by way of expert interviews and the study of the existing case-study literature. This compilation of immediately comparable institutional data on health care systems can be used for further research, for instance on the impact of the institutional setting on the performance of health care systems. Within the frame of the project, the institutional data will be analyzed by usage of data-reducing methods in order to identify types and ‘institutional syndromes’. This project is a sub-project from "Comparative Health Care Systems in the European Union". The project has been transfered to TU Darmstadt in 2005 when the project director accepted a job at this university.