卫生系统特征如何影响卫生系统绩效？

How Do Health SystemFeatures Influence HealthSystem Performance? This work is published under the responsibility of the Secretary-General of the OECD and the Health Foundation. Theopinions expressed and arguments employed herein do not necessarily reflect the official views of the Membercountries of the OECD or the Health Foundation. The names and representation of countries and territories used in this joint publication follow the practice of the OECD. This document, as well as any data and map included herein are without prejudice to the status of or sovereignty overany territory, to the delimitation of international frontiers and boundaries and to the name of any territory, city or area. Specific territorial disclaimers applicable to the OECD: The statistical data for Israel are supplied by and under the responsibility of the relevant Israeli authorities. The use ofsuch data by the OECD is without prejudice to the status of the Golan Heights, East Jerusalem and Israeli settlements inthe West Bank under the terms of international law. Photo credits:Cover © Anchiy/Getty Images. Corrigenda to OECD publications may be found at: https://www.oecd.org/en/publications/support/corrigenda.html.© OECD/The Health Foundation 2025 Attribution 4.0 International (CC BY 4.0) This work is made available under the Creative Commons Attribution 4.0 International licence. By using this work, you accept to be bound by the terms of this licence(https://creativecommons.org/licenses/by/4.0/).Attribution– you must cite the work.Translations– you must cite the original work, identify changes to the original and add the following text:In the event of any discrepancy between the original work and thetranslation, only the text of original work should be considered valid.Adaptations– you must cite the original work and add the following text:This is an adaptation of an original work by the OECD and The Health Foundation. The opinions expressedand arguments employed in this adaptation should not be reported as representing the official views of the OECD or of its Member countries or The Health Foundation.Third-party material– the licence does not apply to third-party material in the work. If using such material, you are responsible for obtaining permission from the third party and forany claims of infringement.You must not use the OECD’s or The Health Foundation’s respective logo, visual identity or cover image without express permission or suggest the OECD or The Health Foundationendorses your use of the work.Any dispute arising under this licence shall be settled by arbitration in accordance with the Permanent Court of Arbitration (PCA) Arbitration Rules 2012. The seat of arbitration shallbe Paris (France). The number of arbitrators shall be one. Foreword Health systems everywhere face major challenges–demographic pressures,funding constraints,workforce shortages, rising inequalities, increasingpatients’ expectations to name a few. In this context,international comparisons can serve as a tool to helppolicy makers identify policy options to better addressthese challenges. These comparisons can raise awareness of health systems’ relative strengths andshortcomings, as well as stimulate policy debates that aim to improve health system outcomes. Health systems differ in all aspects of their design: how they are governed, how they are funded, how theygenerate and deploy resources, and how they deliver services. While there is widespread agreement thatthe design of these functions influence health outcomes, limited work has been able to identify how, andto what degree, they do. This report has two main objectives:to identify groups of countries with similar health systemcharacteristics (health system clusters); and to compare and assess performance between and withinhealth system clusters to assess potential links between system characteristics and performance. Thiswork follows and builds on earlier OECD analysis of health system performance carried outin 2009-10. Itdraws heavily on several rounds ofthe OECD survey on health system characteristics carried out by theOECD Health Committee. The analysis highlights that health systems with a different mix of institutions characteristics can achievesimilar levels of efficiency. In other words, there is no best health system institutional set up that will“automatically”result in higher performance. Rather, health systems with similar institutional arrangementscan learn from each other about how specific policy actions can be leveraged to improve healthsystemperformance. Acknowledgements The preparation and writing of this report were co-ordinated by LucaLorenzoni. Co-authors includeAikateriniGiannadou, NicolásLarrainand GiuliaPerego of the OECD.RuthThorlby and HughAlderwick(The Health Foundation, United Kingdom)provided guidanceandadvice on the analysisandreviewedseveral versions of the report. The authors would like to extend their gratitude to the members of the Technical Adviso