The Identifying a New Typology of European Health Systems
Abstract
Traditional health system classifications may not accurately reflect the complex realities of modern European nations. This study takes a data-driven approach to create a new classification. We used WHO data and applied a K-Means clustering algorithm to 52 European countries, focusing on recent figures for doctor density, nurse density, and catastrophic health spending. The analysis revealed three clear clusters: "High-Resource, Low-Burden" systems (n=14), "Physician-Centric, High-Burden" systems (n=18), and "Lower-Resource" systems (n=20). This classification offers a detailed way to understand current health system structures and to inform policy decisions across Europe.
References
1. Ridic G, Gleason S, Ridic O. Comparisons of health care systems in the United States, Germany and Canada. Mater Sociomed. 2012;24(2):112-120. https://pmc.ncbi.nlm.nih.gov/articles/PMC3633404/
2. Böhm K, Schmid A, Götze R, Landwehr C, Rothgang H. The 'Bismarck' Health Care System. In: The Changing Political Economy of the Welfare State. Springer; 2013.
3. Wendt C, Frisina L, Rothgang H. Healthcare system types: a conceptual framework for comparison. Soc Policy Adm. 2009;43(1):70-90. https://doi.org/10.1111/j.1467-9515.2008.00647.x
4. Saltman RB. The theory of health system convergence: A sociological perspective. Soz Praventivmed. 2003;48:7-13.
5. Lavecchia AM, Zecchinelli M. A new data-driven methodology to profile and classify healthcare systems. Health Policy. 2016;120(5):483-492. https://doi.org/10.1016/j.healthpol.2016.03.006
6. Rechel B, McKee M. Health reform in central and eastern Europe and the former Soviet Union. Lancet. 2009;374(9696):1186-1195. https://doi.org/10.1016/S0140-6736(09)61334-9
7. Popovich L, Potapchik E, Shishkin S, Richardson E, Vacarezza M, Mathivet B. The Russian Federation: health system review. Health Syst Transit. 2011;13(7):1-190. https://www.ecoi.net/en/file/local/1302492/1930_1421317372_hit-russia-en-web-with-links.pdf
8. Buchan J, Shembavnekar N. The health and care workforce in England. The King's Fund; 2022.
9. Chevreul K, Berg Brigham K. France: health system review. Health Syst Transit. 2015;17(3):1-210. https://eprints.lse.ac.uk/65775/
10. MacQueen J. Some methods for classification and analysis of multivariate observations. In: Proceedings of the Fifth Berkeley Symposium on Mathematical Statistics and Probability. 1967:281-297. https://www.cs.cmu.edu/~bhiksha/courses/mlsp.fall2010/class14/macqueen.pdf
This work is licensed under a Creative Commons Attribution 4.0 International License.
Copyright (c) 2025 Poe Hnin Phyu, Mahmood Ahmad, Laiba Khan, Maham Khan, Nijat Rizayev, Manpreet Kour, Touqeer Rana, Andrew Woo, Parichatra Homhuan