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Association between healthcare resources, healthcare systems, and population health in European countries
Blekinge Institute of Technology, Faculty of Engineering, Department of Industrial Economics.ORCID iD: 0000-0003-4620-7472
2025 (English)In: BMC Health Services Research, E-ISSN 1472-6963, Vol. 25, no 1, article id 720Article in journal (Refereed) Published
Abstract [en]

Background: Recently, the demand for care has risen, while in contrast, healthcare resources remain limited. These resources include health expenditure, the number of physicians, nurses, and hospital beds. Many studies have revealed that healthcare resources are one of the most critical factors contributing to a population’s health status. The healthcare system plays a key role in transforming these resources into health outcomes, which are widely used as indicators to measure population health and the performance of healthcare systems. Previous work has primarily investigated the relationship between health expenditure or the number of doctors and population health. However, the association between healthcare resources as a whole has yet to be widely examined.

Methods: This study utilized multilevel regression analysis to explore the association between healthcare resources, healthcare systems, and population health outcomes across 25 European countries. The healthcare systems in these countries are primarily categorized into two types: Beveridge-type and Bismarck-type. In addition to regression analysis, descriptive statistics were used to analyze the allocation patterns of healthcare resources. Welch’s t-test was employed to compare the performance metrics of the Beveridge-type and Bismarck-type healthcare systems, providing a statistical basis for understanding differences in their effectiveness.

Results: The regression analysis revealed positive correlations between health expenditure per capita, the number of physicians, and nurses, and life expectancy at birth, while the number of hospital beds showed a negative correlation. Conversely, infant mortality was negatively correlated with health expenditure per capita and the number of physicians and nurses, and positively correlated with the number of hospital beds. The models did not find statistical significance in the effects of healthcare system type (Beveridge-type or Bismarck-type) on life expectancy at birth or infant mortality rates. Additionally, Welch’s t-test indicated that the Beveridge-type healthcare system generally showed better performance outcomes compared to the Bismarck-type system.

Conclusions: The findings indicate that higher allocations of certain healthcare resources, such as hospital beds, are associated with poorer health outcomes, which suggests potential inefficiencies in resource utilization. Observations also show that countries using the same healthcare systems tend to have similar patterns of resource allocation, which may influence the performance of these systems. Policymakers should consider these associations when planning resource allocation and when selecting or modifying healthcare system models in their countries. 

Place, publisher, year, edition, pages
BioMed Central (BMC), 2025. Vol. 25, no 1, article id 720
Keywords [en]
Health outcomes, Healthcare resources, Healthcare system performance, Multilevel regression model, Population health, Resource allocation
National Category
Health Care Service and Management, Health Policy and Services and Health Economy Public Health, Global Health and Social Medicine
Identifiers
URN: urn:nbn:se:bth-27916DOI: 10.1186/s12913-024-11743-0ISI: 001493859300003Scopus ID: 2-s2.0-105005432218OAI: oai:DiVA.org:bth-27916DiVA, id: diva2:1961985
Available from: 2025-05-28 Created: 2025-05-28 Last updated: 2025-09-30Bibliographically approved

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Kittipittayakorn, Cholada

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