Table 1

Overview of characteristics of participating countries

CountryOrganisation and structureFunding system and healthcare expenditureRegulation of quality and safetyPopulation and country size
Australia
  • Universal health coverage through Medicare

  • Federated structure with agreements between the Commonwealth (Australian) Government and the states and territories44

  • Taxpayer funded for two-thirds of all care; one-third is paid through private health insurance or out-of-pocket expenditure

  • Healthcare expenditure at 9.3% of GDP

  • Government/compulsory spending 67.4% of total health expenditure45

  • Regulation and agencies split across the Federal Government (eg, the Australian Commission on Safety and Quality in Health Care) and the States and Territories (eg, the Clinical Excellence Commission in New South Wales).44

  • Population: 25.37 million

  • Land area: 7.69 million km2

  • Inhabitants per km2: 3.346

Japan
  • Universal health insurance scheme provided by two types of plans: Social Health Insurance (SHI) for those in employment, and National Health Insurance for those not covered through SHI

  • Free access to healthcare providers (hospitals and private practitioners)47–49

  • Insurance premiums subsidised by tax with 10%–30% co-payment

  • Healthcare expenditure at 11% of GDP

  • Government/compulsory spending 84.3% of total health expenditure45

  • Regulation on quality and safety in healthcare institutions is based on Medical Care Act setting standards.

  • Inspections are conducted by central and local government agencies (Regional Bureaus of Ministry of Health and Welfare; Prefectural Health Departments).47–49

  • Population: 126.26 million

  • Land area: 377 975 km2

  • Inhabitants per km2: 33446

Netherlands
  • Universal health coverage through mandatory insurance. Decentralised, ‘regulated competition’ system with private insurers and providers50

  • Mixed system of insurance and taxation-based financing

  • Healthcare expenditure at ~9.9% of GDP

  • Government/compulsory spending 82.7% of total health expenditure45

  • National Health Institute responsible for setting standards; quality and safety supervised by Health and Youth Care Inspectorate.50

  • Population: 17.33 million

  • Land area: 41 873 km2

  • Inhabitants per km2: 41446

Norway
  • Semidecentralised system, parliament as decision-making body; state ownership of hospitals administered by four Regional Health Authorities

  • The Norwegian Board of Health Supervision is a national regulatory body, organised under the Ministry of Health and Care Services; county governors at the regional level oversee services within primary and specialised healthcare51

  • Tax-based system, limited out-of-pocket payment

  • Healthcare expenditure at ~10.5% of GDP

  • Government/compulsory spending 85.4% of total health expenditure45

Comprehensive legislation regarding child welfare, health and social services:
  • requirements for quality of services

  • regulations for authorised healthcare personnel

  • service user rights


Supervision applies to all statutory services (municipalities, private businesses, publicly owned hospitals, etc).51
  • Population: 5.33 million

  • Land area: 385 207 km2

  • Inhabitants per km2: 13.846

Switzerland
  • Universal, government-regulated insurance system of around 60 private health insurance companies that offer mandatory basic coverage52 53

  • Full or partial government subsidies for insurance policies provided based on age and income

  • Healthcare expenditure at ~12.1% of GDP

  • Government/compulsory spending 64.5% of total health expenditure45

  • LAMal (Swiss Federal Law on Health Insurance) provides structure for and governance of the current healthcare system.52 53

  • Population: 8.51 million

  • Land area: 41 285 km2

  • Inhabitants per km2: 20646

UK
  • Universal public healthcare system through the National Health Service54

  • Free at the point of care delivery; funded through general taxation

  • Healthcare expenditure at 10.3% of GDP

  • Government/compulsory spending 77.8% of total health expenditure45

  • Healthcare regulator (CQC) conducts inspections and rates quality.

  • Complex layers of regulation and oversight, including independent investigator, improvement body and accreditation requirements.54

  • Population: 66.79 million

  • Land area: 242 495 km2

  • Inhabitants per km2: 27546

  • CQC, Care Quality Commission; GDP, gross domestic product.