Background: Health system performance is crucial for societal well-being. While past research focused on healthcare budgets, recent studies highlight the importance of institutional context, power dynamics, and governance. E.g., it has been shown that higher female political representation can correlate with better reproductive health outcomes.
Aim: This study explores: (i) How do institutional, administrative, political, and social context affect health system performance? (ii) Is there a link between administrative tradition and health outcomes? (iii) Does female political representation’s impact on public health vary by administrative tradition?
Methods: Health system performance is assessed using a set of UN Sustainable Development Goals indicators (2000-2020, 167 countries). Explanatory variables include health expenditure, social health insurance coverage, healthcare workforce (WHO, World Bank), legal origin, administrative tradition (LaPorta et al., 1999; Bianculli et al., 2013), democracy, female parliamentary representation (V-Dem), state capacity, ideology, populism, social trust (World Values Survey), and GDP per capita. Data analysis is performed via random effects and two-way fixed effects panel data estimation.
Key Results: Health system performance appears to be significantly influenced by administrative tradition. Countries with interventionist administrative traditions (e.g., Socialist, French, Germanic, Scandinavian) tend to achieve better outcomes than those with British tradition. Health expenditure and social health insurance coverage impact specific indicators, like vaccination coverage. Administrative tradition appears to moderate the impact of female political representation on reproductive health outcomes.
Conclusion: Administrative tradition can influence health outcomes more than health expenditure, state capacity and political ideology, emphasizing the importance of how healthcare is managed and delivered.