Health System Characteristics Survey
The OECD Health Systems Characteristics Survey provides a structured view of how health systems are designed and how those design choices influence performance.
It captures the institutional features that shape healthcare delivery, including how care is funded, organized, and regulated, and how providers are incentivized.
This creates a foundation for understanding why health systems perform the way they do.
What it Measures
The survey examines key dimensions of health system design:
- Population coverage and financing models
- Organization of healthcare delivery
- Public and private roles in service provision
- Provider payment systems and incentives
- Patient access and choice
- Regulation of healthcare supply and pricing
Together, these elements define how care is delivered within a system.
What the Findings Show
The OECD analysis highlights several important insights.
There is no single “best” health system model
Different combinations of system characteristics can achieve similar levels of performance.
Incentives play a critical role
Health systems that include stronger incentives for quality tend to achieve better access and outcomes compared to systems relying primarily on volume-based payment models.
Primary care strength is a key driver of performance
Systems with stronger primary care orientation, including continuity, coordination, and GP-led care, are associated with lower avoidable hospitalizations and improved outcomes.
Why This Matters
Health system performance is shaped by design.
Outcomes are influenced by:
- How care is funded
- How providers are incentivized
- How services are organized
Understanding these relationships is critical to improving care.