By Ryan Gamlin

Comparative analysis of international health systems has increased in recent years, serving to inform systemic transformations undertaken (Singapore) or explored (Vermont). Much of this analysis has focused on comparisons of various healthcare financing schemes.

This analysis explores the relationship between healthcare administrative costs and physician-reported efficiency measures across ten industrialized countries, using OECD data to determine the percentage of national health expenditures spent on health administration and insurance (PHEHA) – a measure that allows a par comparison of administrative efficiency across countries with various health financing arrangements – and Commonwealth Fund surveys of physicians in the same countries.

PHEHA was compared to two physician-reported measures of administrative inefficiency: (1) “Doctors report time spent on administrative issues related to insurance or claims is a major problem” and (2) “Doctors report time spent getting patients needed medications or treatment because of coverage restrictions is a major problem”. The correlation (Pearson’s r) between PHEHA and (1) was 0.67, and between PHEHA and (2) was 0.73.

The relationship between PHEA and indicators of administrative inefficiency provides context for a number of additional subjects of investigation, including the relationship between health system administrative structure and physician workforce planning, job satisfaction, and opportunities for labor savings associated with administrative simplification.


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Ryan Gamlin



Published: 4 Mar, 2015

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