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In this chapter, we describe the macro-level relationship between health system design and inequalities in population health (Sect. 4.2). We will give an answer to the question what it is in health system design that could be related to population health equality. We start with health expenditures and out-of-pocket payments (Sect. 4.3). The introduction of market elements in many health care systems from the late 1990s may have affected population health equity (Sect. 4.4). Then we discuss the complexity and fragmentation of health systems that make it difficult for population groups to find their way to appropriate insurance options and care (Sect. 4.5). We finish with discussing the role of primary care in improving population health equity (Sect. 4.6).

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Health System Design and Inequalities in Population Health

  • 章节

  • 出版模式：

    开放获取

  • 发表日期：

    2026年

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  • Peter P. Groenewegen,
  • Ilmo Keskimäki,
  • Alastair H. Leyland

摘要

In this chapter, we describe the macro-level relationship between health system design and inequalities in population health (Sect. 4.2). We will give an answer to the question what it is in health system design that could be related to population health equality. We start with health expenditures and out-of-pocket payments (Sect. 4.3). The introduction of market elements in many health care systems from the late 1990s may have affected population health equity (Sect. 4.4). Then we discuss the complexity and fragmentation of health systems that make it difficult for population groups to find their way to appropriate insurance options and care (Sect. 4.5). We finish with discussing the role of primary care in improving population health equity (Sect. 4.6).