How does the UK NHS compare with European standards? A review of EU health care systems using hierarchical cluster analysis

Objectives: To undertake a review of the EU member states’ health care systems in relation to a framework of health-related variables, and to determine the position of the UK with respect to all other EU countries in the light of recent remarks by Tony Blair in arguing for the UK to move towards European standards. Methods Hierarchical cluster analysis, in conjunction with scatter plots, was used firstly to formulate country-cluster groups for pairs of OECD Health Data variables within the chosen framework, namely health expenditure as a share of GDP and per capita health expenditure; infant mortality and life expectancy (males and females); number of physicians and number of beds per head of population; average length of in-patient stay and in-patient admission rate. Following this a composite cluster analysis was performed using all nine variables to gain an overall country-cluster solution. Results The solutions reveal a strong association between the cluster country-membership and the health care mode of organisation, namely Social Insurance or NHS. The results obtained further reveal that although the UK achieves comparable health outcomes, its health care system is comparatively under-funded and under-resourced. However, the type of health care system employed needs to be taken into account when making cross-European comparisons. Conclusions Tony Blair is justified in seeking to increase health spending for the UK NHS which should address the problems of relative under-funding and under-resourcing and lead to a situation more in line with European standards. Hierarchical cluster analysis is a useful tool in the study of health care systems, and has a high number of potential applications in the field of health economics and other related subjects in determining criteria-specific groups.