Healthcare System Types: A Conceptual Framework for Comparison

This article addresses the need to establish a comprehensive conceptual framework for analysing healthcare systems and their transformations. It begins by offering an overview of the current state of the art in the field, pointing to the literature's absence of conceptual robustness in the definition of system types. By exploring the dimensions 'financing', 'provision' and 'regulation' of healthcare, the article then proceeds deductively in line with the 'Weberian method of ideal-types' to establish a taxonomy of 27 healthcare systems, of which three can be identified as 'ideal-types'. When applying this concept, not only can differences between healthcare systems be analysed, but also changes over time. The article concludes by identifying three forms of healthcare system transformation.     

Regional Contexts and Family Formation: Evidence from the German Family Panel

Substantial regional variation in marriage and fertility patterns continues to exist in Germany. Following a multilevel approach, we exploit longitudinal data from the German Family Panel (pairfam), enhanced by an array of district-level variables, to investigate the extent to which spatial variations in men’s and women’s family formation behaviors result from differences in population composition or from ‘true’ contextual effects. Our multilevel analyses provide evidence for only small—if any—contextual effects on individuals’ family formation behaviors (except for a continuation of significant differences between East and West Germany). However, we still find indication that (1) regional economic circumstances matter in determining individuals’ fertility intentions as well as their transition to first marriage, (2) regional milieus are associated with individuals’ fertility, and that (3) selective family migration takes place. While it seems that social interaction rather than differences in local opportunity structures plays a role here, more research is needed to further substantiate this conclusion.     

Optimal design for linear regression models in the presence of heteroscedasticity caused by random coefficients

Random coefficients may result in heteroscedasticity of observations. For particular situations, where only one observation is available per individual, we derive optimal designs based on the geometry of the design locus.     

On best affine prediction

The theory of best affine prediction (BAP) is extended to the vector case with possibly singular variance matrix of the predictor variable. The theory is then applied to derive Thomson’s classical predictor for factor scores, allowing for a singular variance matrix of the factors. The results are formulated in a free distribution setting. Further, Bartlett’s estimator is considered and compared with Thomson’s predictor. The authors are thankful to the two referees, one for a suggestion that led to the Addendum of the paper, and the other one for several very useful remarks. Research supported by the Spanish grant BEC2000-0983.     

Maternity Leave and Mothers’ Long-Term Sickness Absence: Evidence From West Germany

Exploiting unique German administrative data, we estimate the association between an expansion in maternity leave duration from two to six months in 1979 and mothers’ postbirth long-term sickness absence over a period of three decades after childbirth. Adopting a difference-in-difference approach, we first assess the reform’s labor market effects and, subsequently, prebirth and postbirth maternal long-term sickness absence, accounting for the potential role of the reform in mothers’ selection into employment. Consistent with previous research, our estimates show that the leave extension caused mothers to significantly delay their return to work within the first year after childbirth. We then provide difference-in-difference estimates for the number and length of spells of long-term sickness absence among returned mothers. Our findings suggest that among those returned, mothers subject to the leave extension exhibit a higher incidence of long-term sickness absence compared with mothers who gave birth before the reform. This also holds true after we control for observable differences in prebirth illness histories. At the same time, we find no pronounced effects on mothers’ medium-run labor market attachment following the short-run delay in return to work, which might rationalize a negative causal health effect. Breaking down the results by mothers’ prebirth health status suggests that the higher incidence of long-term sickness absence among mothers subject to the reform may be explained by the fact that the reform facilitated the reentry of a negative health selection into the labor market.