This book compares the health systems of 11 countries in terms of their social determinants, health funding and health expenditure, and explores how the different configurations of these factors, in turn, relate to a range of different outcome measures. It also compares a wider range of countries in relation to the factors found most important for the 11 countries, as well as exploring the first-wave response to COVID-19 in 2020. By exploring health systems in terms of several of their most important aspects, we can assess what they have in common and in difference, and whether those commonalities and differences are linked to better or worse outcomes.

No empirical work takes place in a theoretical vacuum. Things that seem important are more likely to be measured, and those measures often already come in clusters, based on the relationships that we assume exist between them. It is therefore important to actively think about what it is we are trying to measure, what theories are explicit (or implicit) in those measures, and then whether the empirical findings that we find support or challenge those theories.

It is also really important in comparative research to have a method for linking together the existing data and theory, and for testing it in a robust and transparent manner. Not everyone will agree with the findings in this book, but they will be able to see exactly where they agree or disagree. I hope this can lead to debate, and in turn to greater understanding.

The starting point for the book is to identify what perspectives it will take – the different ways health systems will be explored – and, in outline, the debates that it will cover as a result. After that, this chapter moves on to consider the different outcomes each chapter will address, before explaining the method the book uses to achieve its comparative analysis.

Health systems

The dominant book on comparative health policy is that of Blank, Burau and Kuhlmann (2018), now in its fifth edition, which gives us an initial template for the topics or dimensions that this book should reasonably be expected to cover.