This course is discontinued

HME4203 – Topics in comparative health systems and reforms

Schedule, syllabus and examination date

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Course content

Cross-national comparisons and assessment of reforms and innovations in:

  • Hospital, primary and integrated care
  • Public and community health
  • Mental and long-term care
  • Pharmaceuticals
  • Evidence-based policy
  • International transfer of innovations and policies

Learning outcome

During the last decades, a plethora of reforms and innovations in health policies have been launched both in Europe and elsewhere in the world. Some of these reforms and innovations have been closely followed up and assessed by government, research and other agencies. Out of these developments, a new field of knowledge is developing, around the generic label of evidence-based health policy. Health authorities world while are starting to collaborate in order to facilitate the process of innovations and reform transfers across countries, instead of developing their own solutions by trial and error as in the past. Examples of this trend have flourished in the various health care sectors, from integrated care policies, primary care reforms, hospital foundations and enterprises, prospective payment systems and managed competition. The course analyzes developments in those sectors in depth, assesses the extent to which there is a solid evidence base for different policy options, and describes the necessary requirements for an effective international transfer of innovations and reforms.


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Formal prerequisite knowledge



Lectures and seminars. Lectures will focus on the conceptual and cross-national issues. During seminars, specific national reforms in particular sectors will be analyzed in depth. Students are expected to present some of the empirical cases, and to discuss whether or not they can serve as best practice models transferable to other countries.


The course evaluation is a composite of a final exam (50%), a working paper (40%), and seminar presentations (10%).

The exam will last for two hours and will be made of two sections: a series of multiple-choice and short questions (30%); and a series of broad questions around one or two short texts describing a policy reform, taken from the mandatory readings (70%). In the second section of the exam, you will be asked to comment on the facts and theories described in the selected texts. The emphasis will be on the capacity to analyse, criticise and build solid arguments and to illustrate them with relevant evidence from the course readings and the exam texts. The materials required for the exam are summaries of the mandatory readings, both as provided during the lectures and extended by the students through their readings.

For the working paper, students will be asked to work in groups of 3-5 students. Each group should work on one of the topics (lectures or seminars) of the course, and find and analyse comparative recent evidence on several European countries on that particular topic (e.g. comparing choice regulation in Norway and the Netherlands). The working papers should cover the following sections or issues: comparison of recent policy trends across countries; comparison of detailed policy instruments and their consequences; analysis of the causes of the different success of reforms across countries; policy implications, or advice that you would give to a policy-maker in your country who wants to introduce some innovations in your selected field of policy.

For the seminar presentations, further instructions will be given during the Presentation of the course. Students will work in groups, and summarize and present a short case-study in each of the seminars

Facts about this course




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