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Learning From Others

The Diffusion of Hospital Financing Reforms in OECD Countries

University of Zurich, Switzerland

Katharina Füglister

University of Lausanne, Switzerland

Stéphane Luyet

University of Lausanne, Switzerland

The increase in health care expenditures is a major problem of all welfare states. To counter this trend, since the early 1980s, most OECD countries have changed the way hospitals are financed. Although these reforms are certainly linked to country-specific factors, the authors' main argument is that they are in part due to a diffusion process: Policy change in one country is influenced by previous changes in other countries. More specifically, the authors argue that policy makers learn from the experience of others. Using an original data set and event—history methods to test arguments, their results show that policy change is more likely when the existing policy is ineffective and when the experience of other countries suggests that the reform leads to the desired results. In addition, the authors find that the effects of learning grow over time and that early adopters tend to be countries with few veto players.

Key Words: policy diffusion • learning • welfare state • health care • OECD countries

This version was published on April 1, 2009

Comparative Political Studies, Vol. 42, No. 4, 549-573 (2009)
DOI: 10.1177/0010414008327428


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