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1 "Decommodification index"
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Original Article
Healthcare Systems and COVID-19 Mortality in Selected OECD Countries: A Panel Quantile Regression Analysis
Jalil Safaei, Andisheh Saliminezhad
J Prev Med Public Health. 2023;56(6):515-522.   Published online October 15, 2023
DOI: https://doi.org/10.3961/jpmph.23.162
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  • 3 Web of Science
  • 3 Crossref
AbstractAbstract AbstractSummary PDF
Objectives
The pandemic caused by coronavirus disease 2019 (COVID-19) has exerted an unprecedented impact on the health of populations worldwide. However, the adverse health consequences of the pandemic in terms of infection and mortality rates have varied across countries. In this study, we investigate whether COVID-19 mortality rates across a group of developed nations are associated with characteristics of their healthcare systems, beyond the differential policy responses in those countries.
Methods
To achieve the study objective, we distinguished healthcare systems based on the extent of healthcare decommodification. Using available daily data from 2020, 2021, and 2022, we applied quantile regression with non-additive fixed effects to estimate mortality rates across quantiles. Our analysis began prior to vaccine development (in 2020) and continued after the vaccines were introduced (throughout 2021 and part of 2022).
Results
The findings indicate that higher testing rates, coupled with more stringent containment and public health measures, had a significant negative impact on the death rate in both pre-vaccination and post-vaccination models. The data from the post-vaccination model demonstrate that higher vaccination rates were associated with significant decreases in fatalities. Additionally, our research indicates that countries with healthcare systems characterized by high and medium levels of decommodification experienced lower mortality rates than those with healthcare systems involving low decommodification.
Conclusions
The results of this study indicate that stronger public health infrastructure and more inclusive social protections have mitigated the severity of the pandemic’s adverse health impacts, more so than emergency containment measures and social restrictions.
Summary
Key Message
This study investigates whether COVID-19 mortality rates across a group of developed nations are associated with characteristics of their healthcare systems, beyond the differential policy responses in those countries. To this aim, a quantile regression with non-additive fixed effects is applied to estimate mortality rates across quantiles. The results of this study indicate that stronger public health infrastructure and more inclusive social protections have mitigated the severity of the pandemic’s adverse health impacts, more so than emergency containment measures and social restrictions.

Citations

Citations to this article as recorded by  
  • Social globalisation and environmental sustainability: An analysis on ASEAN countries
    Ahmet Kasap
    Journal of Cleaner Production.2026; 538: 147230.     CrossRef
  • Do adverse childhood experiences intensify the impact of hazardous drinking on depression? Application of quantile regression analysis
    Mi-Sun Lee, Joonbeom Kim
    Child Abuse & Neglect.2026; 174: 107976.     CrossRef
  • Clinical Associations with Hospital Escalation Among COVID-19 Patients Receiving Remdesivir in a Hospital-at-Home Service: A Real-World Cohort Study
    Manuel Mirón-Rubio, Regina de la Corte-Carmona, Amaya Palomo-Iloro, Eduardo Fernández-Carracedo, José Ramón Sevilla-Resúa, Santiago Somovilla-Moreno, Isabel Ortega-Fernández, Francisco Bas-Sanchís, María del Carmen Montero-Hernández, Irene Gutiérrez-Gómez
    Journal of Clinical Medicine.2025; 14(19): 6736.     CrossRef

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