THE EFFECT OF HUMAN-CAPITAL AND STATE INTERVENTION ON THE PERFORMANCEOF MEDICAL SYSTEMS

Using theoretical perspectives of several literatures (e.g., human cap ital investment, state theory, mortality, and professional dominance), this study explains variation in the performance of national medical systems. Using an unique data set, if assesses the consequences of hum an capital investments by analyzing the impact that investments in the number of doctors and in the proportion of doctors who were specialis ts have on reductions in mortality (social effectiveness) and mortalit y reductions relative to costs (social efficiency) in Britain, France, Sweden, and the U.S. between 1890 and 1970. Net of other effects, inv estments in both doctors and specialists lead to mortality reductions, but increases in specialists are not socially efficient. The role of the state influences the impact human capital investments have on syst em performance. More than one configuration of the key variables can l ead to the same outcomes. The study analyzes pooled time series and cr oss-sectional data with regression and Boolean methods.