| Summary: | Looking at health care systems in Europe in the long run reveals constant reforming. The analysis is generally done at the micro-economic level. This article aims at shedding some light, from a macro-economic and dynamic viewpoint, on the combination of instruments of reforms, the means of health care systems, the “results”, then on the relationships between these elements. After presenting the methodological choices made to take into account the specificities of the health field, the empirical components are successively analyzed. The article points at the strong robustness of institutional influences in the long term.
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