Mapping Healthcare System Complexity in the European Union: A Perspective on Resources, Determinants, and Outcomes

The transformation of healthcare systems presents a key challenge for EU Member States, as they face growing population needs, resource pressures, and ongoing health disparities among communities. Using a systems-thinking approach provides a suitable framework for analyzing how healthcare resources, behavioral and social health determinants, and overall population outcomes are interconnected. This study aims to explore these relationships from a systemic viewpoint within health communities across the European Union. The research employs a cross-sectional approach, utilizing aggregated data from all 27 EU Member States. It involves descriptive and factor analyses to create composite indices of healthcare resources, positive health determinants, and health outcomes. Furthermore, it uses a univariate Generalized Linear Model (GLM) and multilayer perceptron neural networks to model nonlinear relationships among variables. Cluster analysis is also conducted to classify Member States into different health performance typologies. The results emphasize connections between healthcare system resources and population health outcomes, illustrating how positive determinants impact health status and highlighting structural differences across European communities. The results indicate relevant associations between healthcare system resources and population health outcomes, whereas the analysis of positive health determinants suggests more complex, partly nonlinear patterns. The findings also highlight structural differences across European health communities.