2 conducting a literature search, comprising electronic data base searches in PubMed and SSCI, using the keywords defined in Box 1; exclusion criteria were: developing countries, and US. A more focused hand-search was added; prime sources were: publications of the European Observatory of Health Systems and Poli¬cies and WHO Euro; the international journals: Human Resources for Health; Health Policy; Health Services Research; Journal of Health Services Research and Pol¬icy;