OECD Health Data 2012

U.S. health care system from an international perspective

Released on June 28, 2012 http://www.oecd.org/health/healthdata

Why is the US health spending so high?

US spends two-and-a-half times the OECD average

Total health expenditure per capita, public and private, 2010 (or nearest year)

USD PPP
8 233

8 000

Public expenditure on health

5 388 5 270 4 786

Private expenditure on health

6 000

5 056

4 464

4 445

4 395

4 338

3 974

3 969

3 758

3 718

3 670

3 433

3 309

3 268

3 251

3 076

3 035

2 964

2 914

2 728

4 000

3 022

2 428

2 165

2 095

2 035

1 884

1 601

1 389

1 294

916

1. In the Netherlands, it is not possible to clearly distinguish the public and private share related to investments. 2. Total expenditure excluding investments. Information on data for Israel: http://dx.doi.org/10.1787/888932315602.

Source: OECD Health Data 2012.

913

2 000

1 202

At 17.6% of GDP in 2010, US health spending is one and a half as much as any other country, and nearly twice the OECD average
Total health expenditure as a share of GDP, 2010 (or nearest year)

18 16

17.6

% of GDP 20

Public
12.0 11.6 11.6

Private

11.4

11.4

11.1

14 12 10 8 6 4 2 0

11.0

10.7

10.5

10.2

10.1

9.6

9.6

9.6

9.5

9.5

9.4

9.3

9.3

9.2

9.1

9.0

9.0

8.9

8.0

7.9

7.9

7.8

7.5

7.1

7.0

6.3 4

6.2

1. In the Netherlands, it is not possible to clearly distinguish the public and private share related to investments. 2. Total expenditure excluding investments. Information on data for Israel: http://dx.doi.org/10.1787/888932315602.

Source: OECD Health Data 2012.

6.1

US spends much more on health than what might be expected by its GDP per capita
Health spending per capita (USD PPP)
8 000

2010 (or latest year available)

USA

7 000

6 000
NLD CAN DEU BEL CHE NOR LUX

5 000

DNK AUT

4 000

FRA

3 000

2 000

1 000

IRE SWE GBR AUS NZL ESP ISL FIN GRC JPN R = 0.6065 ITA PRT SVN SVK ISR KOR CZE HUN POL EST CHL MEX TUR

0 0 10 000 20 000 30 000 40 000 50 000 60 000 70 000 80 000 90 000 GDP per capita (USD PPP) 5

Source: OECD Health Data 2012.

US health spending is much greater for all categories of care, particularly for ambulatory care and administration cost
2010 (or latest year available) Current health spending per capita (USD PPP)

Other Public health and administration Pharmaceuticals and medical goods Ambulatory health care
$5,270 $331 $460 $1,677

9 000 8 000 7 000 6 000 5 000 4 000 3 000 2 000

$7,910 (193%) $856 (296%) $1,105 (155%)

Hospitals/Nursing homes
$4,205 $416 $853 $4,187 $3,835 $300 $836 $1,082

$2,852 (236%)

$281
$904 $1,278

$1,188
$3,097 (168%)

$2,979 $120 $507 $810 $1,543

1 000
0

$2,802
$1,716 $1,574 $1,582

United States

Switzerland

Canada

Germany

France

Japan (2009)

Note: Health spending excludes investments. The percentages in the US bar indicate how much more the US spends per category compared with the average of the five other OECD countries. Source: OECD Health Data 2012.

Is US health spending higher due to higher prices or higher service provision? (or both?)

US prices for a set of hospital services are over 60% higher than the average of 12 OECD countries
Comparative price levels for total inpatient hospital services, 2007

Source: Koechlin et al. (2010).

US prices for certain procedures are much higher than in other OECD countries
(US dollars, 2007)
Procedures Appendectomy Normal delivery Caesarean section Coronary angioplasty Coronary artery bypass graft Hip replacement Knee replacement
Source: Koechlin et al. (2010).

AUS 5 044 2 984 7 092 7 131 21 698 15 918 14 608

CAN 5 004 2 800 4 820 9 277 22 694 11 983 9 910

DEU 2 943 1 789 3 732 3 347 14 067 8 899 10 011

FIN 3 739 1 521 4 808 5 574 23 468 10 834 9 931

FRA 4 558 2 894 5 820 7 027 23 126 11 162 12 424

SWE 4 961 2 591 6 375 9 296 21 218 11 568 10 348

USA 7 962 4 451 7 449 14 378 34 358 17 406 14 946

Where the United States health system does LESS than other countries
United States Rank compared with OECD countries 26th 29th 28th 26th OECD average

Practising physicians Doctor consultations Hospital beds Hospital discharges Average length stay in hospitals of

per 1000 population per capita per 1000 population per 1000 population days

2.4 3.9 3.1

per 1000 population per capita per 1000 population per 1000 population days

3.1 6.4 4.9

131.0 4.9

155.1 7.1

29th

Source: OECD Health Data 2012.

Where the United States health system does MORE than other countries
United States 31.6 97.7 40.7 Rank compared with OECD countries 2nd 2nd 3rd 3rd 1st 3rd 1st 6th OECD average 12.5 46.3 22.6

MRI units MRI exams CT scanners CT exams Tonsillectomy Coronary bypass Knee replacements Caesarean sections

per million population per 1 000 population per million population per 1 000 population per 100 000 population per 100 000 population per 100 000 population

per million population per 1 000 population per million population per 1 000 population per 100 000 population per 100 000 population per 100 000 population

265.0 254.4 79.0

123.8 130.1 47.3

226.0 32.9

121.6 26.1

per 100 live births

per 100 live births

Source: OECD Health Data 2012.

Is the quality of care better in the US?

Cancer system is generally performing well

Breast cancer, 5-year survival rate

United States (2003-08)

Colorectal cancer, 5-year survival rate

Japan (2000-05) 68.0

89.3
87.3 86.6

Japan (2000-05)
Canada (2002-07) OECD (16 countries)

United States (2003-08)

Canada (2002-07) Germany (2003-08)

64.5
63.4 60.4 59.9 57.0

83.5
83.3 82.8 81.3 60 70 80 90 100 Age-standardised rates (%)

Germany (2003-08)
France (1997-2002) United Kingdom (2004-09)

OECD (16 countries)

France (1997-2002) United Kingdom (2004-09) 40

53.3
50 60 70 80 Age-standardised rates (%)

Note: 95% confidence intervals are represented by H. Source: OECD Health Data 2012.

Primary care sector is not performing so well

Asthma hospital admission

Canada (2009)

COPD hospital admission

France (2007)
Italy (2009) Canada (2009) 79 126

15.7
19.2 20.8

Italy (2009)
Germany (2009) France (2007) OECD (28 countries) United Kingdom (2009)

183
198 201 213 230 0 100 200 300 Age-sex standardised rates per 100 000 population

43.4
51.8 73.7 120.6

OECD (28 countries)

Germany (2009) United Kingdom (2009)

United States (2008)

United States (2008)

0 50 100 150 Age-sex standardised rates per 100 000 population

Note: 95% confidence intervals are represented by H. Source: OECD Health Data 2012.

What are the trends in key risk factors to health in the US?

Smoking rates have decreased in the US and in most other OECD countries
Adult population smoking daily 2010 Change 2000-10
13.3 15.1 15.1 16.3 19.5 20.9 21.5 21.9 23.1 23.3
25 20 15 10 5 0

Mexico United states Australia Canada Japan OECD United Kingdom Germany Italy France
-50

n.a. -20.9 -23.7 -27.2 -27.8

-19.9

-20.4 -11.3
-5.3

-13.7
-25 0 25

% of population aged 15 years and over

% change over period

Source: OECD Health Data 2012.

Obesity rates have increased substantially over the past 20 years and are highest in the US
36 1990 30 24 25 22 21 2000 2010 30 31 23 26 15 17 13 % 40

20

12

13

10

10 2 3 4

1. Data are based on measurements rather than self-reported height and weight. Source: OECD Health Data 2012.

10

11

14

24

Over one-third of children in the US are overweight or obese

Children aged 5-17 years who are overweight (including obese) Girls Boys
37.0 35.9 30.9 29.0 26.6 26.1 Greece United States Italy Mexico United Kingdom Canada Australia OECD Germany France Japan 10 0 13.1 22.0 22.9 22.6 35.0 32.4 28.1 22.7

45.0

28.9

24.0
21.4 17.6 14.9 14.4 50 40 30 20

16.2 0 10 20 30 40 50

% of children aged 5-17 years % of children aged 5-17 years Source: International Association for the Study of Obesity (2011).

More information

http://www.oecd.org/health/healthdata