U.S. health care system from an international perspective · Germany (2003-08) Canada (2002-07)...
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Health at a Glance 2011
U.S. health care system from
an international perspective
Released on November 23, 2011 http://www.oecd.org/health/healthataglance
Why is the US health spending so high?
US spends two-and-a-half times the OECD average
2009 (or latest year available)
1. In the Netherlands, it is not possible to clearly distinguish the public and private share related to investments. 2. Health expenditure is for the insured population rather than the resident population. 3. Total expenditure excluding investments. Information on data for Israel: http://dx.doi.org/10.1787/888932315602.
Source: OECD Health Data 2011; WHO Global Health Expenditure Database.
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At 17.4% of GDP in 2009, US health spending is half as much as any other country, and nearly twice the OECD average
Source: OECD Health Data 2011; WHO Global Health Expenditure Database for non-OECD countries.
1. In the Netherlands, it is not possible to clearly distinguish the public and private share related to investments. 2. Total expenditure excluding investments. 3. Health expenditure is for the insured population rather than the resident population. Information on data for Israel: http://dx.doi.org/10.1787/888932315602.
2009 (or latest year available)
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US spends much more on health than what might be expected by its GDP per capita
Source: OECD Health Data 2011; WHO Global Health Expenditure Database.
2009 (or latest year available)
AUS
AUT
BEL
BRA
CAN
CHL
CHN
CZE
DNK
EST
FIN
FRA
DEU
GRC
HUN
IDNIND
ISL
IRL
ISR
ITA
JPN
KOR
LUX
MEX
NLD
NZL
NOR
POL
PRT
RUS
SVK
SVN
ZAF
ESP
SWE
CHE
TUR
GBR
USAR² = 0.71
0
1000
2000
3000
4000
5000
6000
7000
8000
0 15000 30000 45000 60000 75000 90000
GDP per capita (USD PPP)
Health spending per capita (USD PPP)
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US health spending is much greater for all categories of care, particularly for ambulatory care and administration cost
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 2011.
2009 (or latest year available)
$2,922 $2,716
$1,643 $1,518 $1,639 $1,458
$2,803
$1,626
$1,171 $1,254 $1,062
$787
$1,070
$463
$860 $887 $842
$466
$803
$339
$434 $271 $298
$121
$7,598
$5,144
$4,139 $4,072 $3,872
$2,832
$-
$1,000
$2,000
$3,000
$4,000
$5,000
$6,000
$7,000
$8,000
UNITED STATES Switzerland Canada Germany France Japan (2008)
USD PPPOther
Public health & administration
Pharmaceuticals and medical goods
Ambulatory (Physicians, specialists, dentists, etc.)
Hospitals/Nursing homes
(163%)
(238%)
(152%)
(274%)
(189%)
Is US health spending higher due to higher prices or higher service provision? (or both?)
Comparative price levels for total inpatient hospital services, 2007
Source: Koechlin et al. (2010).
US prices for a set of hospital services is over 60% higher than the average of 12 OECD countries
US prices for certain procedures are much higher than in other OECD countries
(US dollars, 2007)
Procedures AUS CAN DEU FIN FRA SWE USA
Appendectomy 5 044 5 004 2 943 3 739 4 558 4 961 7 962
Normal delivery 2 984 2 800 1 789 1 521 2 894 2 591 4 451
Caesarean section 7 092 4 820 3 732 4 808 5 820 6 375 7 449
Coronary angioplasty 7 131 9 277 3 347 5 574 7 027 9 296 14 378
Coronary artery bypass graft 21 698 22 694 14 067 23 468 23 126 21 218 34 358
Hip replacement 15 918 11 983 8 899 10 834 11 162 11 568 17 406
Knee replacement 14 608 9 910 10 011 9 931 12 424 10 348 14 946
Source: Koechlin et al. (2010).
Where the United States health system does LESS than other countries
United States Rank compared with OECD countries
OECD average
Practising physicians 2.4
per 1000 population 26th
3.1 per 1000 population
Doctor consultations 3.9
per capita 29th
6.5 per capita
Hospital beds 3.1
per 1000 population 29th
4.9 per 1000 population
Hospital discharges 130.9
per 1000 population 26th
158.1 per 1000 population
Average length of stay in hospitals
4.9 days
29th 7.2 days
Source: OECD Health Data 2011.
Where the United States health system does MORE than other countries
Source: OECD Health Data 2011.
United States Rank compared with OECD countries
OECD average
MRI units 25.9
per million population 2nd
12.2 per million population
MRI exams 91.2
per 1 000 population 2nd
46.6 per 1 000 population
CT scanners 34.3
per million population 5th
22.8 per million population
CT exams 227.9
per 1 000 population 2nd
131.8 per 1 000 population
Tonsillectomy 254.4
per 100 000 population 2nd
133.8 per 100 000 population
Coronary angioplasty 377.2
per 100 000 population 3rd
187.6 per 100 000 population
Knee replacements 212.5
per 100 000 population 1st
118.4 per 100 000 population
Caesarean sections 32.3
per 100 live births 8th
25.8 per 100 live births
Is the quality of care better in the US?
Cancer system is generally performing well
81.3
82.8
83.3
83.5
86.6
87.3
89.3
60 70 80 90 100
United Kingdom (2004-09)
France (1997-2002)
Germany (2003-08)
OECD (16 countries)
Canada (2002-07)
Japan (2000-05)
United States (2003-08)
Age-standardised rates (%)
53.3
57.0
59.9
60.4
63.4
64.5
68.0
40 50 60 70 80
United Kingdom (2004-09)
France (1997-2002)
OECD (16 countries)
Germany (2003-08)
Canada (2002-07)
United States (2003-08)
Japan (2000-05)
Age-standardised rates (%)
Breast cancer, 5-year survival rate Colorectal cancer, 5-year survival rate
Note: 95% confidence intervals are represented by H. Source: OECD Health Data 2011.
Primary care sector not performing so well
Asthma hospital admission COPD hospital admission
Note: 95% confidence intervals are represented by H. Source: OECD Health Data 2011.
15.7
19.2
20.8
43.4
51.8
73.7
120.6
0 50 100 150
Canada (2009)
Italy (2009)
Germany (2009)
France (2007)
OECD (28 countries)
United Kingdom (2009)
United States (2008)
Age-sex standardised rates per 100 000 population
79
126
183
198
201
213
230
0 100 200 300
France (2007)
Italy (2009)
Canada (2009)
OECD (28 countries)
Germany (2009)
United Kingdom (2009)
United States (2008)
Age-sex standardised rates per 100 000 population
What are the trends in key risk factors to health
in the US?
Mexico
United States
Canada
Australia
United Kingdom
Germany
OECD
Italy
Japan
France
Greece
13.3
16.1
16.2
16.6
21.5
21.9
22.1
23.3
24.9
26.2
39.7
01020304050
% of population aged 15 years and over
n.a.
-16.1
-31.9
-24.9
-20.4
-11.3
-17.9
-5.7
-25.9
-6.4
5.6
-50 -25 0 25
% change over the period
Smoking rates have decreased in the US and in most other OECD countries
Adult population smoking daily
Source: OECD Health Data 2011.
2009 Change 2000-09
Obesity rates have increased substantially over the past 20 years and is highest in US
1. Data are based on measurements rather than self-reported height and weight. Source: OECD Health Data 2011.
2
n.a.
6
n.a. n.a.
9
14
11
n.a.
23
3
9 9
12
14 13
21 22
24
31
4
1011
1517 17
2325
30
34
0
10
20
30
40
1990 2000 2009
% of adult population
(or nearest years)
Over one-third of children in the US are overweight or obese
Canada
Australia
OECD
Germany
France
Japan
Italy
Mexico
United Kingdom
Greece
United States
37.0
35.9
30.9
29.0
26.6
26.1
24.0
21.4
17.6
14.9
14.4
01020304050
% of children aged 5-17 years
45.0
35.0
32.4
28.1
22.7
28.9
22.0
22.9
22.6
13.1
16.2
0 10 20 30 40 50
% of children aged 5-17 years
Source: International Association for the Study of Obesity (2011).
Girls Boys
Children aged 5-17 years who are overweight (including obese)