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  • 1. OECD Health Data 2012 U.S. health care system from an international perspective Released on June 28, 2012 http://www.oecd.org/health/healthdata
  • 2. Why is the US health spending so high?
  • 3. US spends two-and-a-half times the OECD average Total health expenditure per capita, public and private, 2010 (or nearest year) USD PPP8 000 8 233 Public expenditure on health Private expenditure on health 5 388 5 270 5 0566 000 4 786 4 464 4 445 4 395 4 338 3 974 3 969 3 758 3 718 3 670 3 433 3 268 3 309 3 251 3 076 3 035 3 0224 000 2 964 2 914 2 728 2 428 2 095 2 165 2 035 1 884 1 601 1 389 1 294 1 2022 000 916 913 0 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.
  • 4. At 17.6% of GDP in 2010, US health spending is one and ahalf as much as any other country, and nearly twice the OECD average Total health expenditure as a share of GDP, 2010 (or nearest year) % of GDP20 17.61816 Public Private14 12.0 11.6 11.6 11.4 11.4 11.1 11.0 10.7 10.5 10.2 10.112 9.6 9.6 9.6 9.5 9.5 9.4 9.3 9.3 9.2 9.1 9.0 9.0 8.910 8.0 7.9 7.9 7.8 7.5 7.1 7.0 8 6.3 6.2 6.1 6 4 2 01. 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. 4Source: OECD Health Data 2012.
  • 5. US spends much more on health than what might be expected by its GDP per capitaHealth spending per 2010 (or latest year available) capita (USD PPP) USA8 0007 0006 000 CHE NOR5 000 NLD LUX CAN DNK DEU AUT BEL4 000 FRA SWE IRE GBR AUS NZL ESP ISL FIN3 000 GRC JPN R² = 0.6065 ITA PRT SVK SVN ISR2 000 KOR CZE POL HUN CHL EST1 000 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.
  • 6. 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 9 000 $7,910 Public health and administration (193%) 8 000 $856 Pharmaceuticals and medical goods (296%) 7 000 $1,105 Ambulatory health care 6 000 (155%) $5,270 Hospitals/Nursing homes 5 000 $331 $2,852 $460 $4,205 $4,187 (236%) $3,835 4 000 $416 $281 $1,677 $300 $853 $904 $2,979 3 000 $836 $120 $507 $1,188 $1,278 2 000 $1,082 $810 $3,097 (168%) $2,802 1 000 $1,716 $1,574 $1,582 $1,543 0 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. 6 Source: OECD Health Data 2012.
  • 7. Is US health spending higherdue to higher prices or higherservice provision? (or both?)
  • 8. US prices for a set of hospital services are over 60% higher than the average of 12 OECD countriesComparative price levels for total inpatient hospital services, 2007 Source: Koechlin et al. (2010).
  • 9. US prices for certain procedures are much higher than in other OECD countries (US dollars, 2007)Procedures AUS CAN DEU FIN FRA SWE USAAppendectomy 5 044 5 004 2 943 3 739 4 558 4 961 7 962Normal delivery 2 984 2 800 1 789 1 521 2 894 2 591 4 451Caesarean section 7 092 4 820 3 732 4 808 5 820 6 375 7 449Coronary angioplasty 7 131 9 277 3 347 5 574 7 027 9 296 14 378Coronary artery bypass graft 21 698 22 694 14 067 23 468 23 126 21 218 34 358Hip replacement 15 918 11 983 8 899 10 834 11 162 11 568 17 406Knee replacement 14 608 9 910 10 011 9 931 12 424 10 348 14 946Source: Koechlin et al. (2010).
  • 10. Where the United States health system does LESS than other countries United States Rank compared OECD average with OECD countries 2.4 3.1Practising physicians 26th per 1000 population per 1000 population 3.9 6.4Doctor consultations 29th per capita per capita 3.1 4.9Hospital beds 28th per 1000 population per 1000 population 131.0 155.1Hospital discharges 26th per 1000 population per 1000 populationAverage length of 4.9 7.1 29thstay in hospitals days daysSource: OECD Health Data 2012.
  • 11. Where the United States health system does MORE than other countries United States Rank compared OECD average with OECD countries 31.6 12.5MRI units 2nd per million population per million population 97.7 46.3MRI exams 2nd per 1 000 population per 1 000 population 40.7 22.6CT scanners 3rd per million population per million population 265.0 123.8CT exams 3rd per 1 000 population per 1 000 population 254.4 130.1Tonsillectomy 1st per 100 000 population per 100 000 population 79.0 47.3Coronary bypass 3rd per 100 000 population per 100 000 population 226.0 121.6Knee replacements 1st per 100 000 population per 100 000 population 32.9 26.1Caesarean sections 6th per 100 live births per 100 live births Source: OECD Health Data 2012.
  • 12. Is the quality of care better in the US?
  • 13. Cancer system is generally performing well Breast cancer, 5-year survival rate Colorectal cancer, 5-year survival rate United States (2003-08) 89.3 Japan (2000-05) 68.0 Japan (2000-05) 87.3 United States (2003-08) 64.5 Canada (2002-07) 86.6 Canada (2002-07) 63.4 OECD (16 countries) 83.5 Germany (2003-08) 60.4 Germany (2003-08) 83.3 OECD (16 countries) 59.9 France (1997-2002) 82.8 France (1997-2002) 57.0United Kingdom (2004-09) 81.3 United Kingdom (2004-09) 53.3 60 70 80 90 100 40 50 60 70 80 Age-standardised rates (%) Age-standardised rates (%) Note: 95% confidence intervals are represented by H. Source: OECD Health Data 2012.
  • 14. Primary care sector is not performing so well Asthma hospital admission COPD hospital admission Canada (2009) 15.7 France (2007) 79 Italy (2009) 19.2 Italy (2009) 126 Germany (2009) 20.8 Canada (2009) 183 France (2007) 43.4 OECD (28 countries) 198 OECD (28 countries) 51.8 Germany (2009) 201United Kingdom (2009) 73.7 United Kingdom (2009) 213 United States (2008) 120.6 United States (2008) 230 0 50 100 150 0 100 200 300 Age-sex standardised rates per 100 000 population Age-sex standardised rates per 100 000 population Note: 95% confidence intervals are represented by H. Source: OECD Health Data 2012.
  • 15. What are the trends inkey risk factors to health in the US?
  • 16. Smoking rates have decreased in the US and in most other OECD countries Adult population smoking daily 2010 Change 2000-10 13.3 Mexico n.a. 15.1 United states -20.9 15.1 Australia -23.7 16.3 Canada -27.2 19.5 Japan -27.8 20.9 OECD -19.9 21.5 United Kingdom -20.4 21.9 Germany -11.3 23.1 Italy -5.3 23.3 France -13.725 20 15 10 5 0 -50 -25 0 25 % of population aged 15 years and over % change over period Source: OECD Health Data 2012.
  • 17. Obesity rates have increased substantially over the past 20 years and are highest in the US %40 36 1990 2000 2010 31 3030 26 25 24 24 23 22 2120 17 15 14 13 13 12 11 10 10 910 9 6 4 3 20 1. Data are based on measurements rather than self-reported height and weight. Source: OECD Health Data 2012.
  • 18. Over one-third of children in the US are overweight or obeseChildren aged 5-17 years who are overweight (including obese) Girls Boys 37.0 Greece 45.0 35.9 United States 35.0 30.9 Italy 32.4 29.0 Mexico 28.1 26.6 United Kingdom 22.7 26.1 Canada 28.9 24.0 Australia 22.0 21.4 OECD 22.9 17.6 Germany 22.6 14.9 France 13.1 14.4 Japan 16.250 40 30 20 10 0 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).
  • 19. More informationhttp://www.oecd.org/health/healthdata