Health expenditure


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Health expenditure

  1. 1. From: Health at a Glance 2011 OECD Indicators Access the complete publication at: expenditure per capita Please cite this chapter as: OECD (2011), “Health expenditure per capita”, in Health at a Glance 2011: OECD Indicators, OECD Publishing.
  2. 2. This document and any map included herein are without prejudice to the status of orsovereignty over any territory, to the delimitation of international frontiers and boundaries and tothe name of any territory, city or area.
  3. 3. 7. HEALTH EXPENDITURE AND FINANCING7.1. Health expenditure per capitaOECD countries vary enormously in how much they spend In countries such as Italy, Switzerland and Germany, healthon health and the rate at which health spending grows. spending per capita has increased at a much slower rateThis reflects a wide array of market and social factors, as over the period – at an annual average of 2% or less. Thiswell as countries’ diverse financing and organisational reflects, in part, a period of relatively low economic growthstructures of their health systems. over the period as a whole and the effect of deliberate cost-The United States continues to outspend all other OECD containment policies.countries by a wide margin. In 2009, spending on health Figure 7.1.3 shows the familiar association between GDPgoods and services per person in the United States rose to per capita and health expenditure per capita across OECDUSD 7 960 (Figure 7.1.1) – two and a half times the average countries. While there is an overall tendency for countriesof all OECD countries. The next highest spending countries, with higher GDP to spend a greater amount on health,Norway and Switzerland, spend only around two-thirds of there is wide variation since GDP is not the sole factorthe per capita level of the United States, but are still more influencing health expenditure levels. The association isthan 50% above the OECD average. Most of the northern stronger among countries with low GDP per capita thanand western European countries, together with Canada among OECD countries with a higher GDP per capita. Evenand Australia, spend between USD PPP 3 200 and 4 400, for countries with similar levels of GDP per capita there arebetween 100% and 130% of the OECD average. Those substantial differences in health expenditure at a givencountries spending below the OECD average include level of GDP. For example, despite Germany and FinlandMexico and Turkey, but also the southern and eastern having similar GDP per capita, their health spending perEuropean members of the OECD together with Korea. Japan capita differs considerably with Germany spending aroundalso spends less on health than the average in OECD 25% more than Finland. The United States spends muchcountries, despite its above-average per capita income. By more on health than what might be expected based only oncomparison the fast growing economies, China and India, its GDP level.spend less than 10% and 5% of the OECD average on health.Figure 7.1.1 also shows the breakdown of per capita spend-ing on health into public and private components (see alsoIndicator 7.5 “Financing of health care”). In general, theranking according to per capita public expenditure remainscomparable to that of total spending. Even if the private Definition and comparabilitysector in the United States continues to play the dominant Total expenditure on health measures the finalrole in financing, public spending on health per capita is still consumption of health goods and services (i.e. currentgreater than that in most other OECD countries (with the health expenditure) plus capital investment in healthexception of Norway, Luxembourg and the Netherlands), care infrastructure. This includes spending by bothbecause overall spending on health is much higher than in public and private sources on medical services andother countries. In Switzerland also, a large proportion of goods, public health and prevention programmes andhealth care financing comes from private sources, and its administration.public spending on health is lower than in certain othercountries, although overall spending is higher. The opposite Differing estimation methodologies for long-term careis true in Denmark where most health care is mostly spending, in particular the allocation of spendingfinanced through public sources. between health and social care, continue to limit the overall comparability of total health spending. SeePer capita health spending over 2000-09 is estimated to Indicators 7.3 “Health expenditure by function” and 8.8have grown, in real terms, by 4% annually on average across “Long-term care expenditure” for further details.the OECD (Figure 7.1.2 and Table A.6). In many countries,the growth rate reached a peak prior to 2004 and slowed in Countries’ health expenditures are converted to amore recent years. common currency (US dollar) and adjusted to take account of the different purchasing power of theIn general, the countries that have experienced the highest national currencies, in order to compare spendinggrowth in health expenditures per capita over this period levels. Economy-wide (GDP) PPPs are used as the mostare those that had relatively low levels at the beginning of available and reliable conversion rates.the period. Health expenditure growth in the SlovakRepublic and Korea, for example, has been more than twice Information on data for Israel: OECD average since 2000, resulting in a degree of 888932315602.convergence between OECD countries over time.148 HEALTH AT A GLANCE 2011: OECD INDICATORS © OECD 2011
  4. 4. 7. HEALTH EXPENDITURE AND FINANCING 7.1. Health expenditure per capita 7.1.1 Total health expenditure per capita, public and private, 2009 (or nearest year) Public expenditure on health Private expenditure on healthUSD PPP8 000 7 960 5 352 6 000 5 144 4 914 4 808 4 363 4 348 42 89 4 218 3 978 3 946 3 781 3 722 3 538 3 487 3 445 3 226 4 000 3 233 3 137 3 067 2 983 2 878 2 724 2 579 2 508 2 165 2 108 2 084 1 879 1 511 1 394 1 393 2 000 1 186 1 036 943 902 918 862 308 132 99 0 m ds 1 Ca rg 2 Ir e m 3 h ey a ec I gal Po r y d e il e do i a a Lu er l nd OE a Sl e c e a k pu l pu c M z il So Tu co Ch a Ko i c Hu r e a E s nd a Br n No tes Ne e y nm a Au r k rm a Fr ny lg e S w and i t e Ic en ng d Au dom Fi CD d Ne S ly Z e in Ja d Gr n r tu a ov e e in Re bli si it z wa De d Ge s tr i li Po eni ni Be c ric tio Ki n an an pa In In d Sl h R sr a bl It a w pa a a a ut rk an F e Ch ra ed i na a la th r l a d ela iu ne u to a ex xe a n ng e l nl al Af ra Sw r ov bo St st d i teUn n ia Cz Un ss Ru1. 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.Source: OECD Health Data 2011; WHO Global Health Expenditure Database. 1 2 Annual average growth rate in health expenditure 7.1.3 Total health expenditure per capita per capita in real terms, 2000-09 (or nearest year) and GDP per capita, 2009 (or nearest year) Luxembourg 0.7 Health spending per capita (USD PPP) Portugal 1.5 8 000 USA Israel 1.5 Italy 1.6 Iceland 1.6 Switzerland 2.0 7 000 Germany 2.0 France 2.2 Austria 2.2 Norway 2.4 Japan 2.4 6 000 Hungary 2.8 Australia 2.8 NOR Mexico 3.1 CHE LUX United States 3.3 5 000 NLD Denmark 3.3 Sweden 3.4 DNK CAN DEU AUT Canada 3.7 Slovenia 3.9 FRA BEL OECD 4.0 4 000 SWE IRL ISL Spain 4.0 GBR AUS ITA FIN Finland 4.0 ESP Belgium 4.0 NZL JPN Netherlands 4.4 3 000 GRC United Kingdom 4.8 PRT SVN New Zealand 4.8 CZE ISR Chile 5.2 SVK KOR Czech Republic 5.7 2 000 Ireland 6.1 HUN POL EST Turkey 6.3 CHL Greece 6.9 BRA RUS Poland 7.3 TUR ZAF MEX Estonia 7.5 1 000 Korea 8.6 IND CHN Slovak Republic 10.9 IDN 0 0 4 8 12 0 15 000 30 000 45 000 60 000 75 000 90 000 Annual average growth rate (%) GDP per capita (USD PPP)Source: OECD Health Data 2011. Source: OECD Health Data 2011; WHO Global Health Expenditure Database. 1 2 1 2 AT A GLANCE 2011: OECD INDICATORS © OECD 2011 149