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Health spending, delivery, and outcomes in OECD countries
G J Schieber1, J P Poullier, L M Greenwald
1Organization for Economic Cooperation and Development (OECD), Paris, France.
Health Affairs (Project Hope)
|January 1, 1993
Summary
The United States spends significantly more on healthcare than other industrialized nations, both per person and as a percentage of GDP. Despite higher spending, U.S. healthcare system performance does not appear superior.
Area of Science:
- Health Economics
- Comparative Healthcare Systems
- Public Health Policy
Background:
- The United States exhibits the highest national health expenditures globally, both in absolute terms and as a proportion of Gross Domestic Product (GDP).
- International comparisons reveal substantial disparities in per capita healthcare spending between the U.S. and other developed nations.
- Previous analyses have not conclusively demonstrated a commensurate improvement in health outcomes or system efficiency to justify the elevated U.S. healthcare expenditure.
Purpose of the Study:
- To compare health expenditures across twenty-four industrialized nations.
- To analyze the relationship between national health spending and healthcare system performance indicators.
Main Methods:
- Comparative analysis of national health expenditure data from industrialized countries.
- Examination of per capita spending and healthcare spending as a percentage of GDP.
- Evaluation of health care utilization and health status metrics.
Main Results:
- In 1991, the U.S. spent $2,868 per person on healthcare, far exceeding the average of $1,305 in Organization for Economic Cooperation and Development (OECD) countries.
- U.S. healthcare spending represented a larger percentage of GDP compared to all other industrialized nations studied.
- The U.S. spent 50% more per capita than Canada, the next highest spending country.
- Data on healthcare use and health status did not support the notion of a superior U.S. healthcare system.
Conclusions:
- The United States incurs the highest healthcare costs among industrialized nations without clear evidence of superior health outcomes or system efficiency.
- Significant financial resources are allocated to the U.S. healthcare system, yet comparative health status indicators do not reflect a commensurate benefit.
- Further research is warranted to understand the drivers of high U.S. healthcare spending and to identify opportunities for improving value in healthcare delivery.
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