Multinational Comparisons of Health Systems Data, 2014

Multinational Comparisons of Health Systems Data, 2014

Chloe Anderson The Commonwealth Fund

November 2014

2

Health Care Spending

0

1000

2000

3000

4000

5000

6000

7000

8000

9000

1980 1984 1988 1992 1996 2000 2004 2008 2012

US ($8,745)

NOR ($6,140)

SWIZ ($6,080)

NETH ($5,219)*

GER ($4,811)

DEN ($4,698)

CAN ($4,602)

FR ($4,288)

SWE ($4,106)

AUS ($3,997)*

JPN ($3,649)

UK ($3,289)

NZ ($3,172)*

Source: OECD Health Data 2014.

Average Health Care Spending per Capita, 1980–2012 Adjusted for Differences in Cost of Living

3

Dollars ($US)

* 2011.

0

2

4

6

8

10

12

14

16

18

1980 1983 1986 1989 1992 1995 1998 2001 2004 2007 2010

US (16.9%)

NETH (12.1%)*

FR (11.6%)

SWIZ (11.4%)

GER (11.3%)

DEN (11.0%)

CAN (10.9%)

JPN (10.3%)

NZ (10.0%)*

SWE (9.6%)

NOR (9.3%)

UK (9.3%)

AUS (9.1%)*

GDP refers to gross domestic product. Source: OECD Health Data 2014.

Health Care Spending as a Percentage of GDP, 1980–2012

Percent

* 2011.

4

5 Health Care Spending per Capita by Source of Funding, 2012 Adjusted for Differences in Cost of Living

4,160 4,001 3,691 4,029 3,224 3,317 3,336

2,733 2,762 2,623

3,540

497 493 85

688 651 92 533 230 202

1,045

1,582

627 584 690 320 678 731

297 347

0

1,000

2,000

3,000

4,000

5,000

6,000

7,000

8,000

9,000

US SWIZ GER DEN CAN FR SWE AUS* UK NZ*

Out-of-pocket spendingPrivate spendingPublic spending

* 2011.

Dollars ($US)


8,745

6,080

4,811 4,698 4,602 4,288 4,106 3,997

3,289 3,172

Spending per Hospital Discharge, 2012 Adjusted for Differences in Cost of Living

5,586 7,147

8,434 8,785 9,346 9,975 11,363 11,472

13,540 14,832

15,754

20,932

0

4,000

8,000

12,000

16,000

20,000

24,000

GER OECDMedian

NZ* FR AUS* SWE** NOR** DEN** SWIZ NETH CAN* US**

Dollars ($US)

6

* 2011. ** 2010. Source: OECD Health Data 2014.

7 Pharmaceutical Spending per Capita, 2012 Adjusted for Differences in Cost of Living

295 297

414 450 478 512 562 588

651 668 718

771

1,010

0

100

200

300

400

500

600

700

800

900

1,000

1,100

DEN NZ* NOR NETH SWE OECDMedian

SWIZ AUS* FR GER JPN* CAN* US

* 2011. Source: OECD Health Data 2014.

Dollars ($US)

36 54 60 77 98 127 147

200 249 250 267

631

0

100

200

300

400

500

600

700

NOR JPN* SWE AUS* DEN NZ* CAN* NETH GER FR SWIZ US

Spending on Health Insurance Administration per Capita, 2012 Adjusted for Differences in Cost of Living


Dollars ($US)

* 2011.

8

9

Health Care Supply and Utilization

Number of Practicing Physicians per 1,000 Population, 2012

4.2 4.0 3.9 3.9

3.3 3.1 3.1

2.8 2.7 2.5 2.5 2.3

0

1

2

3

4

5

NOR GER SWE* SWIZ AUS OECDMedian

FR UK NZ CAN US* JPN


10

* 2011.

11 Magnetic Resonance Imaging (MRI) Machines per Million Population, 2012

46.9

34.5

15.0 11.8 11.1

8.8 8.7 6.8

0

10

20

30

40

50

JPN* US AUS NETH NZ CAN FR UK


Hospital Discharges per 1,000 Population, 2012

83

111 119 125 142 148

163 163 166 168 172 173 175

251

0

50

100

150

200

250

300

CAN* JPN* NETH US** UK* NZ SWE** OECDMedian

SWIZ FR DEN** AUS* NOR** GER


12

13 Average Annual Number of Physician Visits per Capita, 2012

13.0

9.7

7.9 6.9 6.7 6.7

6.2

4.7 4.4 4.0 3.7

0

2

4

6

8

10

12

14

JPN* GER CAN* AUS FR OECDMedian

NETH DEN NOR US** NZ


14 Hip Replacement Inpatient Cases per 100,000 Population, 2012

130.0 144.6

171.9 176.9 203.5

215.7 223.1 230.3 236.9 250.0

287.3 307.0

0

50

100

150

200

250

300

350

CAN* NZ*** OECDMedian

UK*** US** NETH** DEN FR SWE NOR GER SWIZ

* 2011. ** 2010. *** Data from publicly-funded hospitals only. Source: OECD Health Data 2014.

15

Health Promotion and Disease Prevention

Cervical Cancer Screening Rates, 2012

85.0 78.3 77.2 75.9 73.4 71.1

64.9 64.2 57.3

37.7

0

20

40

60

80

100

US* UK NZ NOR CAN FR* NETH DEN AUS JPN*

Percent of women screened

Note: UK, NZ, NOR, DEN, and AUS based on program data; all other countries based on survey data. * 2010. Source: OECD Health Data 2014.

16

Flu Immunization Among Adults Age 65 or Older, 2012

75.5

66.9 64.3 64.1

53.1 51.6 50.0 46.0 43.1

11.4

0

20

40

60

80

100

UK US* NZ CAN FR OECDMedian

JPN SWIZ** DEN NOR

Percent


17

18 Adults Who Report Being Daily Smokers, 2012

13.1 14.2 15.1 16.0 16.1 16.5 18.4 19.1 19.1 20.4 20.7 20.9

24.1

0

10

20

30

40

SWE US AUS** NOR CAN NZ NETH UK* OECDMedian

SWIZ JPN DEN** FR

Percent


* 2011. ** 2010.

19

Quality and Patient Safety

Mortality Amenable to Health Care

Deaths per 100,000 population*

* Countries’ age-standardized death rates before age 75; including ischemic heart disease, diabetes, stroke, and bacterial infections. Analysis of World Health Organization mortality files and CDC mortality data for U.S. Source: Adapted from E. Nolte and M. McKee, “Variations in Amenable Mortality—Trends in 16 High-Income Nations,” Health Policy, published online Sept. 12, 2011.

20

Breast Cancer Five-Year Relative Survival Rate, 2007–2012 (or nearest period)

88.7 87.7 87.7 87.4 87.3 86.4 86.1 85.9 85.0 82.0 82.0

0

20

40

60

80

100

US AUS CAN SWE JPN NZ NOR NETH GER DEN UK


Percent

21

Note: UK and SWE data are from 2007–2012; NZ, NOR, NET, and DEN data are from 2006–2011; AUS data are from 2005–2010; US and GER data are from 2004–2009; CAN data are from 2003–2008; JPN data are from 2000–2005.

* 2012. ** 2010. *** 2009. Source: OECD Health Data 2014.

3.3 4.6 5.1 6.7 7.1 7.1

8.7 9.0 10.0 13.5

17.1 18.4 19.2

0

10

20

30

40

SWE AUS* UK NZ FR SWIZ** NOR OECDMedian

CAN NETH** US** GER DEN***

Diabetes Lower Extremity Amputation Rates per 100,000 Population, 2011

22

23

Prices

Total Hospital and Physician Costs, 2013

4,995 5,177

6,645

9,845

13,910

0

2,000

4,000

6,000

8,000

10,000

12,000

14,000

16,000

NETH AUS NZ SWIZ US

Dollars ($US)

24

Appendectomy

15,742

36,509 40,368 42,130

75,345

0

10,000

20,000

30,000

40,000

50,000

60,000

70,000

80,000

NETH SWIZ NZ AUS US

Bypass Surgery

Notes: US refers to the commercial average. Appendectomy prices reflect a blend of inpatient and outpatient prices based on relative utilization in each setting. Source: International Federation of Health Plans, 2013 Comparative Price Report.

Dollars ($US)

Diagnostic Imaging Prices, 2013

138

350

461

1,005

1,145

0

200

400

600

800

1,000

1,200

1,400

SWIZ AUS NETH NZ US

Notes: US refers to the commercial average. MRI refers to magnetic resonance imaging; CT refers to computed tomography. Source: International Federation of Health Plans, 2013 Comparative Price Report.

25

MRI

97

279

432 500

731

896

0

200

400

600

800

1,000

CAN NETH SWIZ AUS NZ US

CT Scan (abdomen) Dollars ($US) Dollars ($US)

26

Long-Term Care and Social Supports


13.7 13.8 14.2 14.9 15.3 16.2 16.5 16.7 17.1 17.3 17.3 18.7

21.0

24.1

0

10

20

30

US NZ AUS CAN NOR NETH OECDMedian

UK SWIZ DEN FR SWE GER JPN

Percent of Population Age 65 or Older, 2012 27

Percent


72.2 68.5 65.5

59.0 56.8 54.3 52.0 51.6 51.1 48.7

40.2

25.0

0

10

20

30

40

50

60

70

80

SWE SWIZ NETH NZ FR NOR GER* OECDMedian

UK DEN* US* JPN

Beds in Residential Long-Term Care Facilities per 100,000 Population Age 65 or Older, 2012

28

Note: Long-term care facilities include nursing and residential care facilities that provide accommodation and long-term care services. The data used in this measure vary across countries—such as the inclusion of private institutions (in addition to public institutions), psychiatric hospital units, substance abuse treatment centers, and rehabilitation centers—and different countries may have different types or a different mix of facilities. Thus, caution is in order in interpreting cross-national differences.

Source: E. H. Bradley, L. A. Taylor, and H. V. Fineberg, The American Health Care Paradox: Why Spending More is Getting Us Less, Public Affairs, 2013.

Health and Social Care Spending Percent of GDP

12 12 11 11 12 16

9 8 9 10 9

21 21 20 18 15

9

16 15 11 10 11

0

10

20

30

40

FR SWE SWIZ GER NETH US NOR UK NZ CAN AUS

Health care Social care

Percent

29

Multinational Comparisons of Health Systems Data, 2014

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