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Multinational Comparisonsof Health Systems Data, 2010

Gerard F. Anderson and Patricia MarkovichJohns Hopkins University

November 2010

Support for this research was provided by The Commonwealth Fund.

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Total Health Care Spending

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3Health Care Spending per Capita, 2008

Adjusted for Differences in Cost of Living

* 2007.

Source: OECD Health Data 2010 (Oct. 2010).

Dollars

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0

1000

2000

3000

4000

5000

6000

7000

8000

19

80

19

81

19

82

19

83

19

84

19

85

19

86

19

87

19

88

19

89

19

90

19

91

19

92

19

93

19

94

19

95

19

96

19

97

19

98

19

99

20

00

20

01

20

02

20

03

20

04

20

05

20

06

20

07

20

08

USNORSWIZCANNETHGERFRDENSWEAUSUKNZ

Average spending on healthper capita ($US PPP)

0

2

4

6

8

10

12

14

16

1980

1981

1982

1983

1984

1985

1986

1987

1988

1989

1990

1991

1992

1993

1994

1995

1996

1997

1998

1999

2000

2001

2002

2003

2004

2005

2006

2007

2008

USFRSWIZGERCANNETHNZDENSWEUKNORAUS

Total expenditures on healthas percent of GDP

Source: OECD Health Data 2010 (Oct. 2010).

International Comparison of Spending on Health, 1980–2008

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5Average Annual Growth Rate of

Real Health Care Spending per Capita, 1998–2008

* 1997–2007.

Source: OECD Health Data 2010 (Oct. 2010).

Percent

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6Percentage of Gross Domestic Product Spent on Health Care,

1998 and 2008

* 2007.

Source: OECD Health Data 2010 (Oct. 2010).

Percent

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7Percentage of Population with Health Insurance Coverage

Through Public Programs, 2008

* 2007.

Source: OECD Health Data 2010 (Oct. 2010).

Percent

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8Public Spending on Health Care per Capita, 2008

Adjusted for Differences in Cost of Living

* 2007.

Source: OECD Health Data 2010 (Oct. 2010).

Dollars

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9Private Spending on Health Care per Capita, 2008

Excluding Out-of-Pocket Spending, Adjusted for Differences in the Cost of Living

* 2007.

Source: OECD Health Data 2010 (Oct. 2010).

Dollars

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10Out-of-Pocket Health Care Spending per Capita, 2008

Adjusted for Differences in Cost of Living

* 2007.

Source: OECD Health Data 2010 (Oct. 2010).

Dollars

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11Health Care Expenditure per Capita by Source of Funding, 2008

Adjusted for Differences in Cost of Living

* 2007.

Source: OECD Health Data 2010 (Oct. 2010).

Dollars

7,538

4,0793,737 3,696 3,540 3,470 3,353

3,129

2,683

5,0034,627

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Hospitals

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13Percentage of Total Health Care Spending

on Hospital Services, 1998 and 2008

* 2007.** 2006.

Source: OECD Health Data 2010 (Oct. 2010).

Percent

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14Spending on Hospital Services per Capita, 2008

Adjusted for Differences in Cost of Living

1,0041,061

1,1161,116

1,2591,2631,378

1,5451,5671,5671,613

2,359

0

500

1,000

1,500

2,000

2,500

US NOR** SWIZ* DEN* SWE NETH AUS* FR OECDMedian

CAN GER NZ

* 2007.

Source: OECD Health Data 2010 (Oct. 2010).

Dollars

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15Hospital Spending per Discharge, 2008

Adjusted for Differences in Cost of Living

* 2007. ** 2006.

Source: OECD Health Data 2010 (Oct. 2010).

Dollars

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16Hospital Discharges per 1,000 Population, 2008

Source: OECD Health Data 2010 (Oct. 2010).

* 2007. ** 2006.

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17Average Length of Stay for Acute Care, 2008

Days

Source: OECD Health Data 2010 (Oct. 2010).

* 2007. ** 2006.

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18Average Length of Hospital Stay for Acute Myocardial Infarction, 2008

Days

Source: OECD Health Data 2010 (Oct. 2010).

* 2007. ** 2006.

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19Average Length of Stay for Normal Birth Delivery, 2008

Days

Source: OECD Health Data 2010 (Oct. 2010).

* 2007. ** 2006.

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20Average Annual Hospital Inpatient Acute Care Days per Capita, 2008

Source: OECD Health Data 2010 (Oct. 2010).

* 2007. ** 2006.

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21Number of Acute Care Hospital Beds

per 1,000 Population, 2008

Source: OECD Health Data 2010 (Oct. 2010).

* 2007. ** 2006.

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Home Health and Long-Term Care

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23Percentage of Total Health Care Spending on Long-Term Nursing Care, 1998 and 2008

* 2007.

Source: OECD Health Data 2010 (Oct. 2010).

Percent

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24Long-Term Nursing Care Spending per Capita, 2008

Adjusted for Differences in Cost of Living

* 2007.

Source: OECD Health Data 2010 (Oct. 2010).

1,276

574

724

445

868

455407

261

382

506

Dollars

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25Home Health Care Spending per Capita, 2008

Adjusted for Differences in Cost of Living

8998104

139

212226

278

451

477

0

100

200

300

400

500

NOR DEN* NZ GER US SWE FR SWIZ* CAN

* 2007.

Source: OECD Health Data 2010 (Oct. 2010).

Dollars

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26Long-Term Care Beds in Nursing Homes

per 1,000 Population Age 65 and Older, 1998 and 2008

* 2007.

Source: OECD Health Data 2010 (Oct. 2010).

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Health Care Professionals

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28Number of Practicing Physicians per 1,000 Population, 2008

Source: OECD Health Data 2010 (Oct. 2010).

* 2007.** 2006.

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29Average Annual Growth Rate of Practicing Physicians

per 1,000 Population, 1998–2008

* 1997–2007.** 1996–2006.Source: OECD Health Data 2010 (Oct. 2010).

Percent

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30Average Annual Number of Physician Visits per Capita, 2008

Source: OECD Health Data 2010 (Oct. 2010).

* 2007. ** 2006.

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31Number of Professionally Active Nurses

per 1,000 Population, 2008

Source: OECD Health Data 2010 (Oct. 2010).

* 2007.

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Pharmaceuticals

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33Percentage of Total Health Care Spending

on Pharmaceuticals, 1998 and 2008

* 2007.

Source: OECD Health Data 2010 (Oct. 2010).

Percent

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34Pharmaceutical Spending per Capita, 2008

Adjusted for Differences in Cost of Living

257303

368381

457461465480

563607

701

897

0

200

400

600

800

1,000

US CAN FR GER AUS* OECDMedian

SWIZ* SWE NOR UK DEN* NZ

* 2007.

Source: OECD Health Data 2010 (Oct. 2010).

Dollars

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35Drug Prices for 30 Most Commonly Prescribed Drugs, 2006–07

US is set at 1.0

Source: IMS Health.

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Medical Procedures Involving Sophisticated Technology

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37Magnetic Resonance Imaging (MRI) Machines

per Million Population, 2008

Source: OECD Health Data 2010 (Oct. 2010).

* 2007.

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38Magnetic Resonance Imaging (MRI) Exams

per 1,000 Population, 2008

Source: OECD Health Data 2010 (Oct. 2010).

* 2007. ** 2006.

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39MRI Scan and Imaging Fees, 2009

500

1,200

839 824

567

436

179

0

200

400

600

800

1,000

1,200

1,400

1,600

US Medicare US GER CAN NETH FR UK

Source: International Federation of Health Plans, 2009 Comparative Price Report.

Dollars

1,500

US average

US high-end

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40Computer Tomography (CT) Scanners

per Million Population, 2008

Source: OECD Health Data 2010 (Oct. 2010).

* 2007. ** 2006.

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41Computer Tomography (CT) Exams

per 1,000 Population, 2008

Source: OECD Health Data 2010 (Oct. 2010).

* 2007.

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42Volume of Knee and Hip Implants, 2004

Implants per 100,000

164

137

121

95

65

0

50

100

150

200

US UK GER FR ITA

Source: McKinsey & Company, Accounting for the Cost of Health Care in the United States, 2007.

258

208197

141 139

0

50

100

150

200

250

300

GER FR UK ITA US

Knee Replacements Hip Replacements

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43Cost of Knee and Hip Prostheses to Providers, 2004

GDP Adjusted, US $

4,866

3,035

2,5612,390

2,239

0

1,000

2,000

3,000

4,000

5,000

6,000

US ITA FR UK GER

Source: McKinsey & Company, Accounting for the Cost of Health Care in the United States, 2007.

$4,821

$1,537$1,380

$1,168 $1,165

US ITA UK GER FR

Knee Replacements Hip Replacements

Dollars

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44Percutaneous Transluminal Coronary Angioplasty (PTCA) Interventions

per 100,000 Population, 2008

* 2007.** 2006.

Source: OECD Health Data 2010 (Oct. 2010).

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45Coronary Bypass Procedures per 100,000 Population, 2008

* 2007.** 2006.

Source: OECD Health Data 2010 (Oct. 2010).

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46Number of Knee Replacements per 100,000 Population, 2008

* 2007.** 2006.

Source: OECD Health Data 2010 (Oct. 2010).

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47Number of Patients Undergoing Dialysis Treatment

per 100,000 Population, 2008

* 2007.** 2006.

Source: OECD Health Data 2010 (Oct. 2010).

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Public Health and Prevention

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49Breast Cancer Screening, 2008

Percentage of Women Ages 50–69 Receiving a Mammogram

* 2007.** 2006.

Survey Organized Program

Source: OECD Health Data 2010 (Oct. 2010).

Percent

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50Cervical Cancer Screening, 2000 to 2006 (or closest year)

Percentage of Women Ages 20–69

* 2007.** 2006.

Survey Organized Program

Source: OECD Health Care Quality Indicators Data 2009.

Percent

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51Percentage of Population over Age 65

with Influenza Immunization, 2008

* 2007.** 2006.

Source: OECD Health Data 2010 (Oct. 2010).

Percent

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52Diphtheria, Tetanus, and Pertussis Vaccination Rates Among Children Age 2, 2007 (or latest year available)

Source: OECD Health Data 2010 (Oct. 2010).

Percent

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53Measles Vaccination Rates Among Children Age 2, 2007

(or latest year available)

Source: OECD Health Data 2010 (Oct. 2010).

* 2007.

Percent

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54Percentage of Adults Who Report Being

Daily Smokers, 2008

* 2007.

Source: OECD Health Data 2010 (Oct. 2010).

Percent

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55Twenty-Year Change in Smoking Rates,

1988–2008

* 1987–2007.** 1986–2007.

Source: OECD Health Data 2010 (Oct. 2010).

Percent

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56Annual Alcohol Consumption in Liters per Capita

Among People Age 15 and Older, 2008

* 2007.

Source: OECD Health Data 2010 (Oct. 2010).

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57Obesity (BMI>30) Prevalence Among Adult Population, 2008

* 2007.

Source: OECD Health Data 2010 (Oct. 2010).

Measured Self-ReportedPercent

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Mortality

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59Life Expectancy at Birth, 2008

* 2007.

Source: OECD Health Data 2010 (Oct. 2010).

Years

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60Life Expectancy at Age 65, 2008

* 2007.** 2006.

Source: OECD Health Data 2010 (Oct. 2010).

Years

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61Increase in Life Expectancy at Birth, 1988–2008

* 1987–2007.

Source: OECD Health Data 2010 (Oct. 2010).

Years

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62Increase in Life Expectancy at Age 65, 1988–2008

* 1987–2007.** 1996–2006.

Source: OECD Health Data 2010 (Oct. 2010).

Years

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63Acute Myocardial Infarction Deaths

per 100,000 Population, 2008

* 2007.** 2006.

Source: OECD Health Data 2010 (Oct. 2010).

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64Bronchitis, Asthma, and Emphysema Deaths

per 100,000 Population, 2008

* 2007.** 2006.

Source: OECD Health Data 2010 (Oct. 2010).

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65Potential Years of Life Lost Due to Malignant Neoplasms

per 100,000 Population, 2008

* 2007.** 2006.

Source: OECD Health Data 2010 (Oct. 2010).

Years

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66Potential Years of Life Lost Due to Diseases of the Circulatory System

per 100,000 Population, 2008

* 2007.** 2006.

Source: OECD Health Data 2010 (Oct. 2010).

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67Potential Years of Life Lost Due to Diabetes

per 100,000 Population, 2008

* 2007.** 2006.

Source: OECD Health Data 2010 (Oct. 2010).

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68Potential Years of Life Lost Due to Diseases of the Respiratory System

per 100,000 Population, 2008

* 2007.** 2006.

Source: OECD Health Data 2010 (Oct. 2010).

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2009 OECD Quality Indicators

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70Asthma Admission Rates per 100,000 Population

Age 15 and Older, 2007

* 2006.** 2005.*** Among countries shown.

Source: OECD Health Care Quality Indicators Data 2009.

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71Chronic Obstructive Pulmonary Disease Admission Rates

per 100,000 Population Age 15 and Older, 2007

* 2006.** 2005.*** Among countries shown.

Source: OECD Health Care Quality Indicators Data 2009.

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72Diabetes Acute Complications Admission Rates per 100,000 Population

Age 15 and Older, 2007

* 2006.** 2005.*** Among countries shown.

Source: OECD Health Care Quality Indicators Data 2009.

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Congestive Heart Failure Admission Rates per 100,000 Population Age 15 and Older, 2007

* 2006.** 2005.*** Among countries shown.

Source: OECD Health Care Quality Indicators Data 2009.

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Hypertension Admission Rates per 100,000 Population Age 15 and Older, 2007

* 2006.** 2005.*** Among countries shown.

Source: OECD Health Care Quality Indicators Data 2009.

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Diabetes Lower Extremity Amputation Rates per 100,000 Population Age 15 and Older, 2007*

* 2006.** 2005.*** Among countries shown.

Source: OECD Health Care Quality Indicators Data 2009.

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76Mortality After Admission for Acute Myocardial Infarction*

per 100 Patients, 2007

* In-hospital case-fatality rates within 30 days of admission.** 2006.*** 2005.**** Among countries shown.

Source: OECD Health Care Quality Indicators Data 2009.

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77Mortality After Admission for Ischemic Stroke* per 100 Patients, 2007

* In-hospital case-fatality rates within 30 days of admission.** 2006.*** Among countries shown.

Source: OECD Health Care Quality Indicators Data 2009.

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Mortality After Admission for Hemorrhagic Stroke* per 100 Patients, 2007

* In-hospital case-fatality rates within 30 days of admission.** 2006.*** 2005.**** Among countries shown.

Source: OECD Health Care Quality Indicators Data 2009.

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79Breast Cancer Five-Year Relative Survival Rate,

1997–2002 and 2002–2007 (or nearest period)

Source: OECD Health Care Quality Indicators Data 2009.

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80Cervical Cancer Five-Year Relative Survival Rate,

1997–2002 and 2002–2007 (or nearest period)

Source: OECD Health Care Quality Indicators Data 2009.

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81 Colorectal Cancer Five-Year Survival Rate,

Latest Available Period

Source: OECD Health Care Quality Indicators Data 2009.