multinational comparisons of health systems data, 2009 gerard f. anderson and patricia markovich...
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04/10/23
Multinational Comparisonsof Health Systems Data, 2009
Gerard F. Anderson and Patricia MarkovichJohns Hopkins University
November 2009
Support for this research was provided by The Commonwealth Fund. The views presented here are those of the authors and not necessarily those of The Commonwealth Fund or its directors, officers, or staff.
THECOMMONWEALTH
FUND
2International Comparison of Spending on Health, 1980–2007
0
1000
2000
3000
4000
5000
6000
7000
8000
19
80
19
81
19
82
19
83
19
84
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88
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90
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00
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01
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02
20
03
20
04
20
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06
20
07
U.S.NorwaySwitzerlandCanadaNetherlandsFranceGermanySwedenU.K.ItalyNew ZealandAustralia
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
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1993
1994
1995
1996
1997
1998
1999
2000
2001
2002
2003
2004
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2006
2007
U.S.FranceSwitzerlandGermanyCanadaNetherlandsNew ZealandSwedenNorwayItalyU.K.Australia
Total expenditures on healthas percent of GDP
Source: OECD Health Data 2009 (June 2009).
THECOMMONWEALTH
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3Average Annual Growth Rate of
Real Health Care Spending per Capita, 1997–2007
1.7
2.32.42.42.5
3.73.83.8
4.04.14.2
4.5
4.9
0.0
1.0
2.0
3.0
4.0
5.0
UK NZ NETH SWE OECDMedian
CAN AUS* US FR ITA NOR SWITZ GER
* 1996–2006Source: OECD Health Data 2009 (June 2009).
Percent
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4Out-of-Pocket Health Care Spending per Capita, 2007
Adjusted for Differences in Cost of Living
213246
343351
470485528542571580
720
890
1,350
0
200
400
600
800
1,000
1,200
1,400
SWITZ US NOR CAN AUS* ITA SWE OECDMedian
GER NZ UK FR NETH
* 2006Source: OECD Health Data 2009 (June 2009).
Dollars
THECOMMONWEALTH
FUND
5Health Care Expenditure per Capita by Source of Funding, 2007
Adjusted for Differences in Cost of Living
3,3074,005
2,618 2,726 2,844 2,7582,124
2,4462,056
3,092
449589 510
360
441
890
720
1,350 580 246 470528
571
542
2,716
38
88
20479 343
0
1,000
2,000
3,000
4,000
5,000
6,000
7,000
8,000
US NOR SWITZ CAN FR GER SWE AUS* UK ITA
Out-of-pocket spending
Private spending
Public spending
* 2006Source: OECD Health Data 2009 (June 2009).
Dollars
THECOMMONWEALTH
FUND
6Hospital Spending per Discharge, 2007
Adjusted for Differences in Cost of Living
17,206
12,163 11,988
9,398 9,131 9,026
7,312 7,312 7,295
4,667 4,527
0
2,000
4,000
6,000
8,000
10,000
12,000
14,000
16,000
18,000
US* CAN* NETH SWITZ NOR* SWE NZ OECDMedian
AUS* FR GER
* 2006Source: OECD Health Data 2009 (June 2009).
Dollars
THECOMMONWEALTH
FUND
7Hospital Discharges per 1,000 Population, 2007
84
109
126126135139
162163165166172
227
274
0
50
100
150
200
250
300
FR GER NOR SWITZ SWE OECDMedian
AUS* ITA* NZ US* UK NETH CAN*
* 2006Source: OECD Health Data 2009 (June 2009).
THECOMMONWEALTH
FUND
8Average Length of Hospital Stay for Acute Myocardial Infarction, 2007
4.64.85.4
6.26.46.8
7.17.1
7.98.0
8.9
11.0
0
2
4
6
8
10
12
GER UK ITA* SWITZ NETH OECDMedian
CAN* FR AUS* US* SWE NOR
* 2006Source: OECD Health Data 2009 (June 2009).
Days
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9Average Annual Number of Physician Visits per Capita, 2007
7.57.0
6.3 6.3 6.3
5.8 5.7
5.04.7
4.03.8
2.8
0
1
2
3
4
5
6
7
8
GER ITA** AUS FR OECDMedian
CAN* NETH UK NZ SWITZ US* SWE*
* 2006 ** 2005Source: OECD Health Data 2009 (June 2009).
THECOMMONWEALTH
FUND
10Number of Practicing Physicians per 1,000 Population, 2007
2.2
3.9 3.9 3.93.7
3.63.5
3.43.2
2.8
2.52.4
2.3
0
1
2
3
4
NETH NOR SWITZ ITA SWE* GER FR OECDMedian
AUS* UK US NZ CAN
* 2006Source: OECD Health Data 2009 (June 2009).
THECOMMONWEALTH
FUND
11Pharmaceutical Spending per Capita, 2007
Adjusted for Differences in Cost of Living
$241
$381$422$431$446$446$454
$518$542
$588
$691
$878
0
100
200
300
400
500
600
700
800
900
US CAN FR GER ITA SWITZ SWE OECDMedian
AUS* NETH NOR NZ
* 2006Source: OECD Health Data 2009 (June 2009).
Dollars
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FUND
12Drug Prices for 30 Most Commonly Prescribed Drugs, 2006–07
US is set at 1.0
0.34
0.440.450.490.51
0.63
0.760.77
1.00
0.0
0.2
0.4
0.6
0.8
1.0
US CAN GER SWITZ UK AUS NETH FR NZ
Source: IMS Health.
THECOMMONWEALTH
FUND
13Drug Prices for 30 Most Commonly Prescribed Drugs, 2006–07,
Brand-Name and GenericUS is set at 1.0
Source: IMS Health.
AUS CAN FR GER NETH NZ SWITZ UK US
Brand-Name Drugs
0.40 0.64 0.32 0.43 0.39 0.33 0.51 0.46 1.00
Generic Drugs 2.57 1.78 2.85 3.99 1.96 0.90 3.11 1.75 1.00
THECOMMONWEALTH
FUND
14Drug Prices: Lipitor (atorvastatin), 2006–07
Price for one dose
$0.71
$1.01
$1.35$1.45$1.45$1.46$1.52
$1.83
$2.82
$0
$1
$2
$3
US CAN SWITZ AUS UK NETH GER FR NZ
Source: IMS Health.
Dollars
THECOMMONWEALTH
FUND
15Drug Prices: Nexium (esomeprazole), 2006–07
Price for one dose
$0.88$1.02
$1.22$1.28$1.32
$1.97$2.15
$3.91
$0
$1
$2
$3
$4
US SWITZ CAN UK NETH FR AUS GER
Source: IMS Health.
Dollars
THECOMMONWEALTH
FUND
16Magnetic Resonance Imaging (MRI) Machines
per Million Population, 2007
25.9
18.6
14.4
8.8 8.5 8.2 8.26.7 6.6
5.75.1
0
10
20
30
US ITA SWITZ NZ OECDMedian
GER UK CAN NETH** FR AUS
** 2005Source: OECD Health Data 2009 (June 2009).
THECOMMONWEALTH
FUND
17MRI Scan and Imaging Fees, 2009
1,200
839 824
567
436
179
0
200
400
600
800
1,000
1,200
1,400
US GER CAN NETH FR UK
Source: International Federation of Health Plans, 2009 Comparative Price Report.
Dollars
THECOMMONWEALTH
FUND
18Volume 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
THECOMMONWEALTH
FUND
19Cost 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 ReplacementsDollars
THECOMMONWEALTH
FUND
20Coronary Bypass Procedures per 100,000 Population, 2007
3132
132
8581
77 7673 73
59 58 56
45
0
25
50
75
100
125
150
GER US* NOR* NZ AUS* ITA* CAN* OECDMedian
NETH SWE UK FR SWITZ
* 2006Source: OECD Health Data 2009 (June 2009).
THECOMMONWEALTH
FUND
21Percentage of Population over Age 65
with Influenza Immunization, 2007
77.5 77.073.5
69.066.7
64.9 64.3 63.7
58.956.0 56.0
0
10
20
30
40
50
60
70
80
AUS* NETH UK FR US ITA CAN NZ OECDMedian
GER SWITZ
* 2006
a
Source: OECD Health Data 2009 (June 2009).
Percent
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FUND
22Percentage of Adults Who Report Being Daily Smokers, 2007
1515
29
25
2322 22 22
21 20
18 1817
0
5
10
15
20
25
30
NETH FR* GER** ITA OECDMedian
NOR UK SWITZ CAN NZ AUS US SWE*
* 2006** 2005Source: OECD Health Data 2009 (June 2009).
Percent
THECOMMONWEALTH
FUND
23
34.3
26.5
24.0
15.413.6
11.2 10.5 10.2 9.99.0
8.1
0
5
10
15
20
25
30
35
US* NZ UK CAN GER** NETH FR* SWE ITA NOR SWITZ
Obesity (BMI>30) Prevalence Among Adult Population, 2007
* 2006** 2005Note: BMI = body mass index. For most countries, BMI estimates are based on national health interview surveys (self-reported data). However, the estimates for the US, UK, and New Zealand are based on actual measurements of weight and height, and estimates based on actual measurements are usually significantly higher than those based on self-report.
Source: OECD Health Data 2009 (June 2009).
Percent
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FUND
24Life Expectancy at Birth, 2007
81.1 80.782.282.382.382.482.983.083.083.784.084.284.4
78.2 77.1 75.477.278.077.278.278.978.479.078.479.277.5
0
10
20
30
40
50
60
70
80
90
FR SWITZ* ITA* AUS CAN* SWE NOR* GER* NETH OECDMedian
NZ UK** US*
Female Male
* 2006** 2005Source: OECD Health Data 2009 (June 2009).
Years
THECOMMONWEALTH
FUND
25Potential Years of Life Lost Because of Diabetes
per 100,000 Population, 2007
19
2529313335363637
64
99
0
20
40
60
80
100
US** NZ** NOR* SWE* OECDMedian
GER* NETH ITA* FR* UK SWITZ*
* 2006** 2005Source: OECD Health Data 2009 (June 2009).
THECOMMONWEALTH
FUND
26Mortality Amenable to Health Care
Deaths per 100,000 population*
* Countries’ age-standardized death rates before age 75; includes ischemic heart disease, diabetes, stroke, and bacterial infections.Data: E. Nolte and C. M. McKee, “Measuring the Health of Nations: Updating an Earlier Analysis,” Health Affairs, Jan./Feb. 2008 27(1):58–71.Source: Commonwealth Fund National Scorecard on U.S. Health System Performance, 2008.
7681
88 8489 89
99 9788
97
109 106116 115 113
130134
128
115
65 71 71 74 77 80 82 82 84 84 90 93 96104103103101
110
74
0
50
100
150
Fra
nce
Japan
Austr
alia
Spain
Italy
Canada
Norw
ay
Neth
erlands
Sw
eden
Gre
ece
Austr
ia
Germ
any
Fin
land
New
Zeala
nd
Denm
ark
United K
ingdom
Irela
nd
Port
ugal
United S
tate
s
1997–98 2002–03