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Multinational Comparisons of Health Systems Data, 2011. David Squires The Commonwealth Fund November 2011. Health Care Spending and Coverage. THE COMMONWEALTH FUND. Average Health Care Spending per Capita , 1980–2009 Adjusted for differences in cost of living. Dollars. THE - PowerPoint PPT Presentation
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THE COMMONWEALTH
FUND
Multinational Comparisonsof Health Systems Data, 2011
David SquiresThe Commonwealth Fund
November 2011
2
Health Care Spending and Coverage
THECOMMONWEALTH
FUND
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
2009
0
1000
2000
3000
4000
5000
6000
7000
8000 US
NOR
SWIZ
NETH
CAN
DEN
GER
FR
SWE
UK
AUS
NZ
JPN
Source: OECD Health Data 2011 (June 2011).
Average Health Care Spending per Capita, 1980–2009Adjusted for differences in cost of living
3
Dollars
THECOMMONWEALTH
FUND
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
2009
0
2
4
6
8
10
12
14
16
18US
NETH
FR
GER
DEN
CAN
SWIZ
NZ
SWE
UK
NOR
AUS
JPN
GDP refers to gross domestic product.Source: OECD Health Data 2011 (June 2011).
Health Care Spending as a Percentage of GDP, 1980–20094
Percent
THECOMMONWEALTH
FUND
5Health Care Spending per Capita by Source of Funding, 2009
Adjusted for Differences in Cost of Living
US NOR SWIZ CAN GER FR SWE UK AUS* NZ JPN*0
1,000
2,000
3,000
4,000
5,000
6,000
7,000
8,000
3,7954,501
3,072 3,081 3,242 3,100 3,033 2,9352,342 2,400 2,325
3,189
43
504 646 424 58769 188
476 184 99
976
808
1,568 636 552 291
620 364 627 399 454
Out-of-pocket spending
Private spending
Public spending
* 2008.
Dollars
7,960
4,363 4,2183,978
3,7223,487 3,445
2,8782,983
5,352 5,144
Source: OECD Health Data 2011 (June 2011).
THECOMMONWEALTH
FUND
6Pharmaceutical Spending per Capita, 2009
Adjusted for Differences in Cost of Living
US CAN FR GER JPN* SWIZ OECD_x000d_Median
AUS* NETH SWE NOR UK* DEN NZ**0
100
200
300
400
500
600
700
800
900
1,000 956
744
640 628558
521 518 503473 465
391 381319
254
* 2008.** 2007.Source: OECD Health Data 2011 (June 2011).
THECOMMONWEALTH
FUND
Dollars
7
Health Care Supply and Utilization
THECOMMONWEALTH
FUND
Hospital Discharges per 1,000 Population, 2009
FR* GER NOR DEN SWIZ SWE AUS* OECD Me-dian
NZ* UK US* NETH CAN*0
50
100
150
200
250
300
263
237
177 170 168 166 162 160142 138 131
117
84
* 2008.Source: OECD Health Data 2011 (June 2011).
8
THECOMMONWEALTH
FUND
Average Length of Hospital Stay for Acute Myocardial Infarction, 2009
GER NZ* UK SWIZ OECD Me-dian
NETH FR CAN* AUS* US* SWE DEN NOR0
2
4
6
8
10
12
10.8
8.2 8.17.6
6.96.5 6.3 6.2 6.0
5.34.5 4.2 4.2
Days
* 2008.Source: OECD Health Data 2011 (June 2011).
9
THECOMMONWEALTH
FUND
10Inpatient Coronary Bypass Procedures per 100,000 Population, 2009
GER US* DEN NZ NOR* AUS* CAN* NETH* OECD Me-dian
SWE UK SWIZ FR0
25
50
75
100
125
150
120
80 79 7770 70
6358
48 45 40
31 30
THECOMMONWEALTH
FUND* 2008.Source: OECD Health Data 2011 (June 2011).
11Average Annual Number of Physician Visits per Capita, 2009
JPN* GER FR AUS OECD Me-dian
NETH CAN* UK DEN NZ** SWIZ** US* SWE0
2
4
6
8
10
12
14 13.2
8.2
6.96.5 6.3
5.7 5.55.0
4.6 4.3 4.0 3.9
2.9
* 2008.** 2007.Source: OECD Health Data 2011 (June 2011).
THECOMMONWEALTH
FUND
Number of Practicing Physicians per 1,000 Population, 2009
NOR SWIZ SWE* GER DEN* AUS* OECD_x000d_Median
UK NZ US JPN*0
1
2
3
44.0
3.8 3.7 3.63.4
3.0 3.0
2.7 2.62.4
2.2
* 2008.Source: OECD Health Data 2011 (June 2011).
12
THECOMMONWEALTH
FUND
13Magnetic Resonance Imaging (MRI) Units per Million Population, 2009
JPN* US** DEN NETH NZ OECD Median
CAN FR AUS UK*0
10
20
30
40
50
43.1
25.9
15.4
11.0 9.7 8.9 8.06.4 5.9 5.6
THECOMMONWEALTH
FUND
* 2008.** 2007.Source: OECD Health Data 2011 (June 2011).
14
Health Promotion and Disease Prevention
THECOMMONWEALTH
FUND
15Cervical Cancer Screening Rates, 2006
Women Ages 20–69
US UK SWE NOR CAN* FR* NZ NETH AUS0
20
40
60
80
100
83.579.4 78.6
75.672.8 72.4 70.6 69.6
60.6
Percent
* Based on survey data; all other countries based on program data.Source: Health Care Quality Indicators Project, OECD 2009.
THECOMMONWEALTH
FUND
16Adults Who Report Being Daily Smokers, 2009
NETH FR* JPN GER UK OECD_x000d_Median
NOR SWIZ**
DEN NZ** AUS** CAN US SWE0
10
20
30
40
28.026.2
24.9
21.9 21.5 21.5 21.0 20.419.0 18.1
16.6 16.2 16.114.3
Percent
THECOMMONWEALTH
FUND
* 2008.** 2007.Source: OECD Health Data 2011 (June 2011).
US* NZ** AUS** CAN* UK GER NETH FR* SWE NOR* SWIZ** JPN0
5
10
15
20
25
30
35
40
33.8
26.524.6 24.2
23.0
14.7
11.8 11.2 11.210.0
8.1
3.9
17Obesity (BMI>30) Prevalence Among Adult Population, 2009
Note: Body-mass index (BMI) estimates based on national health interview surveys (self-reported data) are usually significantly lower than estimates based on actual measurements.
Percent
Measured Self-reported
THECOMMONWEALTH
FUND
* 2008.** 2007.Source: OECD Health Data 2011 (June 2011).
18
Quality Outcomes
THECOMMONWEALTH
FUND
Mortality Amenable to Health Care
7688 89
8188
99 97109
116106
97
134
115 113127
120
55 57 60 61 61 64 66 67 74 76 77 78 79 80 8396
0
50
100
150 1997–98 2006–07
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.
19
THECOMMONWEALTH
FUND
Breast Cancer Five-Year Relative Survival Rate, 2002–2007 (or nearest period)
US CAN SWE NETH DEN NZ NOR UK0
20
40
60
80
100
90.587.1 86.1 85.2
82.4 82.1 81.978.5
Source: OECD Health Care Quality Indicators Data 2009.
Percent
20
THECOMMONWEALTH
FUND
* 2006.** 2005.*** Among countries shown.
US* DEN SWIZ* FR NZ Median***
SWE CAN NETH** NOR UK0
10
20
30
40
36
21
16
13 12 12 12 11 11 119
Diabetes Lower Extremity Amputation Rates per 100,000 Population Age 15 and Older, 2007
Source: OECD Health Care Quality Indicators Data 2009.
21
THECOMMONWEALTH
FUND
* In-hospital case-fatality rates within 30 days of admission.** 2006.*** 2005.
Mortality After Admission for Acute Myocardial Infarction* per 100 Patients, 2007
NETH** UK US* CAN NZ NOR DEN SWE0
2
4
6
8
6.66.3
5.1
4.2
3.3 3.22.9 2.9
Source: OECD Health Care Quality Indicators Data 2009.
22
THECOMMONWEALTH
FUND
23
Prices
THECOMMONWEALTH
FUND
Drug Prices for 30 Most Commonly Prescribed Brand-Name and Generic Drugs, 2006–07
US is set at 1.00
Source: IMS Health; analysis by Gerard Anderson, Johns Hopkins University.
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
24
THECOMMONWEALTH
FUND
MRI Scan and Imaging Fees, 2009
US Medi-care
US GER CAN NETH FR UK0
200
400
600
800
1,000
1,200
1,400
1,600
500
1,200
839 824
567
436
179
Source: International Federation of Health Plans, 2009 Comparative Price Report.
Dollars
1,500
US average:
US high-end:
25
THECOMMONWEALTH
FUND
Hospital Spending per Discharge, 2009Adjusted for Differences in Cost of Living
US* CAN* NETH JPN* DEN SWIZ NOR** SWE AUS* NZ* OECD Me-dian
FR GER0
2,000
4,000
6,000
8,000
10,000
12,000
14,000
16,000
18,000
20,000
18,142
13,483 13,24412,650
11,112 10,875 10,4419,870
8,350
7,1606,222
5,204 5,072
Dollars
26
* 2008.** 2007.Source: OECD Health Data 2011 (June 2011).
THECOMMONWEALTH
FUND
27Physician Fee for Hip Replacement, 2008
Adjusted for Differences in Cost of Living
US GER UK AUS FR CAN$0
$200
$400
$600
$800
$1,000
$1,200
$1,400
$1,600
$1,800
$1,634
$1,251$1,181
$1,046
$674 $652
Source: M. J. Laugesen and S. A. Glied, “Higher Fees Paid to U.S. Physicians Drive Higher Spending for Physician Services Compared to Other Countries,” Health Affairs, Sept. 2011 30(9):1647–56.
US UK AUS FR$0
$600
$1,200
$1,800
$2,400
$3,000
$3,600
$4,200 $3,996
$2,160$1,943
$1,340
Public payers Private payers
THECOMMONWEALTH
FUND
Dollars
28Physician Incomes, 2008
Adjusted for Differences in Cost of Living
US UK GER CAN FR AUS
186,582159,532
131,809125,104
95,585 92,844
US UK CAN GER AUS FR0
50,000
100,000
150,000
200,000
250,000
300,000
350,000
400,000
450,000
500,000
442,450
324,138
208,634 202,771187,609
154,380
Primary care doctorsOrthopedic surgeons
Source: M. J. Laugesen and S. A. Glied, “Higher Fees Paid to U.S. Physicians Drive Higher Spending for Physician Services Compared to Other Countries,” Health Affairs, Sept. 2011 30(9):1647–56.
THECOMMONWEALTH
FUND
Dollars
