multinational comparisons of health systems data, 2012
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Multinational Comparisons of Health Systems Data, 2012. David Squires The Commonwealth Fund November 2012. Health Care Spending and Coverage. THE COMMONWEALTH FUND. Average Health Care Spending per Capita , 1980–2010 Adjusted for Differences in Cost of Living. Dollars ($US). - PowerPoint PPT PresentationTRANSCRIPT
THE COMMONWEALTH
FUND
Multinational Comparisonsof Health Systems Data, 2012
David SquiresThe Commonwealth Fund
November 2012
2
Health Care Spending and Coverage
THECOMMONWEALTH
FUND
1980
1982
1984
1986
1988
1990
1992
1994
1996
1998
2000
2002
2004
2006
2008
2010
0
1000
2000
3000
4000
5000
6000
7000
8000
9000US ($8,233)NOR ($5,388)SWIZ ($5,270)NETH ($5,056)DEN ($4,464)CAN ($4,445)GER ($4,338)FR ($3,974)SWE ($3,758)AUS ($3,670)*UK ($3,433)JPN ($3,035)*NZ ($3,022)
Source: OECD Health Data 2012.
Average Health Care Spending per Capita, 1980–2010Adjusted for Differences in Cost of Living
3
Dollars ($US)
THECOMMONWEALTH
FUND* 2009
1980
1982
1984
1986
1988
1990
1992
1994
1996
1998
2000
2002
2004
2006
2008
2010
0
2
4
6
8
10
12
14
16
18US (17.6%)NETH (12.0%)FR (11.6%)GER (11.6%)CAN (11.4%)SWIZ (11.4%)DEN (11.1%)NZ (10.1%)SWE (9.6%)UK (9.6%)JPN (9.5%)*NOR (9.4%)AUS (9.1%)*
GDP refers to gross domestic product.Source: OECD Health Data 2012.
Health Care Spending as a Percentage of GDP, 1980–2010 4
Percent
THECOMMONWEALTH
FUND* 2009
5Health Care Spending per Capita by Source of Funding, 2010Adjusted for Differences in Cost of Living
US SWIZ DEN CAN GER FR SWE AUS* UK JPN* NZ0
1,000
2,000
3,000
4,000
5,000
6,000
7,000
8,000
9,000
3,9673,437 3,800
3,158 3,331 3,061 3,0462,515 2,857 2,443 2,515
3,296
508 75656 436 623
80474 270
106 190
970
1,325 589 631 571 290
632 682 306 485 317
Out-of-pocket spendingPrivate spendingPublic spending
* 2009.
Dollars ($US)
8,233
4,463 4,445 4,3383,974 3,758 3,670
3,0353,433
5,269
Source: OECD Health Data 2012.
THECOMMONWEALTH
FUND
3,022
6Pharmaceutical Spending per Capita, 2010Adjusted for Differences in Cost of Living
US CAN GER FR JPN* AUS* SWIZ OECD Median
NETH SWE NOR UK** DEN NZ0
100
200
300
400
500
600
700
800
900
1,000 983
741
640 634 630541 510 508 481 474
395 369331
285
* 2009.** 2008.Source: OECD Health Data 2012.
THECOMMONWEALTH
FUND
Dollars ($US)
7
Health Care Supply and Utilization
THECOMMONWEALTH
FUND
Hospital Discharges per 1,000 Population, 2010
GER NOR DEN SWIZ FR SWE AUS* OECD Median
NZ UK US* NETH* JPN** CAN*0
50
100
150
200
250
300
240
175 172 169 169 163 155 155 147136 131
116 107
83
* 2009.** 2008.Source: OECD Health Data 2012.
8
THECOMMONWEALTH
FUND
Average Length of Hospital Stay for Acute Myocardial Infarction, 2010
GER NZ SWIZ UK OECD Me-dian
NETH* FR CAN* AUS* US* SWE NOR DEN0
2
4
6
8
10
12
10.6
8.2 7.9 7.87.0
6.5 6.2 6.0 5.65.0 4.7
4.0 3.9
Days
* 2009.Source: OECD Health Data 2012.
9
THECOMMONWEALTH
FUND
10Inpatient Coronary Bypass Procedures per 100,000 Population, 2010
GER US* DEN NOR* CAN* NETH* AUS* OECD Me-dian
SWE NZ UK SWIZ FR0
25
50
75
100
125116
7974
62 61 58 56
43 43 42 3730 28
THECOMMONWEALTH
FUND* 2009.Source: OECD Health Data 2012.
11Average Annual Number of Physician Visits per Capita, 2010
JPN* GER FR NETH AUS OECD Me-dian
CAN* NOR* UK* DEN US** NZ SWE0
2
4
6
8
10
12
14 13.1
8.9
6.7 6.6 6.5 6.35.5 5.2 5.0 4.6
3.92.9 2.9
* 2009.** 2008.Source: OECD Health Data 2012.
THECOMMONWEALTH
FUND
Number of Practicing Physicians per 1,000 Population, 2010
NOR SWIZ SWE* GER DEN* AUS* OECD Median
UK NZ US JPN0
1
2
3
4
5
4.13.8 3.8 3.7
3.53.1 3.1
2.7 2.62.4
2.2
* 2009.Source: OECD Health Data 2012.
12
THECOMMONWEALTH
FUND
13Number of Acute Care Hospital Beds per 1,000 Population, 2010
JPN GER FR AUS** SWIZ OECD Me-dian
NETH DEN US* NOR UK SWE CAN*0
2
4
6
8
10
8.1
5.7
3.5 3.4 3.1 3.1 3.0 2.9 2.6 2.4 2.42.0 1.7
THECOMMONWEALTH
FUND* 2009.** 2008.Source: OECD Health Data 2012.
14Magnetic Resonance Imaging (MRI) Units per Million Population, 2010
JPN** US DEN* NETH NZ OECD Median
CAN FR UK AUS0
10
20
30
40
50
43.1
31.6
15.412.2
10.5 9.5 8.2 7.0 5.9 5.6
THECOMMONWEALTH
FUND* 2009.** 2008.Source: OECD Health Data 2012.
15Computed Tomography (CT) Scanners per Million Population, 2010
JPN** AUS US*** SWIZ DEN OECD Median
NZ CAN NETH FR UK0
20
40
60
80
100 97.3
42.8
34.3 32.627.6
15.6 15.6 14.2 12.3 11.88.2
THECOMMONWEALTH
FUND** 2008.*** 2007.Source: OECD Health Data 2012.
16Positron Emission Tomography (PET) Scanners per Million Population, 2010
DEN* NETH US** JPN** SWIZ AUS CAN OECD Median
NZ FR0
1
2
3
4
5
6 5.6
4.8
4.2
3.73.2
1.41.2 1.2 1.2
0.9
THECOMMONWEALTH
FUND* 2009.** 2008.Source: OECD Health Data 2012.
17
Health Promotion and Disease Prevention
THECOMMONWEALTH
FUND
THECOMMONWEALTH
FUND
Cervical Cancer Screening Rates, 2010
US GER* NOR* UK CAN** NZ FR DEN* NETH AUS* JPN0
20
40
60
80
100
85.078.7 78.5 78.5 75.3 75.2
71.166.3 65.7
58.2
37.7
Percent of women screened
Note: Norway, UK, NZ, Denmark, and Australia based on program data; all other countries based on survey data.* 2009.** 2008.Source: OECD Health Data 2012.
18
Flu Immunization Among Adults Ages 65 or Older, 2010
AUS* NETH* UK FR NZ SWE** US GER** CAN OECD_x000d_Median
JPN SWIZ DEN0
20
40
60
80
100
74.6 74.070.3
66.0 65.8 64.0 63.9 61.1 59.4 57.553.0
46.0 45.6
Percent
* 2009.** 2008.Source: OECD Health Data 2012.
THECOMMONWEALTH
FUND
19
20Adults Who Report Being Daily Smokers, 2010
FR GER* UK* NETH OECD Me-dian
DEN JPN NOR CAN AUS US SWE0
10
20
30
40
23.3 21.9 21.5 20.9 20.9 20.0 19.5 19.016.3 15.1 15.1 14.0
Percent
THECOMMONWEALTH
FUND* 2009.Source: OECD Health Data 2012.
US NZ* UK CAN** GER* DEN FR SWE NETH NOR** JPN0
5
10
15
20
25
30
35
4035.9
27.826.1
24.2
14.7 13.4 12.9 12.911.4 10.0
3.5
21Obesity (BMI>30) Prevalence Among Adult Population, 2010
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* 2009.** 2008.Source: OECD Health Data 2012.
22
Quality and Patient Safety
THECOMMONWEALTH
FUND
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.
23
THECOMMONWEALTH
FUND
Breast Cancer Five-Year Relative Survival Rate, 2004–2009(or nearest period)
US JPN CAN NOR SWE NZ NETH GER DEN UK0
20
40
60
80
10089.3 87.3 86.6 86.5 86.0 84.5 84.4 83.3 82.0 81.3
Source: OECD Health Data 2011.
Percent
THECOMMONWEALTH
FUND
24
* 2008.** 2007.Source: OECD Health Data 2011.
UK SWE NZ SWIZ* CAN NOR OECD Me-dian
AUS NETH**
FR** DEN US* GER0
10
20
30
40
4.8 5.7 7.0 7.49.5 9.9 9.9 11.0 12.0 12.6
18.1
32.9 33.7
Diabetes Lower Extremity Amputation Rates per 100,000 Population, 2009
THECOMMONWEALTH
FUND
25
† In-hospital case-fatality rates within 30 days of admission. Age-sex standardized rates.
In-Hospital Mortality After Admission for Acute Myocardial Infarction† per 100 Patients, 2009
DEN NOR SWE** NZ AUS CAN US* SWIZ* OECD Me-dian
UK NETH**
GER JPN*0
2
4
6
8
10
2.3 2.52.9 3.2 3.2
3.94.3 4.5 4.6
5.2 5.3
6.8
9.7
Source: OECD Health Care Data 2012.
26
THECOMMONWEALTH
FUND* 2008.** 2007.
Note: Age-sex-SDX standardized rates.
Foreign Object Left in Body During Procedure per 100,000 Hospital Discharges, 2009
DEN** SWE GER US* FR UK NZ CAN AUS SWIZ*0
3
6
9
12
15
1.82.6
3.44.9 5.5 5.7
8.79.7 9.8
13.8
Source: OECD Health Care Data 2012.
27
THECOMMONWEALTH
FUND* 2008.** 2010.
Note: Age-sex-SDX standardized rates.
Postoperative Sepsis per 100,000 Hospital Discharges, 2009
SWIZ* GER DEN*** CAN FR SWE US* NZ AUS0
300
600
900
1,200
1,500
354
541
754 769858
9261,077
1,452 1,455
Source: OECD Health Care Data 2012.
28
THECOMMONWEALTH
FUND
* 2008.** 2007.*** 2010.
29
Prices
THECOMMONWEALTH
FUND
Drug Prices for 30 Most Commonly Prescribed Drugs, 2006–2007US is set at 1.0
US CAN GER SWIZ UK AUS NETH FR NZ0.0
0.2
0.4
0.6
0.8
1.01.00
0.77 0.76
0.63
0.51 0.490.45 0.44
0.34
Source: IMS Health; analysis by Gerard Anderson, Johns Hopkins University.
30
THECOMMONWEALTH
FUND
Diagnostic Imaging Prices, 2011
US Com-mercial Av-
erage
SWIZ GER FR$0
$200
$400
$600
$800
$1,000
$1,200
$1,080
$903
$599
$281
Note: MRI refers to magnetic resonance imaging; CT refers to computed tomography.Source: International Federation of Health Plans, 2011 Comparative Price Report.
31
MRI scanning and imaging fees
US Com-mercial Av-
erage
SWIZ GER FR$0
$100
$200
$300
$400
$500
$600
$510
$319$272
$141
CT scanning and imaging fees (head)
THECOMMONWEALTH
FUND
Hospital Spending per Discharge, 2010Adjusted for Differences in Cost of Living
US* CAN* NETH* JPN** DEN SWIZ NOR* SWE AUS* FR NZ OECD Me-dian
GER0
2,000
4,000
6,000
8,000
10,000
12,000
14,000
16,000
18,000
20,000 19,319
14,896
13,134 12,65011,295 11,219 11,021
9,990 9,5318,049 7,856
7,180
5,192
Dollars
32
* 2009.** 2008.Source: OECD Health Data 2012.
THECOMMONWEALTH
FUND
33Physician Fee for Hip Replacement, 2008Adjusted 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
34Physician Incomes, 2008Adjusted 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