The United States continues to spend the most on
health care when compared to other
Organization for Economic Cooperation and Development
countries, and health care prices and higher
per capita incomes are major factors, according to a study
by researchers at the Johns Hopkins
Bloomberg School of Public
Health and Princeton University. Compared to the
average OECD country
in 2004, the United States has fewer health resources
— physicians, nurses and hospital beds — and
lower utilization of these resources. Health spending for
chronic health issues, such as obesity,
alcohol consumption and smoking, also contributes to high
health spending in the United States. The
study is published in the September/October issue of
Health Affairs.
"We spend so much more money on health care in the
United States than other industrialized
countries [spend in theirs] primarily because our prices
are so much higher," said lead author Gerard
Anderson, a professor in the Department
of Health Policy and Management at the Bloomberg
School.
Using 2004 data, which is the most recent available,
the researchers report the following key
study results:
U.S. health care spending per
capita was 2.5 times greater than in the median OECD
country.
The United States spent 15.3
percent of its gross domestic product on health care, a
figure
that is substantially higher than in any other OECD
country.
U.S. growth in health care
spending per capita from 1994 to 2004 was similar to the
OECD
median.
The United States has promoted
policies to reduce the number of hospital days as a way to
contain costs. It is now ranked fourth highest among OECD
countries for hospital spending per capita.
The United States spent 3.6 times
what the median OECD country spent in 2004 for outpatient
care. Most of the difference is attributable to higher
spending on physician services.
The United States had fewer
physicians, nurses and hospital beds per capita than the
OECD
median.
The United States also had lower
utilization rates than the OECD median for physician visits
per capita, acute care bed days and average length of
inpatient stay.
The study authors examined the prevalence of chronic
disease as an increasing financial burden
in the United States and other countries. Five chronic
diseases — diabetes, respiratory disease,
cerebrovascular disease, heart disease and malignant
neoplasm — cause two-thirds of deaths in the
United States. Compared to other OECD countries, we have
the highest mortality rate for some but
not all of these chronic diseases.
The authors explain that policy-makers in the United
States and elsewhere need to devote
more attention to chronic disease, something that is
already beginning to happen. "Policy-makers in
many countries have recognized the necessity of
coordinating efforts to manage chronic disease,
especially for people with multiple chronic diseases,"
Anderson said. "It is recognized that behaviors
such as diet, inactive lifestyle, and alcohol and tobacco
consumption must be modified in order for
chronic disease to decrease, which would in turn reduce
overall health care spending."
Bianca K. Frogner, a doctoral candidate at Johns
Hopkins, and Uwe E. Reinhardt, a professor at
Princeton, co-authored the study, which was supported by a
grant from the Commonwealth Fund.