OECD Health Data 2003 Show Health Expenditures at an All-time High

23/06/2003 - OECD countries are spending record amounts on health care, largely due to the rising cost of pharmaceuticals and the diffusion of modern medical technologies.

Latest available data show that OECD countries spent record amounts on health care in 2001 - an average 8.4% of their gross domestic product, up by three tenths of a percentage point from 2000. This is just some of the information available in OECD Health Data 2003: a comparative analysis of 30 countries - the most comprehensive source of comparable statistics on health and health systems across industrialised countries. Healthcare expenditure in OECD countries has grown more than one percent faster than their economies in the past decade, the OECD figures show ( table 1) .

The increase in 2001 was borne by both public and private healthcare funding, with public spending growing at 5.8% in 2001, somewhat faster than private spending at 4.8%. This was not enough to significantly change the share of public spending in total health spending, which stood at 72% on average across countries, ranging from 44% in the United States to over 80% in most Nordic countries.

The United States continues to top the OECD ranking for overall healthcare spending at $4900 per capita in 2001 - more than twice the OECD average of $2100 ( Chart 1) . Though more than half of this is private funding, public spending per capita in the United States is also high (only Norway, Luxembourg and Iceland spend more), even though only about one-quarter of the population is insured through public programmes compared with 90 per cent or more in most other OECD countries.

Health expenditure as a percentage of GDP in the United States jumped from 13.1% in 2000 to 13.9% in 2001, largely reflecting the American economic slowdown. Switzerland, which spent 10.9% of GDP on health and Germany, which spent 10.7% of GDP, were the next highest spenders in relation to their GDP. The lowest spenders as a proportion of GDP were Korea, Luxembourg and the Slovak Republic, spending less than 6% of their GDP on health in 2000 or 2001.

Rising pharmaceutical costs

The increase in public and private spending on pharmaceuticals has been one of the main drivers of rising health expenditure in many OECD countries in recent years, reflecting the introduction of new and more expensive drugs. Pharmaceutical spending rose by more than 70%, in real terms, between 1990 and 2001 in Australia, Canada, Finland, Ireland, Sweden and the United States ( Chart 2) . Pharmaceuticals now account for more than 10% of total health spending in nearly all OECD countries, and over 20% of health spending in France and Italy.

Falling average length of stays in hospitals

The average length of stays (ALOS) in hospitals continued to decline in nearly all OECD countries as a result of less invasive surgical treatments and efforts to control costs. ALOS for acute hospital care decreased, on average, from 8.8 days in 1990 to 7 days in 2000. ALOS fell particularly quickly during the past decade in Nordic countries - Denmark, Finland and Sweden - as well as in other European countries including Austria, France and Switzerland. In the United States, ALOS for acute hospital care fell from 7.3 days in 1990 to 5.8 days in 2000 ( Chart 3) .

The length of hospitalisation for maternity care has become an important issue in some countries because of concerns about premature discharge of new mothers. For women delivering babies in 2000, there were striking variations across countries in ALOS ranging from only 2 days in Canada, New Zealand and the United States, to more than 5 days in Austria, Poland, Luxembourg and Belgium. In France and Germany, ALOS for a normal delivery remained close to 5 days. The average across OECD countries in 2000 was 4 days ( Chart 4) .

Changing nature of health risks

Risk factors to health are changing. Many OECD countries have achieved remarkable progress over the past few decades in reducing tobacco consumption, though it is still a leading cause of premature mortality. Current rates of daily smokers among adults now stand at less than 20% in Australia, Canada, Sweden and the United States, down from over 32% in these countries in 1980. Greece reported the highest rate of 35% in 2000 ( Chart 5) .

At the same time, obesity rates have increased in all OECD countries over the past two decades due to poor eating habits and lack of physical activity. Obesity is a known risk factor for several diseases such as diabetes, hypertension, cardiovascular diseases, respiratory problems (asthma) and musculoskeletal diseases (arthritis). But there is a time lag between the onset of obesity and increases in chronic disease, so the large increase in obesity since 1980 will have substantial implications for future incidence of health problems and related spending. Though the United States still has the highest rate of adult obesity, the gap is narrowing. More than 20% of people in Mexico, the United Kingdom and Australia are now considered obese ( Chart 6) . Obesity rates are higher when measured by direct health examinations, but these are only available on a regular basis for the United States, Australia and the United Kingdom.

OECD Health Data 2003 is available on CD-ROM, in a quadrilingual version (English, French, German and Spanish). It uses fast, user-friendly Windows TM-based software (98/NT/2000/Me/XP), which enables users to carry out data extractions and build customised graphs and tables. This twelfth edition covers over 1 200 indicators. Key items span the period 1970 to 2000/2001, with some time series going back to 1960. An extensive documentation of definitions for each indicator, national sources and estimation methods accompanies the database. Free technical assistance and data updates are accessible via the Internet at www.oecd.org/health/healthdata.

Subscribers and readers at subscribing institutions can access theCD-Rom via SourceOECD our online library. Non-subscribers will be able to purchase it via our Online Bookshop.

A limited number of CD-ROMs are available for journalists from the OECD Media Relations Division .

OECD Health Data is a co-production OECD- IRDES