Along with Switzerland, the U.S. has the fewest physician consultations per capita among higher-income OECD countries. Consistent with this lower physician use, the U.S. also has fewer physicians per capita and about one in every ten adults (11%) report that they either delayed or did not receive needed medical care due to cost in 2013.
Compared to comparable countries, the U.S. had roughly half as many physician consultations per capita in 1995. This gap has remained generally consistent over time, even as use has grown in the U.S. and other countries.
U.S. patients on average experience shorter hospital stays than in other OECD comparable countries.
The average length of hospital stays has steadily decreased over time due to changes in medical guidelines and practices, improved technology, as well as shifts in hospital reimbursement and financial constraint. Such decreases have been sharper in comparable countries than in the U.S. since 1994. In addition to the average length of stay, the U.S. has seen a decrease in the number of acute care hospital beds and the number of hospitals per capita.
The U.S. performs fewer angioplasty and more coronary bypass surgeries than most comparable countries
The U.S. performs fewer angioplasty surgeries and more coronary bypass surgeries than comparable OECD countries. Both procedures are used to treat heart disease, but bypass surgery is generally recommended for patients with the most severe disease. Angioplasties are a less invasive way to combat heart disease and can be used during earlier stages of disease and during a heart attack to reduce and/or eliminate damage to the heart.
The U.S. has a higher mortality rate when compared to comparable countries, but the U.S. and other countries have made dramatic progress in lowering mortality from diseases of the circulatory system. In the U.S., the mortality rate has fallen from 629 deaths per 100,000 population in 1980 to 261 in 2010.
The number of angioplasties performed in the U.S. is declining. Emergency angioplasty can be used to stop heart attacks before they cause damage to the heart. Angioplasties can also be used to reduce deaths, heart attacks or strokes. One study found that when angioplasties are used preventatively, there is no significant difference in deaths, heart attacks, and strokes than when medication is used in its place. Some physicians may choose to treat patients with medication instead of surgery which may be part of the reason for the decline of angioplasties performed in the U.S.
The number of coronary bypass surgeries in the U.S. has declined from 106 per 100,000 population to 79 per 100,000 population in less than a decade. While the OECD comparable country average is still lower than the U.S., there is progress.
The average price of an angioplasty or bypass in the U.S. is higher than in other comparable countries
The U.S. performs fewer angioplasties and more coronary bypass surgeries than comparable countries, but for both procedures prices are substantially higher than in other countries where data are available. According to the International Federation of Health Plans, the national 95th percentile average for an angioplasty in the US is $61,184. The average price per coronary bypass surgery in the U.S is 2.4 times higher than in other countries where data are available.
The U.S. performs about 1.5 times more Caesarean sections than comparable OECD countries.
The average price of a caesarean section in the U.S. is more than the price of a normal delivery
The average cost per Caesarean section in the U.S. is 1.7 times higher than in comparable countries where data are available. The average cost of normal delivery in the U.S. is about 13 percent higher than in comparable countries and about 254 percent higher than normal deliveries in the Netherlands (the country with the lowest cost).
U.S. leads comparable OECD countries in MRI availability and use
The U.S. has both the largest number of MRI units available per million population and the highest number of MRI exams performed per 1,000 population among comparable countries with data available. This correlation is not necessarily found in other comparably wealthy OECD countries. For example, France has just 9 MRI units available per million population but the second largest volume of MRI exams performed. Medical practice patterns or cultural trends driving demand may be contributing to the utilization of medical technology.
In 2013, the U.S. performed 107 MRI exams per 1,000 population. The average price per MRI exam in the U.S is 3.6 times higher than the comparable country average (though most countries do not have data available). According to the International Federation of Health Plans, the national 25th percentile average price in the US, $532, is still higher than the country average for countries where data are available and the national 95th percentile average in the US is $2,929.