Health system performance can be assessed in part by examining the resources (e.g., medical professionals, infrastructure, and technology) necessary to function. The U.S. has fewer acute care hospital beds per capita than in most comparable countries, and the OECD average, though it outpaces Canada, Sweden, the Netherlands and the United Kingdom. The number of acute hospital beds per 1000 in population fell in the U.S. from 3.7 in 1990 to 2.6 in 2010.
In the past 15 years the number of hospitals per capita has decreased in both the U.S. and comparably wealthy OECD countries, on average. The density of hospitals in the U.S. has decreased somewhat faster since 1995 (by about 21%, compared to an average decrease of 10% in comparable OECD countries).
U.S. patients on average experience shorter hospital stays than in other OECD comparable countries. The average length of stay has steadily decreased over time due to changes in medical guidelines and practices, improved technology, as well as shifts in hospital reimbursement and financial constraints.
Some attention has been given recently to a potential doctor shortage in the U.S., particularly as more people are expected to gain health insurance coverage in the coming years. The U.S. has fewer doctors per capita than comparable countries, with the exception of Canada and Japan.
In the past 15 years, the U.S. has seen little growth in the number of doctors per capita. While the number of physicians per capita has increased 20% since 1995 in similarly wealthy countries, growth in the U.S. was 10% leading to a widening gap between the U.S. and other OECD countries.
The distribution of physicians in the U.S. is skewed heavily towards higher paid specialists versus general practitioners when compared with similar high-income countries.
The numbers of psychiatrists and nurses per 100,000 in population in the U.S. working in mental health are lower than the comparable country average. The number of psychologists per 100,000 in population in the U.S. is close to the comparable country average.
On a per capita basis, the range in the number of nurses is narrower across countries than for physicians, with the U.S. just below the average for similarly wealthy countries.
Both the U.S. and comparably wealthy OECD countries have seen about a 14% growth in the number of nurses per capita since the year 2000.
The U.S. has substantially more MRI machines per person than any comparably wealthy country except for Japan.
The density of MRI units has increased more rapidly in the U.S. than in comparable countries
Since the mid-1990s, the number of MRI machines in the U.S. has more than doubled from about 12 per million population to 32 per million population in 2010. While this may lead to more availability of MRI testing, it also contributes to health spending growth.
More availability of medical technology does not always equate to higher utilization
The U.S. has both the largest number of MRI units available per million population and the highest number if MRI exams performed per 1,000 population. 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 guidelines or cultural trends driving demand may be contributing to the utilization of medical technology.