How U.S. utilization and price of healthcare compare to other countries

In this blog post, we take a look at how utilization and price of healthcare in the United States compare to similarly wealthy and sizable OECD countries. The analysis uses 2013 health utilization data from the OECD Health Statistics database, and medical and hospital price variation data from the International Federation of Health Plans (IFHP) 2013 Comparative Price Report. Generally speaking, we find that people in the U.S. use health services overall less than in other countries, while services in the U.S. are consistently more expensive than in comparably wealthy OECD countries (where data are available).

 Along with Switzerland, the U.S. has the fewest physician consultations per capita among comparable OECD countries. Twenty years ago, the U.S. had roughly half as many physician consultations per capita than comparable OECD countries, and the gap has remained generally consistent over time, even as consultation use has grown in both the U.S. and other countries.  As noted in our earlier analyses, the U.S. also has fewer physicians per capita than the average of comparable counties and about one in every ten adults in the U.S. (11%) report that they delayed or went without needed medical care due to cost in 2013.

Although the U.S. has a higher mortality rate than comparable countries, 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. Notably, the U.S. performs fewer coronary angioplasty surgeries and more coronary bypass surgeries than comparable OECD countries, and the number of coronary angioplasties performed in the U.S. is declining. (Both procedures are used to treat heart disease, but bypass surgery is generally recommended for patients with the most severe disease.) For both procedures, prices are substantially higher than in comparable countries with available data. One recent study suggests that publicly-available hospital quality reporting may contribute to a moderation in increasing prices for coronary angioplasties and bypass surgeries.

The chart collection also explores availability, use, and price of MRIs, and imaging is one area where use of the health system is higher in the U.S. than in other countries.  The U.S. has both the largest number of MRI units available per capita and the highest number of MRI exams performed.  This correlation between availability and utilization 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.

The average price per MRI exam in the U.S is 3.6 times higher than the average of comparable countries with data available (though pricing data is not available for most countries).  According to the International Federation of Health Plans, the national 25th percentile MRI price in the US ($532) is still higher than the average for countries where data are available.