How do healthcare prices and use in the U.S. compare to other countries?

Total health spending is a function of both price paid to providers or for drugs and the volume of services used. These charts explore prices and use of health services in the U.S. relative to comparable countries (those with both a total GDP above the median for OECD countries and a per capita GDP greater than the OECD median). While available data are limited to select services and drugs, we find that higher prices – more so than utilization – explain the United States’ high health spending relative to other high-income countries.

The U.S. has higher prices for most health care services and prescription drugs, according to available internationally comparable data. Meanwhile, utilization of several services, including physician consultations and hospital stays, is lower than in many comparable countries. Use of some services, such as C-sections and knee replacements, is higher in the U.S. than in similar countries.

Despite having fewer office visits and shorter average hospital stays, the U.S. overall spends twice as much per person on healthcare than do comparable countries.

These charts accompany an analysis showing how prices for health services in the U.S. have grown over time.

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On average, other wealthy countries spend half as much per person on healthcare than the U.S.


In 2016 the U.S. spent 18% of its GDP on healthcare, whereas the next highest country (Switzerland) devoted 12% of its GDP to healthcare. The average amount spent on healthcare per person in comparable countries ($5,198) is half that of the U.S. ($10,348).

The U.S. has fewer physician consultations per capita than most comparable countries


Aside from Sweden, the U.S. has the fewest physician consultations per capita among similarly wealthy countries. In 2015, comparable countries saw an average of 7.6 total consultations per person at physician offices, hospital outpatient departments, and emergency rooms, while the U.S. averaged 3.9 consultations per person.

The U.S. has fewer physicians per capita relative to similar countries (2.6 per 1,000 in 2013 compared to the comparable country average of 3.4).

The U.S. has consistently had fewer physician consultations per capita than comparable countries


In 2000, the U.S. had about 46% fewer physician consultations per capita than similarly wealthy countries, and the gap has remained generally consistent over time. In 2015, comparable countries saw an average of 7.6 consultations per person at physician offices, hospital outpatient departments, and emergency rooms, while the U.S. averaged 3.9 consultations per person.

Patients in the U.S. have much shorter average hospital stays than patients in comparable countries


Shorter hospital stays can potentially be more cost-effective than longer ones – assuming no change in the effectiveness and quality of care – but they may also result in higher costs and service intensity per day. U.S. patients experience shorter hospital stays on average (6 days) than patients in comparable countries (10 days).

The U.S. has consistently had much shorter average hospital stays than patients in comparable countries


The average length of stay has steadily decreased over time due to changes in medical guidelines and practices, improved technology, and shifts in hospital reimbursement and financial constraints. The U.S. and most comparable countries have seen hospitals visits shorten at a similar pace since 1994.

The average nightly hospital price is slightly higher in the U.S. than in Switzerland, and much higher than in Australia


Hospital spending represents 32% of total health spending in the U.S. Average prices for select health services in the U.S. (based on employer-based insurance claims and patient cost-sharing) and a few comparable countries are available from the International Federation of Health Plans. Although hospital stays are shorter on average in the U.S., the average price of a night in the hospital is far higher in the U.S. than in Australia, and slightly higher than in Switzerland.

The U.S. averages fewer angioplasty and more bypass surgeries than most comparable countries


The U.S. performs fewer angioplasty and slightly more coronary bypass surgeries on average relative to comparable OECD countries. Both procedures are used to treat heart disease, but bypass surgery is generally recommended for patients with more severe heart disease.

The average price of an angioplasty or bypass in the U.S. is higher than in comparable countries


The U.S. performs fewer angioplasties and more coronary bypass surgeries than comparable countries, but its average prices for both procedures are substantially higher than in comparable countries where data are available. According to the International Federation of Health Plans, the average price of an angioplasty in the U.S. is 183% higher than in Australia, which sees the next-highest price among those comparable countries with available data. The average price per coronary bypass surgery in the U.S is 129% more than Switzerland’s next-highest average.

The U.S. performs more caesarean sections than most comparably wealthy countries


The U.S. performs more caesarean sections than most comparable countries, although the rate of cesarean deliveries in the U.S. has declined slightly after increasing nearly 60% between 1996 and 2009 to peak of 32.9% of live births. Although caesarean section deliveries may be necessary in certain cases, they are often performed unnecessarily, are more expensive and often pose more risks for mother and child than a natural delivery.

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The average price of a caesarean section in the U.S. is higher than in comparable countries with available data


In 2014, the price of a normal delivery in the U.S. averaged $10,808, about 33% less than the average price of a caesarean section ($16,106). Compared to similar countries for which data are available, prices for both types of deliveries are much higher on average in the U.S.

The U.S. leads most comparable countries in MRI availability and use


The U.S. has more MRI units available per million population than most comparable countries have on average, and it performs more MRI examinations per 1,000 people than the comparable country average. This correlation is not necessarily found in other similarly wealthy countries. For example, France has a below-average number of MRI units available per million population but an above-average 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 of an MRI in the U.S. is significantly higher than in comparable countries


In 2014, the U.S. performed more MRI exams than most similarly wealthy countries at an average price of $1,119 per MRI. This was 42% more than the average price in the United Kingdom, 122% more than the average price in Switzerland, and 420% more than the average price in Australia. According to the International Federation of Health Plans, the national 95th percentile average price of an MRI in the U.S. is $3,031.

The average price of an appendectomy in the U.S. is at least double the average price in comparable countries


While fewer appendectomies are performed on average in the United Kingdom compared to the U.S., the price per surgery in the U.S. is $15,930 – nearly double the price in the United Kingdom. Meanwhile, in Australia and Switzerland, where far more appendectomies are performed on average than in comparable countries, the price of each surgery is even less, at only $3,814 in Australia and $6,040 in Switzerland.

The U.S. performs more knee replacements than comparably wealthy countries


Both the U.S. and similarly wealthy countries for which data are available have seen an increase in the number of total knee replacements performed since 2000, though the U.S. has consistently performed more of these surgeries. In 2014, the U.S. saw an average of 227 total knee replacements performed per 100,000 population, compared to the average of 180 per 100,000 in similarly wealthy countries.

The average price of a knee replacement in the U.S. is higher than in comparable countries with available data


The average price of a knee replacement in the U.S. was $28,184 in 2014, 40% more than the average price in Switzerland, 53% more than in the United Kingdom, and 77% more than in Australia.

The average price of a hip replacement in the U.S. is higher than in comparable countries with available data


The average price of a hip replacement in the U.S. is much more than the average price in those comparable countries for which data is available.

The average price of a colonoscopy is higher in the United Kingdom than in the U.S.


The average price of a colonoscopy in the United Kingdom is 135% more than the average price in the U.S.

The average price of Humira in the United States is about 96% higher than in the United Kingdom


Humira, prescribed to treat rheumatoid arthritis, is priced 96% higher in United States than in the United Kingdom and 225% higher than in Switzerland, according to data from the International Federation of Health Plans. For the U.S., these data reflect the average payments made, including insurance and patient cost-sharing, but does not reflect rebates.

The average price of Xarelto in the U.S. is more than double the price in the United Kingdom


Xarelto, a drug prescribed to prevent or treat blood clots, is priced more than twice as high in the United States, on average, than in the United Kingdom or Switzerland.

The average price of Harvoni in the U.S. is 42% higher than in the United Kingdom


Harvoni, a high-cost specialty drug prescribed to treat Hepatitis C, is priced 42% higher in the United States, on average, than in the United Kingdom and 90% higher than in Switzerland.

The average price of Truvada in the United States is 44% higher than in Switzerland


Truvada, prescribed to treat HIV/AIDS, is priced 44% higher in the United States, on average, than in Switzerland, and 89% higher than in the United Kingdom.

The average price of Tecfidera in the United States is 174% higher than in Switzerland


On average in the United States, Tecfidera (prescribed to treat relapsing multiple sclerosis) is priced 174% higher than in Switzerland, and 668% higher than in the United Kingdom.

The average price of Avastin in the United States is 124% higher than in Switzerland


Avastin, prescribed to treat some cancers, is priced 124% higher in Switzerland, on average, and 125% higher than in the United Kingdom. Unlike some other drugs included in the International Federation of Health Plans, the price range for Avastin is relatively large; the 25th percentile was $2,289 and the 95th percentile was $8,831 in 2014.

The Peterson Center on Healthcare and KFF are partnering to monitor how well the U.S. healthcare system is performing in terms of quality and cost.

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