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OECD Factbook 2011-2012: Economic, Environmental and Social Statistics
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branch Health
branch Resources
    branch Health expenditure

In most OECD countries, spending on health is a large and growing share of both public and private expenditure. Health spending as a share of GDP varies widely across countries, reflecting market and social factors as well as the diverse financing and organisational structures of the health system in each country.

Definition

Total expenditure on health care measures the final consumption of health goods and services plus capital investment in health care infrastructure. It includes spending by both public and private sources (including households) on medical goods and services, on public health and prevention programmes, and on administration.

For a more comprehensive assessment of health spending, the health spending to GDP ratio should be considered together with per capita health spending. Countries having a relatively high health spending to GDP ratio might have relatively low health expenditure per capita, while the converse also holds. For example, Portugal and Sweden both spent a similar proportion of their GDP on health at around 10% of GDP; however, per capita spending (adjusted to USD PPP) was close to 50% higher in Sweden.

Comparability

OECD countries are at varying stages of reporting health expenditure data according to the definitions proposed in the OECD manual A System of Health Accounts (SHA). While the comparability of health expenditure data has improved recently, some limitations do remain, e.g. on the measurement of long-term care.

In the Netherlands, it is not possible to clearly distinguish the public and private share for the part of health expenditures related to investments. For Belgium, total expenditure excludes investments. In Luxembourg, health expenditure is for the insured population rather than the resident population.

Overview

Trends in the health spending to GDP ratio are the result of the combined effect of trends in GDP and health expenditure. Apart from Luxembourg, health spending grew more quickly than GDP since 2000 resulting in a higher share of GDP allocated to health. In 2009, OECD countries devoted 9.6% of their GDP to health spending, a sharp increase from 8.8% in 2008, following the recession that started in many countries in 2008 and became widespread in 2009. The rise in the health spending share of GDP was particularly marked in Ireland, where the percentage of GDP devoted to health increased from 7.7% in 2007 to 9.5% in 2009, and in the United Kingdom, where it rose from 8.4% in 2007 to 9.8% in 2009.

In 2009, there were large variations in how much OECD countries spent on health as a share of GDP. The United States spent 17.4% on health in 2009, 5 percentage points more than in the next two countries, the Netherlands and France (which allocated 12.0% and 11.8% of their GDP to health). Of the OECD countries, Korea and Mexico spent less than 7.0% of their GDP on health. The fast-growing economies of China and India spent on health 4.6% and 4.2% of their GDP respectively in 2009, while South Africa and Brazil allocated 8.5% and 9.0% of GDP to health. The share of public expenditure on health to GDP also varies among OECD countries from a high of 9.8% in Denmark to a low of 3.1% in Mexico.

Since 2000, after an initial period of growth in the health spending to GDP ratio, there was a period of relative stability until 2009. The subsequent reduction in GDP, due to the economic downturn, has led to rises in the health spending to GDP ratios. Previous recessions show that, in many countries, the health spending share of GDP has tended to go up strongly during periods of economic downturn, and then stabilise or go down only slightly during periods of economic growth.

 

Sources

Further information
Analytical publications
Statistical publications
Methodological publications
Online databases
Websites
Indicator in PDF Acrobat PDF page

Table
Public and private expenditure on health
    Table in Excel

Figure
Public and private expenditure on health Figure in Excel
Public and private expenditure on
health