U.S. Low on Hospital Beds, Physician Visits, High on Costs

In its annual tracking and reporting on more than 1,200 health system measures across 30 industrialized countries, the Organization for Economic Cooperation and Development (OECD), an international study group, found that the United States may be spending its healthcare dollars less efficiently when compared with those other nations.

In particular, the U.S. has a comparatively low number of hospital beds and physicians per capita, while American patients have fewer hospital and physician visits than most other countries. But on the flip side of the coin, spending per hospital visit is higher in the U.S.—with patients more likely to receive procedures requiring complex technology during their stay.

Despite these major investments, the U.S. has failed to achieve improvements in life expectancy comparable to its peer countries. This gap between the investment—and what is delivered in return—"suggests health services in the U.S. are less effectively deployed or come at a higher price," the authors say.

Here's a snapshot of the key findings from the researchers found in the report sponsored by The Commonwealth Fund:

Healthcare spending per capita in the U.S. in 2006 was $6,714—or more than twice the median per capita expenditure of the 30 OECD industrialized countries ($2,880), and 50% greater than Norway ($4,520), the second highest spending country.

Health care expenditures made up 15.3% of GDP in the U.S., while in the other OECD countries, it was generally less than 10% and did not exceed 11.3%.

Per capita spending in the U.S. on pharmaceuticals ($843) was higher than any of the other 30 countries, although pharmaceutical spending accounted for a lower share of total health expenditures in the U.S. (12.6%) than the OECD median (16.6%).

Physicians visits in the U.S. on a per capita basis generally were lower (4) than found in the 30 other industrialized countries (6.4). The rate in the U.S. was lower than all but four of the 25 countries that reported on this measure.

On a per capita basis, fewer practicing physicians were found in the U.S. (2.4 per 1,000 population) than most other OECD countries. The median there was 3.3 physicians.

Hospital stays in the U.S. were less frequent and shorter—but more expensive. The number of hospital discharges per 1,000 population in the U.S. (119) was in the bottom quartile among OECD countries—much lower than the OECD median of 162.

The U.S. had among the fewest acute care hospital beds per capita (2.7 per 1,000 population) among OECD countries (median was 3.4).

Spending per hospital discharge in the U.S was ($17,126), which was 2.5 times higher than the average of OECD median ($6,867) and almost 50 percent higher than the Netherlands, the second most expensive OECD country ($11,522).

Average life expectancy at birth in the U.S. was 77.8 years— placing it at the bottom quartile among the 30 OECD countries in 2006 (Exhibit 5). Ten countries had life expectancies at birth of over 80 years. The U.S. had the smallest increase in life expectancy among all OECD countries from 1986 to 2006—3.1 years, compared with the median of 4.7 years.

High tech medical procedures are performed at a high rate in the U.S. Sophisticated imaging technology was comparatively prevalent in the U.S., with 33.9 computed tomography (CT) scanners and 26.5 magnetic resonance imaging (MRI) units per million population, compared with 14.8 CT scanners and 7.7 MRI units in the OECD median. Only two countries (Australia and Belgium) had more CT scanners per capita than the U.S., and only one country (Japan) had more MRI units.